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基于数据挖掘的某中医院重症医学科治疗脓毒症的中药组方规律分析

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目的 运用数据挖掘技术分析首都医科大学附属北京中医医院重症医学科治疗脓毒症的组方用药规律,为临床治疗提供参考.方法 通过医渡云平台数据库检索出于2007年7月1日至2022年7月31日在北京中医医院重症医学科入院的脓毒症患者的就诊信息,建立数据库,利用R语言进行药物频数统计,筛选出核心药物;通过Excel软件进行药物药味、药性、归经、功效的统计;通过R语言操作Apriori算法,进行关联规则分析,筛选出核心药物组合;通过SPSS 25.0软件进行聚类分析,筛选出有效类方群.结果 共纳入571例脓毒症患者,共903次就诊信息,累计药味总数346味,其中核心药物分别是人参、炙甘草、大黄、麸炒白术、茯苓、黄芪、当归等.处方药物性味以苦寒、甘温为主,归肝经、肺经、胃经,功效主要是清热、补虚、化瘀、祛痰浊.关联规则分析得出常用药物组合为人参—麦冬—五味子、黄芪—当归—金银花、制附子—人参—干姜、桂枝—麸炒白术—茯苓等,通过聚类分析将核心药物分为3个有效类方群.脓毒症不同感染部位的用药各有侧重,以扶正和祛邪药共举为特点.近15年的脓毒症治疗规律体现出人参等扶正药的使用更加突出.结论 北京中医医院重症医学科治疗脓毒症以扶助正气兼祛除热毒、痰浊、瘀血邪实为主,扶正与祛邪并用,可为中医临床参与救治脓毒症提供治疗思路和用药策略参考.
Analysis on the rule of TCM formulation in the treatment of sepsis in intensive care department of a hospital of Traditional Chinese Medicine based on data mining
Objective To analyze the rules of prescription and medication for sepsis in Intensive Care Unit of Beijing Hospital of Traditional Chinese Medicine Affiliated to Capital Medical University by data mining technology,so as to provide references for clinical treatment.Methods The medical information of sepsis patients admitted to the Intensive Care Unit of Beijing Hospital of Traditional Chinese Medicine from July 1,2007 to July 31,2022 was retrieved from Yidu Cloud platform database.The database was established,and the core drugs were screened out by drug frequency statistics using R language.Excel software was used to conduct the statistics of drug taste,property,meridian return and efficacy;Apriori algorithm was operated by R language,association rules were analyzed,and common drug combinations were screened out.SPSS 25.0 software was used for cluster analysis to screen out effective cluster groups.Results A total of 571 patients with sepsis were included,with a total of 903 visits,and a total of 346 drugs were accumulated.The core drugs were ginseng,processed licorice,rhubarb,fried at-ractylodes with bran,Poria cocos,Astragalus membranaceus,and angica sinensis.The prescription drug tastes were mainly bitter cold,warm,which mainly belonged to liver meridian,lung meridian,stomach meridian.The main effects were clearing heat,filling deficiency,removing blood stasis and removing phlegm turbidity.Association rule analysis showed that the common drug combinations were ginseng-Ophiopogon-Schisandrae,Astragalus membranaceus-Angelica sinensis-honeysuckle,aconite-ginseng-dried ginger,Cassia twig-fried atractylodes with bran-Poria coing,etc.The core drugs were divided into three effective groups by cluster analysis.The drugs used in different infection sites of sepsis had different emphasis,which are characterized by the combination of advocating healthy qi and removing pathogenic products.In the past 15 years,the law of sepsis treatment reflected that the use of ginseng and other advocating healthy qi drugs were more prominent.Conclusion The treatment of sepsis in the Intensive Care Unit of Beijing Hospital of Traditional Chinese Medicine mainly focused on advocating healthy qi and removing heat toxicity,phlegm turbidity and blood stasis.The treatment of strengthening healthy qi and e-liminating pathogenic factors were combined,which provided treatment ideas and medication strategies for the clinical participation of traditional Chinese medicine in the treatment of sepsis.

sepsisICU from Beijing hospital of traditional Chinese medicineTCMformula formation rulesdata mininginfection sites

魏一鸣、徐霄龙、胡雅慧、杨思雯、李珍萱、赵春霞、刘清泉

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100029 北京中医药大学临床医学院(北京中医医院)

首都医科大学附属北京中医医院重症医学科

北京市中医药研究所

中医感染性疾病基础研究北京市重点实验室

天津中医药大学中西医结合学院

首都医科大学中医药临床医学院

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脓毒症 北京中医医院重症医学科 中药 组方规律 数据挖掘 感染部位

2024

环球中医药
中华国际医学交流基金会

环球中医药

CSTPCD
影响因子:1.553
ISSN:1674-1749
年,卷(期):2024.17(2)
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