基于因子分析及关联法则挖掘中医药治疗冠心病心绞痛合并焦虑抑郁用药规律

目的探讨中医药治疗冠心病心绞痛合并焦虑抑郁的用药规律。方法检索中国知网、万方数据库、维普数据库从建库至2021年1月31日期间中医药治疗冠心病心绞痛合并焦虑和/或抑郁的文献,对符合纳入标准的文献进行方剂和药物信息提取,建立Excel方剂数据库,进行药物频数、高频药物功效、药性、药味、归经统计,应用SPSS Statistics 25统计学软件对高频药物进行聚类分析和因子分析,应用SPSS Modeler 18统计学软件对所有药物进行关联规则分析。结果数据库共检索出791篇文献,筛选后纳入79篇,涉及方剂83首,中药107味,药物总频数845次。频数≥10次的药物有26味,前5味为柴胡、甘草、白芍、丹参和川芎;功效分为补虚药、活血化瘀药和安神药等12类;药性有苦、辛、甘等7类;药味以温、寒、平为主;多归于肝、心、脾经。聚类分析将药物聚成6类,核心药物有龙骨、牡蛎、黄芩、桂枝、大枣、党参、半夏。因子分析可提取药组3个、药对2个、单味中药3个。所有药物关联规则可得到33个药对或药组,其中柴胡和白芍药对的支持度最高。结论中医药治疗冠心病心绞痛合并焦虑抑郁以补虚药、活血化瘀药和安神药为主,苦、辛合用,寒、温并调,以肝、心、脾经为主,临床可从疏肝理气、活血化瘀、益气活血、养心安神等思路遣方用药,达到祛瘀调神治双心的目的。

Medication Rule of TCM in the Treatment of Angina Pectoris Coexisting Psychological Disorder Based on Data Mining

Objective To explore the rules of traditional Chinese medicine for the treatment of angina pectoris with anxiety and/or depression.Methods The CNKI,Wanfang database,and VIP database were searched from the establishment of the database to January 31,2021 for Chinese medicine treatment of coronary heart disease angina pectoris complicated with anxiety and/or depression literature,and the prescription and drug information were extracted from the literature that met the inclusion criteria.Establish an Excel prescription database to conduct statistics on drug frequency,high-frequency drug efficacy,drug properties,drug flavor,and meridian return,and apply SPSS Statistics 25 statistical software to perform cluster analysis and factor analysis on high-frequency drugs.Drugs were analyzed by association rules.Results A total of 791 articles were retrieved from the database,and 79 articles were included after screening,involving 83 prescriptions,107 traditional Chinese medicines,and a total frequency of 845 medicines.There are 26 kinds of drugs with frequency≥10 times,the top 5 are Bupleurum,Licorice,Baishao,Danshen and Chuanxiong;the efficacy is divided into 12 categories such as tonics/activating blood and removing blood stasis and tranquilizers;medicinal properties are bitter,acrid,7 categories such as sweet;the medicinal flavor is mainly warm,cold,and flat;it is mostly attributed to the liver,heart,and spleen meridians.Cluster analysis clustered the drugs into 6 categories,and the core drugs were keel,oyster,skullcap,cassia twig,jujube,Codonopsis,and Pinellia.Factor analysis can extract 3 drug groups,2 drug pairs,and 3 single traditional Chinese medicines.All drug association rules can get 33 drug pairs or drug groups,of which Bupleurum and Paeonia lactiflora have the highest support.Conclusion The treatment of angina pectoris with anxiety and/or depression is mainly based on tonic-deficiency drugs,blood-activating and stasis-relieving drugs,and tranquilizing drugs.It is combined with bitterness and pain,cold and warm,and mainly regulates the liver,heart,and spleen.Clinically,the medicine can be prescribed from the ideas of soothing the liver and regulating qi,promoting blood circulation and removing blood stasis,replenishing qi and activating blood circulation,nourishing the mind and calming the nerves,etc.,so as to achieve the purpose of“relieving stasisand regulating the mind”and treating“heart disease with mental illness”.