基于数据挖掘探讨李兰主任治疗肿瘤疾病用药经验

Exploring Director Li Lan’s Medication Experience in Tumor Treatment Based on Data Mining

摘要: 目的：通过数据挖掘总结李兰教授治疗肿瘤疾病经验，为中医药治疗肿瘤疾病提供新思路，以资参考。方法：收集2020年1月~2023年12月李兰主任门诊所有肿瘤处方86首，运用Excel、SPSS Modeler 18.0、SPSS Statistics 26.0对其进行功效、性味归经、频数分析统计、关联规则分析及聚类分析。结果：① 药物频次：共纳入的86首处方中包含单味中药121味，总频次达1016次，用药频次 ≥ 10次的中药有28味，频率较高的有鳖甲、莪术、冬凌草、茯苓、苍术、厚朴等；② 性味归经及功效：五味多为辛、甘、苦，药性为寒、温居多，归肝、肺、胃、脾、心经；③ 关联规则：经关联规则分析可得核心药对为鳖甲–莪术、苍术–厚朴、莪术–川芎等；④ 聚类分析：聚类分析得出核心处方主要为莪术鳖甲煎类方、藿朴夏苓汤类方等。结论：李兰教授治疗肿瘤疾病主要从“痰瘀”论治，其病机为本虚标实，虚者责之于正气亏损、气血阴阳之不足，实者为血瘀、痰浊、气滞、毒结等，“气郁”贯穿全过程，治以软坚散结、蠲化痰浊、扶本培源，阴阳平调、标本兼顾，兼顾脾胃，使气血生化有源，兼以解郁行气、宁心安神、疏肝和胃等，据个体不同而综合施策。

Abstract: Objective: To summarize Professor Li Lan’s experience in treating tumor diseases through data mining, providing new insights for traditional Chinese medicine (TCM) in oncology treatment as a reference. Methods: A total of 86 tumor prescriptions from Director Li Lan’s outpatient clinic between January 2020 and December 2023 were collected. Excel, SPSS Modeler 18.0, and SPSS Statistics 26.0 were used for efficacy analysis, properties and meridian tropism classification, frequency analysis, association rule analysis, and cluster analysis. Results: ① Drug frequency: Among the 86 prescriptions, 121 individual Chinese medicinal herbs were included, with a total usage frequency of 1016 times. A total of 28 herbs were used more than 10 times, with the most frequently used ones being Turtle shell (Biejia), Zedoary rhizome (Ezhu), Scutellaria barbata (Donglingcao), Poria (Fuling), Atractylodes (Cangzhu), and Magnolia Bark (Houpo). ② Properties, meridian tropism, and efficacy: The five flavors were mostly pungent, sweet, and bitter; the nature of the herbs was predominantly cold and warm, mainly entering the liver, lung, stomach, spleen, and heart meridians. ③ Association rules: Analysis identified core herb pairs such as Turtle Shell-Zedoary rhizome, Atractylodes-Magnolia Bark, and Zedoary rhizome-Szechuan Lovage Root (Chuanxiong). ④ Cluster analysis: The core prescription patterns identified through cluster analysis included modified Ezhu-Biejia Decoction and Huopo-Xialing Decoction, among others. Conclusion: Professor Li Lan’s approach to tumor treatment is primarily based on the TCM theory of “phlegm and blood stasis” as the root causes. The disease mechanism is characterized by underlying deficiency and superficial excess: deficiency is attributed to the depletion of vital qi and insufficiency of qi, blood, yin, and yang, while excess is associated with blood stasis, phlegm accumulation, qi stagnation, and toxin retention. “Qi stagnation” runs throughout the disease process. The treatment principles involve softening and resolving hard masses, eliminating phlegm and turbidity, supporting the fundamental vitality, balancing yin and yang, and addressing both root and symptoms. Additionally, spleen and stomach function is considered to ensure the generation of qi and blood, supplemented by therapies for soothing the liver, regulating qi, calming the mind, and harmonizing the stomach, with individualized treatment strategies.