摘要
目的 通过数据挖掘探索以含砷中药复方为基础治疗骨髓增生异常综合征(MDS)的中医证型及用药规律.方法 通过医院信息系统筛选纳入2014年4月2日-2021年10月31日就诊于中国中医科学院西苑医院血液科门诊的MDS患者数据,规范药名与诊断,建立标准化数据库.应用古今医案云平台2.3.5对患者基本信息、中医证型、中药处方进行统计及关联规则分析、聚类分析、复杂网络分析,并结合Cytoscape3.8.0对数据进行可视化.结果 最终纳入患者457例,其中脾肾两虚、毒瘀阻滞证413例,气阴两虚、毒瘀阻滞证44例.中药处方819首,涉及中药346味,药物应用频次较高的有雄黄、青黛、茯苓、麸炒白术、熟地黄等,其药味以甘、辛、苦味为主,药性多为平、温、寒性,归经多属肾经、肝经、脾经.关联规则分析得到药对51对,其中提升度最高的为菟丝子-补骨脂.证型与中药分析得到9组结果,提升度最高的为气阴两虚证→茯苓.聚类分析得到青黄散、四君子汤、六味地黄汤等6组不同方剂的类方.复杂网络分析共涉及22味中药,节点度最高为青黛、雄黄.结论 MDS中医证型以脾肾两虚、毒瘀阻滞证为主.由含砷中药雄黄与青黛组成的青黄散,临床多与补脾益肾为主的中药汤剂合用,扶助正气兼清热解毒、活血化瘀.
Abstract
Objective To explore the TCM symptom types and medication law for the treatment of myelodysplastic syndrome based on arsenic-containing TCM compounds through data mining.Methods The information data of patients with myelodysplastic syndrome who visited the Hematology Clinic of Xiyuan Hospital of China Academy of Chinese Medical Sciences from April 2,2014 to October 31,2021 were screened by the HIS system,and a standardized database was established to standardize drug names and diagnoses.The Ancient and Modern Medical Case Cloud Platform 2.3.5 was used to perform statistics,association rules,clustering analysis and complex network analysis of basic patient information,TCM syndrome types,and TCM prescriptions.The data were visualized in combination with Cytoscape 3.8.0.Results A total of 457 patients were enrolled,including 413 cases of spleen and kidney deficiency and toxin stasis stagnation,and 44 cases of qi-yin deficiency and toxin stasis stagnation.A total of 819 TCM prescriptions were included,involving 346 kinds of Chinese materia medica,and the drug application frequency was relatively high,such as Realgar,Indigo Naturalis,Poria,fried Atractyodis Macrocephalae Rhizoma and Rehmannize Radix et Praeparata,etc.The main tastes were sweet,pungent and bitter,and the main properties were mild,warm and cold,and the main meridians were kidney,liver and spleen meridians.In the analysis of association rules,51 medicinal pairs were obtained from the Chinese materia medica and analysis,among which the highest degree of improvement was Cuscutae Semen-Psoraleae Fructus.The analysis of syndrome types and Chinese materia medica obtained 9 sets of results,and the highest improvement was qi-yin deficiency syndrome →Poria.Clustering analysis yielded 6 groups of prescriptions with different formulas,such as Qinghuang Powder,Sijunzi Decoction,and Liuwei Dihuang Decoction.A total of 22 kinds of Chinese materia medica were involved in the complex network,and the highest node degree was Indigo Naturalis and Realgar.Conclusion The TCM syndrome types of myelodysplastic syndrome is mainly characterized by spleen and kidney deficiency and toxin stasis stagnation.Qinghuang Powder,composed of Realgar and Indigo Naturalis,is clinically combined with TCM decoction mainly to replenish the spleen and benefit the kidney,and uses arsenic-containing TCM compounds form to support healthy qi while clearing heat and detoxification,activating blood circulation and removing stasis.
基金项目
国家自然科学基金面上项目(82074258)
国家自然科学基金面上项目(82274502)
第二批北京市研究型病房示范建设项目(BCRW202108)
中国中医科学院科技创新工程重大攻关项目(CI2021A01701)
国家科技期刊平台
NSTL
万方数据