摘要
目的:基于回顾性分析和数据挖掘,研究中医药治疗高危肺结节(pulmonary nodule,PN)的用药规律和特点,并得到相应的新药(方)组合,为临床诊疗提供参考.方法:检索中国知网等数据库中关于中医药治疗高危肺结节的文献,筛选后构建药(方)数据库,运用Excel 2010,SPSS Modeler 18.0,Origin 2018 和Cytoscape 3.9.1 软件对处方进行高频药物统计和关联规则、系统聚类、复杂网络分析.结果:共筛选出中医药治疗高危肺结节文献38 篇,得到63 首处方,涉及202 味中药,其中有20 味药出现频次≥10,频次排名前10 位分别为黄芪、陈皮、半夏、党参、白花蛇舌草、甘草、茯苓、薏苡仁、白术、莪术.对中药性味归经进行分析可知,四气以寒为主,五味以甘、苦和辛味居多,归经以肺经、脾经、肝经为最.关联规则分析得到10 个常用药对,系统聚类得到7 个新方组合,复杂网络分析结果与系统聚类基本一致.结论:中药治疗高危肺结节多以益气解毒、活血破瘀、化痰散结为主,尤其重视消瘤防癌专药的应用.数据挖掘得到的新药(方)组合,尤其是白花蛇舌草、半枝莲、莪术、浙贝母、桑白皮、炙甘草组合对临床用药有较好的参考价值.
Abstract
Objective:Based on retrospective analysis and data mining,this study investigates the medication patterns and characteristics of traditional Chinese medicine in the treatment of high-risk pulmonary nodules(PN).Methods:The literature was retrieved from databases on the treatment of high-risk pulmonary nodules with traditional Chinese medicine such as China National Knowledge Infrastructure(CNKI),after which a prescription database was screened and constructed.Using Excel 2010,SPSS Modeler 18.0,and Origin 2018,high-frequency drug statistics,association rules,and systematic clustering on prescriptions were conducted.Results:A total of 38 literature on the treatment of high-risk pulmonary nodules with traditional Chinese medicine were selected,and 63 prescriptions involving 202 traditional Chinese medicines were obtained.There are 20 medicines with a frequency of≥10,and the top 10 medicines with a frequency are Astragalus membranaceus,Chenpi,Pinellia ternata,Codonopsis pilosula,Hedyotis diffusa,Licorice,Poria cocos,Coix seed,Atractylodes macrocephala,and Curcuma zedoary.The one of four qi are mainly cold,while the five flavors are mainly sweet,bitter,and spicy.The meridians are most concentrated in the lungs,spleen,and liver.Association rule analysis resulted in 10 commonly used drug pairs.The system clustering resulted in 7 new combinations.Conclusion:Traditional Chinese medicine treatment for high-risk pulmonary nodules mainly focused on tonifying qi and detoxifying,promoting blood circulation and breaking blood stasis,and resolving phlegm and nodules.Special attention is paid to the application of anti-tumor and anti-cancer drugs.The new formulas obtained from data mining,especially the combination of Hedyotis diffusa,Scutellaria barbata,Zedoary turmeric,Fritillaria thunbergii,Sang Bai and roasted licorice,can provide good clinical reference.
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