摘要
目的:基于R语言初步探讨儿童抽动障碍(TD)合并注意缺陷多动障碍(ADHD)的证型证素及中医用药规律.方法:计算机检索 CNKI、万方、维普、CBM、PubMed、the Cochrane Library、EMBase、Web of Science 等数据中建库至 2023年11月10日收录的所有中医药治疗TD合并ADHD的文献,采用Excel软件筛选文献,对证型证素及中药规范化整理后,建立数据库,运用R语言及RStudio软件进行相应的数据挖掘,包括关联分析和聚类分析,探索儿童TD 合并ADHD证型证素分布及中药分布规律.结果:最终纳入23篇文献.共得到20个证型,频次最高的证型为风痰内扰证,共提取证素16个,主要病位证素是肝、肾、脾、心,主要病性证素是阳亢、阴虚、动风、外风、痰,关联分析后得到支持度和置信度最高的组合是外风-动风.聚类分析后可得到5个聚类组:(1)痰、动风、外风;(2)肝、阳亢、肾、阴虚;(3)脾、气虚;(4)心、火/热、津亏;(5)胃、血虚、气滞、精亏.共纳入中药98味,其中14味频次≥10,排名前5为白芍、龙骨、钩藤、远志、天麻;分为18类,主要为补虚药、解表药、清热药、安神药、息风止痉药;主归肝、心、肺、脾、肾经;关联规则与聚类分析形成以白芍、熟地黄、天麻、钩藤、石决明、全蝎、珍珠母、龙骨、远志9味药为基础的核心药物组方.结论:儿童TD合并ADHD病位在肝、肾、脾、心,常见病性证素为阴虚、阳亢、动风、外风、痰,以养血滋阴、平肝息风、清热安神为主要治则,核心组方为白芍、熟地黄、天麻、钩藤、石决明、全蝎、珍珠母、龙骨、远志,需根据辨证灵活加减组方.
Abstract
Objective:Based on the R language,to explore the traditional Chinese medicine syndrome types and elements and medication rules of tic disorder(TD)complicated with attention deficit hyperactivity disorder(ADHD)in children.Methods:CNKI,Wanfang,VIP,CBM,PubMed,the Cochrane Library,EMBase,and Web of Science were retrieved to collect literature related to traditional Chinese medicine in the treatment of TD complicated with ADHD from the establishment of the database to Nov.10th,2023.Literature were screened by Excel software,and the databases were established after the syndrome types and elements and traditional Chinese medicine were standardized.By using R language and RStudio software,the corresponding data mining,including association analysis and cluster analysis,was carried out to explore the distribution of syndrome types and elements and traditional Chinese medicine of TD complicated with ADHD in children.Results:Totally 23 articles were finally included.And 20 syndrome types were obtained,the most frequent syndrome type was Fengtanneirao syndrome,and 16 syndrome elements were extracted.The main syndrome elements of location of the disease were liver,kidney,spleen and heart,and the main syndrome elements of characteristics of the disease were Yangkang,Yinxu,Dongfeng,Waifeng and Tan.After correlation analysis,the combination with the highest support and confidence was Waifeng-Dongfeng.After cluster analysis,five cluster groups were obtained:(1)Tan,Dongfeng,and Waifeng;(2)liver,Yangkang,kidney,and Yinxu;(3)spleen and Qixu;(4)heart,Huo/Re,and Jinkui;(5)stomach,Xuexu,Qizhi,and Jingkui.A total of 98 kinds of traditional Chinese medicine were enrolled,including 14 kinds of traditional Chinese medicine with frequency ≥ 10,and the top 5 in frequency were Baishao,Longgu,Gouteng,Yuanzhi and Tianma.The traditional Chinese medicines were divided into 18 categories,mainly for deficiency-tonifying drugs,rxterior-releasing drugs,heat-clearing drugs,mind-easing drugs,and Xifeng Zhijing drugs,mainly acted on the liver,heart,lung,spleen and kidney.Association analysis and cluster analysis formed a core drug formula based on 9 drugs:Baishao,Shudihuang,Tianma,Gouteng,Shijueming,Quanxie,Zhenzhumu,Longgu and Yuanzhi.Conclusion:The main syndrome elements of location of TD complicated with ADHD in children were liver,kidney,spleen and heart.Yangkang,Yinxu,Dongfeng,Waifeng and Tan are common syndromes.The main therapeutic principles are Yangxue Ziyin,Pinggan Xifeng and Qingre Anshen.The core formulas are Baishao,Shudihuang,Tianma,Gouteng,Shijueming,Quanxie,Zhenzhumu,Longgu and Yuanzhi,which need to be flexibly added or subtracted according to different syndromes in clinic.
国家科技期刊平台
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万方数据