首页|探讨师伟教授治疗子宫腺肌病的用药规律信息学研究

探讨师伟教授治疗子宫腺肌病的用药规律信息学研究

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目的:基于数据挖掘探讨师伟教授治疗子宫腺肌病(Adenmyosis,AM)的用药规律。方法:收集2020年5月1日-2023年5月31日就诊于山东中医药大学附属医院师伟教授专家门诊的子宫腺肌病患者病案信息,用Excel软件建立处方数据库,采用SPSS Modeler18。0、SPSS Statistics 25。0软件对中药处方中的药物分别进行药物的复杂网络分析、二项、三项关联分析、系统聚类。结果:纳入254例子宫腺肌病患者临床病案处方信息,收集有效处方768首,涉及药物174味,用药总频次15 827次。统计分析得出,师伟教授在治疗子宫腺肌病的组方中使用频次最多的药物是甘草、黄芪、赤芍、茯苓、皂角刺、重楼、桂枝、桃仁、没药、牡丹皮;"四气"使用频次较多的是寒、温、平性,"五味"使用频次最多的是甘、苦、辛味,"归经"使用频次最多的是肝经、心经、脾经,中药功效使用频次最多的是补虚药、活血化瘀药。复杂网络核心处方主要由桂枝茯苓丸合黄芪建中汤合没竭散化裁组成,高频药物系统聚类分析得到5个药物聚类组合。结论:师伟教授认为AM病机是阳虚血瘀为本,病位在冲任、胞宫,变化在气血,表现为痛证与血证。在治疗AM时,师伟教授遵循"衰其大半而止"的原则,治法重在平心、调肝、健脾,燮理冲任气血,恢复脏腑功能;用药寒温平调,攻邪不忘扶正,以益气活血、祛瘀消癥为主;临证遣方擅于化裁经典方剂,方简效宏。治疗时谨守病机,审证求因,分期施治。
Medication Laws of Professor Shi Wei in Treating Adenomyosis Based on Data Mining
Objective:To explore the medication Laws of Professor Shi Wei in treating adenomyosis(AM)based on data mining.Methods:The medical records of AM patients who received treatment in Professor Shi Wei's specialist clinic in the Affiliated Hospital of Shandong Universi-ty of Traditional Chinese Medicine from May 1,2020 to May 31,2023 were collected.A prescription library was established in Excel,and SPSS Modeler 18.0 and SPSS Statistics 25.0 were used for complex network analysis,bivariate and trivariate association analyses,and systematic clustering on the drugs in the prescriptions.Results:The clinical records of 254 AM patients were included,from which 768 valid prescriptions were collected.The prescriptions involved 174 Chinese medicines,with a total frequency of 15 827.The most commonly used Chinese medicines used by Professor Shi Wei for treating AM were Gancao(甘草),Huangqi(黄芪),Chishao(赤芍),Fuling(茯苓),Zao-jiaoci(皂角刺),Chonglou(重楼),Guizhi(桂枝),Taoren(桃仁),Moyao(没药),and Mudanpi(牡丹皮).In terms of medicinal prop-erties,cold,warm,and plain Chinese medicines were commonly used with high frequency.In terms of medicinal tastes,the Chinese medicines with sweet,bitter,and pungent tastes had high frequency.In terms of meridian tropism,the Chinese medicines with tropism to the liver,heart,and spleen meridians had high frequency.Regarding the medicinal functions,the Chinese medicines with the functions of Buxu(补虚)and Huoxuehuayu(活血化瘀)were commonly used.The complex network analysis showed that the core prescription was modified from Guizhi-fuling(桂枝茯苓)Pills combined with Huangqijianzhong(黄芪建中)Decoction and Mojie(没竭)Powder.The systematic clustering of high-frequency Chinese medicines yielded five medicine combinations.Conclusion:Professor Shi Wei believes that AM is rooted in Yangx-uxueyu(阳虚血瘀)and located in Chongren(冲任)and Baogong(胞宫).The disease evolves as the Qi(气)and blood change and pres-ents as pain syndrome and blood syndrome.In treating AM,Professor Shi Wei follows the principle that when half of the disease is reduced,the use of drugs should be stopped,and chooses the methods of Pingxin(平心),Tiaogan(调肝),and Jianpi(健脾).He emphasizes the balance of Chongren(冲任)and Qixue(气血)and the restoration of organ functions.The medication used is aimed at balancing the cold,warm,and plain properties,which treats the Xie(邪)while Fuzheng(扶正),with focuses on Yiqihuoxue(益气活血)and Quyuxiaozheng(祛瘀消癥).In clinical practice,Professor Shi Wei is skilled at modifying classical prescriptions according to different cases,advocating simple and effective treatment.Moreover,he carefully examines the syndromes and implements treatment in stages according to the pathogene-sis.

Data miningAdenomyosisMedication lawsProfessor Shi Wei

刘洋、师伟

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山东中医药大学第一临床医学院,济南 250014

山东中医药大学附属医院妇科,济南 250014

数据挖掘 子宫腺肌病 用药规律 师伟教授

2024

中药药理与临床
中国药理学会 四川省中医药科学院

中药药理与临床

北大核心
影响因子:0.996
ISSN:1001-859X
年,卷(期):2024.40(8)