基于数据挖掘的名老中医应用二陈汤规律分析

目的:探索名老中医应用二陈汤及与其他方药配伍的规律和特点。方法:对341例以二陈汤为主方的名老中医医案进行数据挖掘,先用频数分析统计出频次10的高频症状、药物及证型,再分别对高频症状、药物进行因子和聚类分析,最后分别对高频药物(剔除二陈汤药组后)间关联分析,再与高频症状(剔除二陈汤主治症状后)进行关联规则分析,找出有意义的因子组、聚类组,支持度、置信度符合定义的二阶、三阶、四阶、五阶关联结果。结果:得到有意义的因子组、聚类组分别为9组和8组,据定义的最小支持度、置信度,去主方药物后剩余高频药物间二联10组,三联20组,四联3组;去主方主治症状和主药后剩余高频症状、药物三联16组,四联8组,五联8组。结论:二陈汤主治证型为痰浊阻肺、脾虚湿困;主治症状有肺系(咳、喘、痰),脾胃系(腹胀、纳呆、便溏),心系(胸闷、心悸、头晕、失眠),全身症状(发热、恶寒、身痛),舌脉(舌淡、苔白腻,脉滑弦);常用药有橘红、半夏、茯苓、甘草;常配伍药有莱菔子、紫苏子、白芥子、桔梗、苦杏仁等化痰止咳平喘药,枳实等行气药,白术、山药等补气健脾药,干姜、细辛、麻黄等性温药;常配伍方有三子养亲汤、六君子汤、麻杏石甘汤等;二陈汤为治痰基础方,可化裁为导痰汤、半夏茯苓汤、温中化痰丸等。

Regularity of Famous Traditional Chinese Medicine Doctors in Using Erchentang Based on Data Mining

Objective: To explore the regularity and characteristics of famous traditional Chinese medicine(TCM) doctors in using Erchentang. Method: Data mining was performed for 341 cases of famous TCM doctors, with Erchentang as the main formula. First, frequency analysis showed symptoms, drugs and syndromes with the frequency of more than 10. Second, factor and cluster analysis was made for frequently used symptoms and drugs. Finally, correlation analysis for frequently used drugs (deducting Erchentang group) and association rule analysis for frequent symptoms (deducting target symptoms of Erchentang) showed meaningful factor group, cluster group, and support and confidence-defined second-order, third-order, fourth-order, five-order correlation results. Result: Meaningful factor group and cluster group were group 9 and group 8, respectively. According to the minimum defined support and confidence, deducting the main formula, there were 10 dual combinations of frequently used drugs, 20 triple combinations and three quadruple combinations. There were 16 triple combinations of drugs for frequent symptoms deducting target symptoms of the main formula and main drugs, eight quadruple combinations and eight quintuple combinations. Conclusion: Erchentang''s target symptom types are obstruction of lung by phlegm, dampness stagnancy due to spleen deficiency. Target symptoms are correlated to lung (cough, asthma, sputum), spleen and stomach (abdominal distension, anorexia, loose stools), heart (chest tightness, palpitation, dizziness, insomnia), systemic symptoms (fever, bad cold, body aches), tongue and pulse (pale tongue with whitish and greasy coating, slippery pulse). Commonly used herbs are Cttriexocarpium Rubrum, Pinelliae Rhizoma, Poria, Glycyrrhizae Radix et Rhizoma. Commonly combined drugs herbs include Raphani Semen, Perillae Fructs,Sinapis Semen, Platycodonis Radix, Armeniacae Semen Amarum, and other expectorant, cough suppressant and anti-asthmatic drug, Aurantii Fructus Immaturus and other Qi-activating drugs, Atractylodis Macrocephalae Rhizoma, Dioscoreae Rhizoma and other Qi-invigorating and spleen-tonifying drugs, Zingiberis Rhizoma, Asari Radix et Rhizoma, Ephedrae Herba and other warm-natured drugs. Frequently combined formulas include Sanzi Yangqintang, Liujunzi Tang, Maxing Shigan Tang. Erchentang is a basic phlegm-removing formula, and can be modified into Daotantang, Banxia Fuling Tang and Wenzhong Huatanwan.