摘要
目的:基于医院电子病例库分析总结真实世界的数据,采用数据挖掘的方法探讨中医药治疗肝硬化食管胃静脉曲张破裂出血(esophagogastric variceal bleeding,EGVB)的用药规律.方法:收集2018年7月-2023年6月上海中医药大学附属曙光医院电子病例库确诊EGVB患者的诊疗信息,建立Excel数据库.运用Mi-crosoft Excel 2019软件对患者的基本信息、高频药物的四气、五味、归经、功效进行频数频率统计;通过SPSS Modeler 18.0软件构建药物关联网状图和关联规则分析表;借助SPSS 29.0软件进行聚类分析和因子分析.结果:最终纳入240例接受中药饮片治疗的EGVB患者,在612条处方信息中,涉及中药431种;使用频数排名前5位的中药分别是黄芪、茯苓、白术、当归、甘草;使用频数前5类的中药类别分别是补虚药、利水渗湿药、清热药、活血化瘀药、止血药;在30味高频药物中,以甘、苦药味最为常见;寒性药使用最多;归经以肝经、脾经、肺经、心经、胃经为主;关联规则分析结果显示,治疗EGVB的药物组合中主要为黄芪、泽泻、茯苓、黄芩等与其他药物的组合;因子分析共得到9个公因子;聚类分析得到7个处方.结论:中医药治疗EGVB的主要治疗原则为补益虚损、清热泻火、化痰祛瘀、利水渗湿.
Abstract
Objective:Analysing and summarising real-world data based on the hospital's electronic medical re-cords(EMR)and using data mining methods to explore the medication patterns of Traditional Chinese Medicine(TCM)in the treatment of esophagogastric variceal bleeding(EGVB).Methods:The diagnosis and treatment in-formation of EGVB of EMR in Shuguang Hospital affiliated to Shanghai University of Traditional Chinese Medi-cine from July 2018 to June 2023 was collected,and an Excel database was established.Perform statistics on pa-tient's basic information,Siqi,Wuwei,Meridian and efficacy;use Apriori algorithm in SPSS Modeler 18.0 soft-ware to analyze association rules,and use web nodes to construct a drug-pair association network diagram;use SPSS 29.0 statistical software to perform cluster analysis and factor analysis.Results:This study finally included 240 patients with EGVB who were treated with decoction pieces of TCM.Among the 612 prescriptions informa-tion,431 types of Chinese herbal medicines were involved;the top 5 Chinese herbal medicines used in frequency were Astragalus,Poria,White art,Angelica,Licorice;the top 5 categories of Chinese herbal medicines in terms of frequency of use were deficiency tonic,diuretic and dampness-inducing medicines,heat-clearing medicines,medicines for activating blood circulation and removing blood stasis,and medicines for stopping bleeding;among the 30 high-frequency drugs,bitter and sweet are the most common;the drugs are cold in nature.The number of liver meridians,spleen meridians,lung meridians,heart meridians and stomach meridians are mostly;factor anal-ysis yielded a total of 7 effective factors;cluster analysis yielded a total of 9 effective prescription.Conclusion:TCM treatments of EGVB are tonifying deficiency loss,clearing heat and expelling fire,eliminating phlegm and removing blood stasis,and promoting water and dampness.
基金项目
国家自然科学基金面上项目(81874390)
上海市科委自然科学研究面上项目(21ZR1464100)
上海市科委"科技创新行动计划"生物医药科技支撑专项(2022)(22S11901700)
上海市临床重点专科建设项目(shslczdzk01201)
维普
万方数据