基于数据挖掘的常占杰治疗肝癌用药规律分析
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摘要
目的:基于数据挖掘分析常占杰教授治疗肝癌的临床经验。方法:收集患者基本信息资料,建立数据库,统计首诊处方用药,分析用药频率,SPSS 21.0软件进行药物之间的相互作用规律的聚类分析,IBM SPSS Modeler 18.0软件对高频次的药物进行关联规则分析,以Apriori模块进行处理。结果:共收集治疗肝癌首诊处方114张,常用中药共95味,使用1355次,前7类高频率药物依次为补气药、活血药、清热药、理气药、利水药、补血药、温阳药,累计频率达90.04%,从药物功效结果分析,补气健脾、活血化瘀、清热解毒、疏肝理气、温补脾肾等药物居多。对42味高频率药物进行聚类分析,得到14个常用的药对及6类核心药物群;用关联规则分析法,得出20条药物相关性规则。结论:常占杰教授治疗肝癌旨在通过调养脾胃而长养肝木之脏,调动肝木生发的机能,通过扶正助肝脾生养发陈以祛除毒邪,这种治疗疑难顽疾的临证思路值得研究、发挥和进一步扩展应用。
Objective:To summarize Professor CHANG Zhanjie′s clinical experience on treating liver cancer.Methods:We collected cases of Professor CHANG Zhanjie′s treatment on liver cancer,and then established datebase of symptoms and prescription.SPSS 21.0 software was used to analyze the relation of herbs by cluster analysis.IBM SPSS Modeler 18.0 software was used to analyze high frequency drugs by performing an association rule analysis with the Apriori module.Results:Totally 114 prescriptions for liver cancer patients were collected.It comprised a total of 95 herbs,and all herbs were used 1355 times.The first seven class of high frequency drugs were Qi-reinforcing drugs,blood-activation drugs,heat-clearing drugs,Qi-regulating drugs,promoting diuresis drugs,blood-tonifying drugs and warming yang drugs.The cumulative frequency was up to 90.04%.According to the analysis of medicial efficacy,the first six types were drugs for invigorating Qi and spleen,activating blood circulation,clearing away heat and toxic material,smoothing liver to regulate Qi,warming and tonifying spleen and kidney,and tonifying blood.The results of cluster analysis showed that there were 14 commonly paired drugs and 6 core drug groups.The results of association rule analysis showed 20 drug correlation rules.Conclusion:Professor CHANG Zhanjie treated patients with liver cancer through regulating and nurishing spleen and stomach and maintaining the liver,which mobilized the function of liver germination.This academic ideas and clinical experiences in treating difficult diseases is worthy of further studying and applying.
Objective:To summarize Professor CHANG Zhanjie′s clinical experience on treating liver cancer.Methods:We collected cases of Professor CHANG Zhanjie′s treatment on liver cancer,and then established datebase of symptoms and prescription.SPSS 21.0 software was used to analyze the relation of herbs by cluster analysis.IBM SPSS Modeler 18.0 software was used to analyze high frequency drugs by performing an association rule analysis with the Apriori module.Results:Totally 114 prescriptions for liver cancer patients were collected.It comprised a total of 95 herbs,and all herbs were used 1355 times.The first seven class of high frequency drugs were Qi-reinforcing drugs,blood-activation drugs,heat-clearing drugs,Qi-regulating drugs,promoting diuresis drugs,blood-tonifying drugs and warming yang drugs.The cumulative frequency was up to 90.04%.According to the analysis of medicial efficacy,the first six types were drugs for invigorating Qi and spleen,activating blood circulation,clearing away heat and toxic material,smoothing liver to regulate Qi,warming and tonifying spleen and kidney,and tonifying blood.The results of cluster analysis showed that there were 14 commonly paired drugs and 6 core drug groups.The results of association rule analysis showed 20 drug correlation rules.Conclusion:Professor CHANG Zhanjie treated patients with liver cancer through regulating and nurishing spleen and stomach and maintaining the liver,which mobilized the function of liver germination.This academic ideas and clinical experiences in treating difficult diseases is worthy of further studying and applying.
引文
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[11] 叶丽红,程海波,章永红,等.原发性肝癌的中医治则与治法探讨[J].南京中医药大学学报,2010,26 (1):10-13.
[12] 蒋建龙,沈士明,徐海东.理肝实脾汤对晚期原发性肝癌患者生活质量的影响[J].现代中西医结合杂志,2011,20(30):3796-3800.
[13] 张锡纯.医学衷中参西录(下册)[M].北京:人民卫生出版社,2006:661.
[14] 刘彦晶,刘铁军.刘铁军教授治疗肝癌的思路和方法初探[J].中西医结合肝病杂志,2015,25(2):104-105.
[15] 李小红,张翠丽,刘亚珠.常占杰教授治疗肝病之经验 [J].四川中医,2012,30(1):12-13.
[2] McGuire S.World Cancer Report 2014.Geneva,Switzerland:World Health Organization,International Agency for Research on Cancer,WHO Press,2015[J].Adv Nutr,2016,7(2):418-419.doi:10.3945/an.116.012211.
[3] Cheng A L,Kang Y K,Chen Z,et al.Efficacy and safety of sorafenib in patients in the Asia-Pacific region with advanced hepatocellular carcinoma:a phase III randomised,double-blind,placebo-controlled trial[J].Lancet Oncology,2009,10(1):25-34.
[4] 韩中颖,韩政,祝峻峰.中医药治疗原发性肝癌临床研究进展[J].长春中医药大学学报,2016,32(2):426.
[5] 王会峰,徐德龙.吴孟超院士中医药治疗肝癌思想初探[J].中医学报,2012,27(1):35-36.
[6] 李京涛,郭师,席奇,等.益脾养肝方联合肝动脉化疗栓塞术治疗原发性肝癌的疗效观察[J].陕西中医,2015,36(8):944-945.
[7] 南然,宋春荣.常占杰教授用益脾养肝法治肝病经验谈[J].光明中医,2012,27(12):2408-2409.
[8] 高学敏.中药学[M].北京:中国中医药出版社,2006.
[9] 国家药典委员会.中华人民共和国药典[M].北京:中国医药科技出版社,2010.
[10] 李让钱,江宇泳.原发性肝癌从“温法”论治的理论分析[J].中医药学报,2012,40(3):67.
[11] 叶丽红,程海波,章永红,等.原发性肝癌的中医治则与治法探讨[J].南京中医药大学学报,2010,26 (1):10-13.
[12] 蒋建龙,沈士明,徐海东.理肝实脾汤对晚期原发性肝癌患者生活质量的影响[J].现代中西医结合杂志,2011,20(30):3796-3800.
[13] 张锡纯.医学衷中参西录(下册)[M].北京:人民卫生出版社,2006:661.
[14] 刘彦晶,刘铁军.刘铁军教授治疗肝癌的思路和方法初探[J].中西医结合肝病杂志,2015,25(2):104-105.
[15] 李小红,张翠丽,刘亚珠.常占杰教授治疗肝病之经验 [J].四川中医,2012,30(1):12-13.