基于文献数据挖掘的糖尿病视网膜病变中药用药关联规则分析
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摘要
目的基于文献探讨中药治疗糖尿病视网膜病变(diabetic retinopathy, DR)常用药物的用药特点和组方规律,为DR的中医药治疗提供参考依据。方法检索中国知网、万方数据知识服务平台、维普数据库、中国生物医学文献数据库,获取中药治疗DR的汤剂复方,对纳入文献的提取资料信息进行编码并建立数据库,通过SPSS20.0统计分析软件、RapidMiner6.0数据挖掘软件对DR按分期对用药规律进行挖掘。结果最终纳入中药复方治疗DR的中文文献152篇,涉及中药方剂152首,含中药1657味,用药频次占50%以上的中药有:非增殖期DR病变为黄芪、丹参、生地黄(54首方剂,572味中药);增殖期DR病变为蒲黄、三七(4首方剂,41味中药)。整体用药频次前5位的是黄芪、丹参、生地黄、枸杞子、葛根(152首方剂,中药1657味)。药物归类:各期DR均以补虚药为主,其次为清热药,再次为活血化瘀药、解表药和止血药;各期用药药性均偏寒凉。关联规则分析显示:所有组合以黄芪为中心,丹参、生地黄、枸杞子、葛根4味药分别与黄芪有较强关联,另外进行关联规则分析发现当归、赤芍、川芎3味药相互间也存在组方关联。结论中药治疗非增殖期DR病变以益气活血滋阴药为主,增殖期DR病变以活血化瘀药为主,在增殖期DR病变中清热药、活血化瘀药以及寒凉药的比例稍增加;核心药物组合以黄芪为中心,并与丹参、生地黄、枸杞子、葛根等组合用药。
OBJECTIVE To discuss the characteristics and the rules of Chinese medicinal decoction based on the literature and to provide references for the treatment of diabetic retinopathy using Chinese medicine.METHODS We searched four Chinese databases(including CNKI, Wan Fang, VIP, SinoMed) up to May2018, and included the clinical trials concerning Chinese medicinal decoction on diabetic retinopathy, extracted the data of included articles then coded and build the database. The SPSS20.0 and RapidMiner6.0 data mining software was used in our study to evaluate the characteristics and the rules of Chinese medicinal decoction in treatment of different stage diabetic retinopathy.RESULTS A total of 152 articles(involving 152 Chinese medicinal decoctions with 1657 Chinese herbs) were included in this article. Drugs in frequency more than 50% were as below: huangqi, danshen, sheng di for nonproliferative diabetic retinopathy(54 Chinese medicinal formulae with 572 herbs);Puhuang, sanqiforproliferative diabetic retinopathy(4 formulae with41 herbs);Huangqi, danshen, shengdi, gouqiandgegen were the most frequently used herbs in the whole(involving 152 formulae with 1657 herbs).Chinese herb classification:tonifying drugs were the most common herb in the whole stage, heat herbs was the secondly common herb, and then followed the circulation-activating herbs. The medicinal of the most common used herbwas cold. The result of association rules mining showed that the combinations were centered on huangqi and danshen, shendi, gouqi, gegen had strong correlations with huangqi.Inaddition,danggui, chishao and chuanxiong also shared a strong correlation.CONCLUSIONS The qi-boosting, blood-activating and yin-nourishing herbs were commonly used in nonproliferative diabetic retinopathy; blood-activating and stasis-removing herbs were most common ones for proliferative diabetic retinopathy. The proportion ofheat-removing blood-activating stasis-removing herbs and cold herbs increased in management of proliferative diabetic retinopathy. The core drug was huangqi and it was often used in combinations withdanshen, shengdi, gouqi, gegen.
OBJECTIVE To discuss the characteristics and the rules of Chinese medicinal decoction based on the literature and to provide references for the treatment of diabetic retinopathy using Chinese medicine.METHODS We searched four Chinese databases(including CNKI, Wan Fang, VIP, SinoMed) up to May2018, and included the clinical trials concerning Chinese medicinal decoction on diabetic retinopathy, extracted the data of included articles then coded and build the database. The SPSS20.0 and RapidMiner6.0 data mining software was used in our study to evaluate the characteristics and the rules of Chinese medicinal decoction in treatment of different stage diabetic retinopathy.RESULTS A total of 152 articles(involving 152 Chinese medicinal decoctions with 1657 Chinese herbs) were included in this article. Drugs in frequency more than 50% were as below: huangqi, danshen, sheng di for nonproliferative diabetic retinopathy(54 Chinese medicinal formulae with 572 herbs);Puhuang, sanqiforproliferative diabetic retinopathy(4 formulae with41 herbs);Huangqi, danshen, shengdi, gouqiandgegen were the most frequently used herbs in the whole(involving 152 formulae with 1657 herbs).Chinese herb classification:tonifying drugs were the most common herb in the whole stage, heat herbs was the secondly common herb, and then followed the circulation-activating herbs. The medicinal of the most common used herbwas cold. The result of association rules mining showed that the combinations were centered on huangqi and danshen, shendi, gouqi, gegen had strong correlations with huangqi.Inaddition,danggui, chishao and chuanxiong also shared a strong correlation.CONCLUSIONS The qi-boosting, blood-activating and yin-nourishing herbs were commonly used in nonproliferative diabetic retinopathy; blood-activating and stasis-removing herbs were most common ones for proliferative diabetic retinopathy. The proportion ofheat-removing blood-activating stasis-removing herbs and cold herbs increased in management of proliferative diabetic retinopathy. The core drug was huangqi and it was often used in combinations withdanshen, shengdi, gouqi, gegen.
