基于数据挖掘探讨吴良村教授治疗原发性肝细胞癌的用药规律
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摘要
[目的]探讨吴良村教授辨治肝细胞癌的用药规律,指导临床用药,提高中医药治疗肝癌的临床疗效。[方法]通过计算机和人工检索相结合,收集2014年01月01日～2017年01月01日期间吴良村教授在浙江省中医院门诊的肝细胞癌患者病案。将患者临床信息转化为有效数据表,对药物累计频数、药物性味、药物归经及其功效归类采用描述性分析,对频数最高的33种药物进行系统聚类分析。[结果]共纳入80例患者,共计160诊次及用药150种,累积用药2681次,其中使用频数最多者为枸杞子,其次为北沙参、甘草、茯苓、青蒿、黄芩、鸡内金。药性使用频次最多的为平性药,药味使用频次最多的为甘味药,归经使用频次最多的为足阳明胃经,药物种类使用频次最多的为补虚药。聚类分析结果最终将药物分为14类,涉及方剂有一贯煎,药对涉及青蒿和黄芩、茯苓和山药、白术和太子参、绿梅花和柴胡等,单药可见佛手、三叶青、白花蛇舌草。[结论]吴良村教授辨治肝细胞癌以一贯煎滋阴疏肝为主,随证辅以益气健脾、清利湿热、解毒抗癌、消食和中之法,临证用药多以甘、苦、平、寒性味为主。
[Objective] To summarize WU Liangcun's experience in differentiating and treating hepatocellular carcinoma. [Methods] Combining with computer and manual retrieval,we collected the cases of hepatocellular carcinoma from Professor WU Liangcun in the clinic of Zhejiang Provincial Hospital of Traditional Chinese Medicine from January 01,2014 to January 01,2017. The patient's clinical information was transformed into an effective data table. Descriptive analysis was carried out on the cumulative frequency of drugs,drug taste,drug return and its efficacy classification. The cluster analysis was performed on 33 drugs with the highest frequency. [Results] A total of 80 patients were enrolled,with a total of 160 diagnosis and 150 medications,and 2,681 cumulative medications. The most frequently used was Fructus Lycii,followed by inner membrane of Coastal Glehnia Root,Licorice,Indian Bread,Sweet Wormwood Herb,Radix Scutellaria,chicken gizzard. The drug property with the highest frequency was calm,the drug flavor with the highest frequency was sweet,the drug channel tropism with the highest frequency was gastric meridian,and the drug effect attribution with the highest frequency was tonic drugs. The result of cluster analysis finally divided the drugs into 14 categories involving prescription as Yiguan Decoction. Herb pairs were Sweet Wormwood Herb and Radix Scutellaria,Indian Bread and Rhizoma Dioscoreae,Atractylodes and Heterophylly Falsestarwort Root,Green Plum-Blossom and Radix Bupleuri,etc. Single drug was Bergamot,Tetrastigma hemsleyanum and Hedyotis Diffusa Willd.[Conclusion] WU Liangcun's experience in treating hepatocellular carcinoma gives priority to nourishing Yin and dispersing stagnated liver Qi by suing Yiguan Decoction,and supplements by replenishing Qi to invigorate the spleen,eliminating dampness and heat,removing toxic substance and anti-cancer,and resolving food stagnation for regulating stomach. He is good at using medicine compatibilities as sweet,bitter,calm and cold.
[Objective] To summarize WU Liangcun's experience in differentiating and treating hepatocellular carcinoma. [Methods] Combining with computer and manual retrieval,we collected the cases of hepatocellular carcinoma from Professor WU Liangcun in the clinic of Zhejiang Provincial Hospital of Traditional Chinese Medicine from January 01,2014 to January 01,2017. The patient's clinical information was transformed into an effective data table. Descriptive analysis was carried out on the cumulative frequency of drugs,drug taste,drug return and its efficacy classification. The cluster analysis was performed on 33 drugs with the highest frequency. [Results] A total of 80 patients were enrolled,with a total of 160 diagnosis and 150 medications,and 2,681 cumulative medications. The most frequently used was Fructus Lycii,followed by inner membrane of Coastal Glehnia Root,Licorice,Indian Bread,Sweet Wormwood Herb,Radix Scutellaria,chicken gizzard. The drug property with the highest frequency was calm,the drug flavor with the highest frequency was sweet,the drug channel tropism with the highest frequency was gastric meridian,and the drug effect attribution with the highest frequency was tonic drugs. The result of cluster analysis finally divided the drugs into 14 categories involving prescription as Yiguan Decoction. Herb pairs were Sweet Wormwood Herb and Radix Scutellaria,Indian Bread and Rhizoma Dioscoreae,Atractylodes and Heterophylly Falsestarwort Root,Green Plum-Blossom and Radix Bupleuri,etc. Single drug was Bergamot,Tetrastigma hemsleyanum and Hedyotis Diffusa Willd.[Conclusion] WU Liangcun's experience in treating hepatocellular carcinoma gives priority to nourishing Yin and dispersing stagnated liver Qi by suing Yiguan Decoction,and supplements by replenishing Qi to invigorate the spleen,eliminating dampness and heat,removing toxic substance and anti-cancer,and resolving food stagnation for regulating stomach. He is good at using medicine compatibilities as sweet,bitter,calm and cold.
引文
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[13]谢璐帆,蔡艳阳,杨京京,等.吴良村教授运用滋水涵木法治疗原发性肝癌经验撷菁[J].中国中医药信息杂志,2018,25(3):121-122.
[2]Fujiwara N,Friedman SL,Goossens N,et al.Risk factors and prevention of hepatocellular carcinoma in the era of precision medicine[J].Journal of Hepatology,2017,68(3):526-549.
[3]Sintra SN,ToméL,Cipriano MA,et al.Long-term outcome of the first 150 Liver transplant recipients:A single-center experience[J].Transplantation Proceedings,2013,45(3):1119-1121.
[4]黄静,马萍,卢建峰.中医药干预肝癌干细胞的研究进展[J].世界最新医学信息文摘,2018,18(43):74-76,78.
[5]高学敏.中药学[M].2版.北京:中国中医药出版社,2007:51-523.
[6]缪希雍.本草经疏[M].上海:上海古籍出版社,2013:311-316.
[7]魏之琇.续名医类案[M].北京:人民卫生出版社,1997:565-566.
[8]单思,谢斌,严小军,等.一贯煎治疗肝癌的分子机制生物信息学分析[J].中华中医药杂志,2018,33(5):1804-1807.
[9]王文成,王彬彬.吴良村教授治疗原发性肝癌七法述要[J].新中医,2015,47(3):10-11.
[10]郭俊,杨靖,李艳.双氢青蒿素诱导肝癌细胞Huh-7凋亡并抑制其迁移的机制研究[J].中华实验和临床病毒学杂志,2016,30(3):274-278.
[11]Luo R,Wang J,Zhao L,et al.Synthesis and biological evaluation of baicalein derivatives as potent antitumor agents[J].Bioorganic&Medicinal Chemistry Letters,2014,24(5):1334-1338.
[12]李振涛,陈剑群.三叶青提取物抗消化系统肿瘤作用的研究进展[J].中成药,2016,38(11):2444-2447.
[13]谢璐帆,蔡艳阳,杨京京,等.吴良村教授运用滋水涵木法治疗原发性肝癌经验撷菁[J].中国中医药信息杂志,2018,25(3):121-122.