基于数据挖掘现代中药复方治疗非小细胞肺癌用药规律探讨

目的:基于数据挖掘技术探讨现代复方治疗非小细胞肺癌的用药规律,为临床用药提供参考。方法:选取2010年至2017年北京301医院治疗非小细胞肺癌(NSCLC)的中药复方,建立现代中药复方治疗NSCLC方剂数据库,并采用SPSS 22.0及SPSS Modeler14.2软件进行频数及频率分析、因子分析、关联分析等,进而对中药复方用药规律进行定量、定性分析并探讨其可能相关机制。结果:中药复方治疗肺癌复方231首,中药389种,高频中药135味,其中用药频次排名前5位的中药依次是川贝母、炒黄芩、生龙骨、茯神、半枝莲;在涉及的39类药物中清热解毒药、补气药居于前列;归经以肺经、脾经、胃经为主;四气以寒、温、平、微寒为主;五味以甘、苦、辛为主。因子分析最后提取了12个公因子,累积贡献率达65.595%,其中以补益气血、养阴清热散结、健脾理气化痰为主;通过聚类分析,提取了40常用得药对或药组;关联分析共得到63条关联规则,药对以茯苓→陈皮、炒白术→陈皮为常用,3味药组以生黄芪→炒白术、茯苓,生神曲→炒白术、茯苓,陈皮→炒白术、茯苓为常用。结论:肺癌主因癌毒阻滞,痰热互结,临床诊疗以扶正祛邪为基本原则,以祛邪宜清热解毒、为主,并兼顾正气,补益气血以培元扶正。

Discussion on Medication Rules of Modern Chinese Compound in the Treatment of Non-small Cell Lung Cancer Based on Data Mining

Objective:Based on data mining technology to explore the medication rules of modern Chinese medicine compound for the treatment of non-small cell lung cancer,so as to provide reference for clinical medication.Methods:Chinese medicine compounds for treating NSCLC in Chinese PLA General Hospital from 2010 to 2017 were collected.The database of modern Chinese medicine compound for the treatment of NSCLC was established.And the frequency and frequency analysis,factor analysis,association analysis etc.were performed by SPSS 22.0 and SPSS Modeler14.2,in order to quantitatively and qualitatively analyze the medication regularity of Chinese medicine compound and explore its possible mechanisms.Results:There were 231 Chinese medicine compounds for lung cancer,389 kinds of Chinese medicine and 135 kinds of high-frequency Chinese medicine,of which Bulbus Fritillariae Cirrhosae,stir-baked Radix Scutellariae,raw Os Draconis,Fushen and Herba Scutellariae Barbatae were the top 5 in the frequency of Chinese medicines.Among the 39 types of drugs involved,clearing heat and removing toxicity drugs,supplementing qi drugs were at the forefront;channel tropism was based on the lung,spleen and stomach;Four qi were mainly cold,warm,smooth and slightly cold;Five flavors were mainly sweet,bitter and pungent.The factor analysis finally extracted 12 common factors,with a cumulative contribution rate of 65.595%,of which mainly were tonifying qi and blood,tonifying yin,clearing heat and eliminating stagnation,tonifying spleen,regulating qi and eliminating phlegm.Through the cluster analysis,40 commonly used drug pairs or groups were extracted.And a total of 63 association rules were obtained from the association analysis.The drug pair was commonly used with Poria→Pericarpium Citri Reticulatae,fried Rhizoma Atractylodis Macrocephalae→dried Pericarpium Citri Reticulatae.Three flavor medicines group was commonly used with raw Radix Astragali seu Hedysari→fried Rhizoma Atractylodis Macrocephalae,Poria,Massa Medicata Fermentata→fried Rhizoma Atractylodis Macrocephalae,Poria and Pericarpium Citri Reticulatae→fried Rhizoma Atractylodis Macrocephalae,Poria.Conclusion:Lung cancer is mainly caused by obstruction of cancer toxin,and phlegm and heat are interlinked.In the clinical diagnosis and treatment,the basic principle is to strengthen vital qi to eliminate pathogenic factor;and dispelling pathogens is mainly by clearing heat and removing toxicity,and the vital qi,and supplementing qi and blood should be taken into account to recover primordial qi and strengthen the body resistance.