基于关联规则和复杂系统熵聚类研究历代原发性肝癌方剂遣药组方规律

Analysis on the Principles of Primary Liver Cancer Prescriptions Based on Association Rules and Entropy Clustering of Complex Systems

摘要: 目的：我国是肝癌大国，自秦汉起就有对其症状的描述和用药的记载。本研究基于历代医案，揭示自秦汉至现代治疗原发性肝癌内服方剂的遣药组方规律。方法：收集《中医方剂大辞典》自秦汉至现代治疗原发性肝癌相关的方剂727首，涉略医书235本，运用中医传承辅助系统(V2.5)中关联规则和复杂系统熵聚类分析历代肝癌用药遣药组方规律；通过大数据挖掘和比对，发现治疗原发性肝癌的新处方。结果：历代肝癌用药频次前30味中药以甘草、陈皮、茯苓、当归、木香为主，158个常用药对以陈皮–甘草、黄芩–甘草、陈皮–茯苓和甘草–柴胡为主，36个核心组合以三棱–莪术–青皮为主，以及以柴胡类方为主的8个演化新方。结论：历代肝癌用药体现了原发性肝癌多以脏腑气血亏虚为主，夹杂湿、热、痰、瘀等实证的病机特点，用方侧重于柴胡类方，旨在条达肝气、和解少阳、疏利三焦，为现代临床治疗肝癌用药思想及新药研发提供了一定的理论依据，以期指导临床遣药组方并推进中医肝癌的精准治疗。

Abstract: Objective: Primary liver cancer (PLC) is an aggressive malignancy with increasing mortality in China. The description of PLC symptoms and treatment has been recorded from the Qin-Han Dy-nasty. The aim of present study is to reveal the principles of the PLC internal prescriptions from Qin-Han Dynasty to nowadays according to the medicinal records. Method: 727 prescriptions of the PLC treatment from Qin-Han Dynasty to nowadays were collected in the Dictionary of Chinese Medicine Prescription (DCMP), containing 235 medical books. The methods of Association Rules and Entropy Clustering of Complex Systems and data mining from TCM Inheritance Support System (V2.5) approached to analyze the prescription principles of PLC and to identify new prescriptions for the PLC treatment, respectively. Results: The top 30 herbs used in the PLC treatment frequency were mainly related to Gan Cao, Chen Pi, Fu Ling, Dang Gui, Mu Xiang, etc. 158 commonly used herb pairs were mainly associated with Chen Pi-Gan Cao, Huang Qin-Gan Cao, Chen Pi-Fu Ling, and Gan Cao-Chai Hu, etc. The core of 36 combinations is San Leng-E Zhu-Qing Pi. 8 evolved new prescriptions look like a party of Chai Hu Decoction. Conclusion: The medications of PLC treatment in the past days reflected the pathogenic characteristics of PLC, which is response to the deficiency of qi and blood, interspersed with actual symptoms such as dampness, heat, phlegm, and stasis. The prescriptions focused on Chai Hu decoction, which aims to promote liver qi, reconcile Shao Yang and regulate Sanjiao. It provides the theoretical evidence for how to correctly use TCM and new prescriptions development for the PLC treatment, leading to guide clinical prescriptions and promote the progress of precision treatment of PLC in TCM.