《张聿青医案》辨治脾胃病用药规律数据挖掘研究

Data Mining Study on the Rule of Medication Used to Discriminate Spleen and Stomach Diseases of The Medical Cases of Zhang Yuqing

摘要: 目的：运用数据挖掘技术探讨《张聿青医案》辨治脾胃病的处方用药规律及组方配伍特点。方法：收集《张聿青医案》中治疗脾胃病的医案，应用Microsoft Excel 2010软件对医案处方进行药物频次、性味归经、功效分类统计分析，应用SPSS Modeler18.0和Cytoscape3.9.1软件对核心药物进行探索及共现关系分析。使用RStudio4.4.1软件Apriori算法进行关联规则分析，使用RStudio4.4.1软件对核心药物进行聚类分析，使用SPSS Statistics25软件对核心药物进行因子分析。结果：共纳入206首处方，涉及217味中药，累计频次为2033次。所用药物中，茯苓、陈皮、半夏频次最高；药性以温性最多，药味以辛、苦、甘味使用最频繁，归经以脾、胃、肺、肝经最多，药物功效以理气药、补虚药、利水渗湿药、化痰止咳平喘药使用最多。共得到26味核心中药，核心药物共现次数前3位分别为陈皮–茯苓、半夏–茯苓、半夏–陈皮。关联规则分析得到置信度≥60%、支持度≥10%的关联规则30条，按提升度大小前3位分别为香附→砂仁、当归→白芍、陈皮–竹茹→半夏。聚类分析共分为11类，公因子分析共生成8个公因子。结论：张聿青辨治脾胃病在博采诸家之长基础上，认为痰饮是诱发脾胃病的重要病理因素，对此常使用角药“茯苓–陈皮–半夏”加减治疗；注重调和肝脾；且善用“辛开苦降”法以调节中焦气机升降。

Abstract: Objective: Using data mining techniques to explore the prescription medication patterns and the characteristics of formula composition and compatibility in the treatment of spleen and stomach diseases by the renowned late The Medical Cases of Zhang Yuqing. Methods: Collect medical cases of spleen and stomach diseases treated from “The Medical Cases of Zhang Yuqing”. The software Microsoft Excel2010 was used to conduct statistical analysis of drug frequency, sex and taste normalization, and efficacy classification of medical records prescriptions. The software SPSS Modeler18.0 and Cytoscape3.9.1 software used to explore core drugs and analyze their co-occurrence relationship. RStudio4.4.1 software Apriori algorithm was used for association rule analysis, RStudio4.4.1 software was used for cluster analysis of core drugs, SPSSStatistics25 software was used for factor analysis of core drugs. Results: A total of 206 prescriptions were included, involving 217 traditional Chinese medicines, with a cumulative frequency of 2033. Among the drugs used, Tuckahoe, orange peel and pinellia were the most frequent. The most common medicinal property was warmth; the most frequently used flavors were pungent, bitter, and sweet; the meridians most associated were the spleen, stomach, lung, and liver channels; the most used medicinal effects were qi-regulating herbs, tonifying herbs, diuretic and dampness-dispelling herbs, and phlegm-resolving, cough-relieving, and asthma-alleviating herbs. A total of 26 core Chinese medicines were obtained, and the top 3 cooccurrences of core medicines were tangerine peel - Poria cocos, pinellia - Poria cocos and pinellia peel. Association rules were analyzed and 30 association rules with confidence ≥60% and support ≥10% were obtained. The top 3 association rules according to the degree of improvement were: Pandan → Amomum kernel, Angelica sinensis → white peony, orange peel - bamboo Ru → Pinellia. Cluster analysis is divided into 11 categories, and common factor analysis generates 8 common factors. Conclusion: Zhang Yuqing, on the basis of collecting the knowledge of various families, thought that phlegm was an important pathological factor inducing spleen and stomach diseases, and he often used the Angle medicine “poria tuckae - orange peel - pinellia” to treat it. Pay attention to harmonizing liver and spleen; And make good use of “Xin open bitter drop” method to adjust the rise and fall of the middle jiao Qi machine.