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基于数据挖掘的孙世道治疗皮肤病方药规律研究

Data mining-based research on the medication patterns of Professor Sun Shidao’s prescriptions for skin diseases

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【作者】 茅婧怡; 竺炯; 马欣; 丁佩军; 张慧敏;

【Author】 MAO Jingyi;ZHU Jiong;MA Xin;DING Peijun;ZHANG Huimin;Department of Dermatology,Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine;

【通讯作者】 竺炯;

【机构】 上海中医药大学附属曙光医院皮肤科;

【摘要】 目的 分析孙世道教授治疗皮肤病的处方用药规律,总结其学术思想。方法 收集孙教授治疗皮肤病的病案,建立病案数据库。采用SPSS 22.0统计软件进行频次分析,借助IBM SPSS Modeler 18.0软件的Apriori算法进行关联规则、组方网络分析,挖掘处方用药规律。结果 (1)共选定7 289例患者,5 239首方剂,涉及402味中药;西医病名346种,中医病名223种,其中皮炎湿疹(湿疮)患者最多,其后依次为红斑狼疮(红蝴蝶疮)、痤疮(粉刺)、银屑病(白疕)。(2)整体而言,孙教授治疗皮肤病的常用药物有牡丹皮、丹参、生地黄、玄参、知母、黄芩、土茯苓、白花蛇舌草;细分疾病及中医证型后发现,孙教授治疗痤疮以清热利湿为主,兼顾滋阴降火;治疗红斑狼疮以滋阴益气、凉血养血为法;治疗银屑病“从血论治”,凉血、养阴、活血法并重。(3)关联规则分析结果显示,白花蛇舌草、地肤子、苦参、山药、白术、玄参、玉竹、白鲜皮、生地黄、土茯苓等20味中药为孙教授常用的皮肤科用药组合,其中生地黄、土茯苓、白鲜皮、玉竹、牡丹皮与其他中药的关系网络最为密切;药对关联分析中共获得6组关联规则,含7味中药,其中白鲜皮、蒲公英和白花蛇舌草呈强关联性。结论 孙世道教授临床以治疗皮炎湿疹(湿疮)、红斑狼疮(红蝴蝶疮)、痤疮(粉刺)、银屑病(白疕)见长,常在清热的基础上联合使用祛风、利湿、凉血、滋阴诸法,擅用白鲜皮、蒲公英、白花蛇舌草等药物组合。

【Abstract】 ObjectiveTo analyze the prescription and medication patterns of Professor Sun Shidao in treating skin diseases and summarize his academic thoughts.MethodsThe cases of skin diseases treated by Professor Sun Shidao were collected and a medical record database was established. The statistical software SPSS 22.0 was used for frequency analysis,and Apriori algorithm of IBM SPSS Modeler 18.0 was used for association rules and network analysis to mine the prescription and medication patterns.Results(1) A total of 7,289 patients involving 5,239prescriptions and 402 traditional Chinese herbal medicines(TCHMs)were included. There were 346 disease names in modern medicine and 223disease names in traditional Chinese medicine(TCM)[The number of patients suffering from dermatitis eczema(damp sore)was the highest,followed by the number of patients with lupus erythematosus(red butterfly sore),acne(comedo),and psoriasis(white tinea)].(2) The drugs commonly used by Prof. Sun Shidao for treating skin diseases included Mudanpi(Moutan Cortex),Danshen(Salviae Miltiorrhizae Radix et Rhizoma),Dihuang(Rehmanniae Radix),Xuanshen(Scrophulariae Radix),Zhimu(Anemarrhenae Rhizoma),Huangqin(Scutellariae Radix),Tufulin(Smilacis Glabrae Rhizoma)and Baihuasheshecao(Hedyotis Diffusae Herba). By analyzing the classification of diseases and TCM syndromes,it was found that Professor Sun had adopted different methods for different diseases and syndromes. When treating acne,he used the method of clearing heat and dampness as the main method,taking into account nourishing yin and reducing fire;When treating lupus erythematosus,he used the methods of nourishing yin and benefiting qi, cooling blood and nourishing blood; When treating psoriasis,he focused on the treatment of blood,putting equal emphasis on the methods of cooling blood,nourishing yin and invigorating blood.(3)According to the results of association rule analysis,Professor Sun commonly used 20 TCHMs for the treatment of skin diseases,including Baihuashesehcao(Hedyotis Diffusae Herba),Difuzi(Kochiae Fructus),Kushen(Sophorae Flavescentis Radix),Shanyao(Dioscoreae Rhizoma),Baizhu(Atractylodis Macrocephalae Rhizoma),Xuanshen(Scrophulariae Radix),Yuzhu(Polygonati Odorati Rhizoma),Baixianpi(Dictamni Cortex),Dihuang(Rehmanniae Radix)and Tufulin(Smilacis Glabrae Rhizoma). Among them,Dihuang(Rehmanniae Radix),Tufulin(Smilacis Glabrae Rhizoma),Baixianpi(Dictamni Cortex),Yuzhu(Polygonati Odorati Rhizoma)and Mudanpi(Moutan Cortex)showed the closest network relationship with other TCHMs. According to the network analysis,there were 6 medicinal groups containing 7 TCHMs,among which Baixianpi(Dictamni Cortex), Pugongying(Taraxaci Herba) and Baihuasheshecao(Hedyotis Diffusae Herba) were strongly correlated.ConclusionsProfessor Sun Shidao specializes in the treatment of dermatitis eczema(damp sore),lupus erythematosus(red butterfly sore),acne(comedo)and psoriasis(white tinea). He often uses the method of clearing heat as the basis,and combines it with other methods such as winddispelling method,dampness-relieving method,blood-cooling method and yin-nourishing,etc. He is good at using the medication group of Baixianpi(Dictamni Cortex),Pugongying(Taraxaci Herba)and Baihuasheshecao(Hedyotis Diffusae Herba),etc.

【基金】 国家自然科学基金青年基金项目(82004359);上海中医药大学预算内项目(2020LK049);上海市卫计委海派中医流派传承人才培养项目(LRC2017041);上海市市级非物质文化遗产保护专项(2021-2023)
  • 【文献出处】 上海中医药杂志 ,Shanghai Journal of Traditional Chinese Medicine , 编辑部邮箱 ,2022年06期
  • 【分类号】R275.9
  • 【下载频次】308
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