引文
[1]杨亚丽.糖尿病视网膜病变的相关因素及其中医证候要素的研究[D].北京:北京中医药大学,2016.
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[9]相萍萍,王旭.中医药治疗糖尿病视网膜病变研究进展[J].中华中医药杂志,2014,29(3):813-815.
[10]高学敏.中药学[M].北京:中国中医药出版社.2011,321-428.
[11]卢伟波,杨丕坚,李舒敏,等.丹参多酚酸盐对早期糖尿病肾病患者炎症细胞因子及肾血管内皮功能的影响[J].中国实验方剂学杂志,2014,20(2):184-187.
[12]YIN Y,GUAN Y,DUAN J,et al.Cardioprotective effect of Danshensu against myocardial ischemia/reperfusion injury and inhibitsapoptosis ofH9c2cardiomyocytes via Akt and ERK1/2 phosphorylation[J].Eur J Pharmacol,2013,699(1):219.
[13]李卫民.影响方剂中地黄功效发挥方向的诸因素研究[D].成都中医药大学,2009.
[14]许晓乐,季晖,谷舒怡等.黄芪甲苷对小鼠实验性心室重构及基质金属蛋白酶表达的影响[J].中国药科大学学报,2010,41(1):70-75.
[15]熊静.益气养阴活血利水法治疗单纯型糖尿病视网膜病变气阴两虚血络瘀阻证的临床观察[D].长沙:湖南中医药大学,2011:26.
[16]吴嘉瑞,王凯欢,纪凯,等.基于数据挖掘的中医治疗糖尿病处方用药规律分析[J].中国实验方剂学杂志,2015,21(22):214-217.
[17]段俊国,金明,接传红.糖尿病视网膜病变中医防治指南[J].中国中医药现代远程教育,2011,9(4):154-155.
[2]DUH EJ,SUN JK,STITT AW.Stitt.Diabetic retinopathy:current understanding,mechanisms,and treatment strategies[J].JCI Insight,2017,2(14):e93751.
[3]李筱荣,李晓辛,惠延年.糖尿病眼病[M].北京:人民卫生出版社,2010:3-5.
[4]MARIA VALERIA JIMENEZ-BORACIO MARQUEZ-GONZALEZ,RODOLFO BARCENAS-CONTRERAS.Early diagnosis of diabetic retinopathy in primary care[J].Colomb Med(Cali),2015,46(1):14-18.
[5]郜旭亮,张晓昀,王旭玲等.糖尿病视网膜病变的中医药治疗进展[J].中国中医药现代远程教育,2017,15(16):163-164.
[6]陈封能.数据挖掘导论(完整版)[M].北京:人民邮电出版社,2011(1):201-225.
[7]王玉,张伟红,刘雨.基于Apriori关联规则在信息无障碍网站的应用[J].吉林大学学报:信息科学版,2013,31(1):101-106.
[8]张华平.预测分析与数据挖-RapidMiner实现[M].北京:人民邮电出版社,2014(5):2-5.
[9]相萍萍,王旭.中医药治疗糖尿病视网膜病变研究进展[J].中华中医药杂志,2014,29(3):813-815.
[10]高学敏.中药学[M].北京:中国中医药出版社.2011,321-428.
[11]卢伟波,杨丕坚,李舒敏,等.丹参多酚酸盐对早期糖尿病肾病患者炎症细胞因子及肾血管内皮功能的影响[J].中国实验方剂学杂志,2014,20(2):184-187.
[12]YIN Y,GUAN Y,DUAN J,et al.Cardioprotective effect of Danshensu against myocardial ischemia/reperfusion injury and inhibitsapoptosis ofH9c2cardiomyocytes via Akt and ERK1/2 phosphorylation[J].Eur J Pharmacol,2013,699(1):219.
[13]李卫民.影响方剂中地黄功效发挥方向的诸因素研究[D].成都中医药大学,2009.
[14]许晓乐,季晖,谷舒怡等.黄芪甲苷对小鼠实验性心室重构及基质金属蛋白酶表达的影响[J].中国药科大学学报,2010,41(1):70-75.
[15]熊静.益气养阴活血利水法治疗单纯型糖尿病视网膜病变气阴两虚血络瘀阻证的临床观察[D].长沙:湖南中医药大学,2011:26.
[16]吴嘉瑞,王凯欢,纪凯,等.基于数据挖掘的中医治疗糖尿病处方用药规律分析[J].中国实验方剂学杂志,2015,21(22):214-217.
[17]段俊国,金明,接传红.糖尿病视网膜病变中医防治指南[J].中国中医药现代远程教育,2011,9(4):154-155.