基于中医传承辅助系统肾病蛋白尿防治组方配伍规律的数据挖掘研究

目的 中医传承辅助系统分析白志军教授治疗肾病蛋白尿的组方用药规律,为肾病蛋白尿的临床遣方用药及新药开发提供依据。方法 搜集2018年1月-2020年12月白志军教授治疗肾病蛋白尿的中药处方（包括门诊处方和住院处方）,运用中医传承辅助系统（V1.1）和Mircrosoft Office Excel对筛选出的中药方剂进行组方配伍规律分析。结果 共筛选出符合标准的中药处方110首,涉及中药139味,其中使用频次较高的中药为黄芪、白花蛇舌草、半枝莲、白茅根、党参、炙甘草、茯苓等;药味以甘味、苦味为主,药性以寒性、平性居多,归经多属胃、肺、脾、肝经;高频次药物组合有黄芪＋白花蛇舌草、半枝莲＋白花蛇舌草、半枝莲+黄芪、半枝莲+黄芪＋白花蛇舌草、白茅根+黄芪等;通过熵层次聚类分析得到5个新方。结论 肾病蛋白尿的病机特点多为本虚标实,本虚主要是脾肾亏虚、气阴不足,标实为瘀血、热毒、水湿。主要治则是以健脾固肾益气为首要,重视清热解毒,贯穿活血化瘀。

Analysis on compatible principles of prescriptions for nephropathic proteinuria by traditional chinese medicine inheritance assistant system

Objective Based on traditional Chinese medicine inheritance assistant system (TCMIAS), the medication rules of Professor Bai Zhijun in treatment of nephrotic proteinuria were analyzed in order to provide basis for the clinical prescription and new drug development.Methods The Chinese medicine prescriptions of Professor Bai Zhijun in treatment of nephrotic proteinuria were collected from January 2018 to December 2020 (includes outpatient and inpatient prescriptions), and the compatibility rule of them were analyzed using TCMIAS and Microsoft Office Excel software.Results A total of 110 compliant prescriptions including 139 traditional Chinese herbs were collected, among them, the frequency of Astragalus, Oldenlandia, Scutellaria barbata, Cogongrass rhizome Codonopsis pilosula, Glycyrrhiza uralensis and Poria cocos, et al. were highest sequentially. The herbs is mainly sweet and bitter in taste with cold and flat in nature mostly, and attribute to stomach, lung, spleen and liver meridians mostly. The herbs combinations with high frequency are Astragalus+Oldenlandia, Scutellaria barbata+Oldenlandia, Scutellaria barbata+Astragalus, Scutellaria barbata+ Astragalus+Oldenlandia,Cogongrass rhizome+Astragalus, et al; and five new prescriptions are obtained by entropy hierarchical cluster analysis.Conclusion The pathogenesis of nephrotic proteinuria is asthenia in origin and asthenia in superficiality. Asthenia in origin is mainly due to spleen and kidney deficiency, and qi-yin deficiency; Asthenia in superficiality is marked by blood stasis, heat toxin and water dampness. The therapeutically principle is to strengthen the spleen, kidney and invigorate Qi, with emphasis on heat-clearing and detoxifying always activating blood circulation to dissipate blood stasis.