数据挖掘法探讨周珉教授治疗原发性肝癌用药规律及经验总结
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摘要
[目的]数据挖掘法分析周珉教授治疗原发性肝癌的中医用药规律,探讨相关病机并进行经验总结。[方法]收集2016年2月—2018年5月周珉教授门诊期间治疗原发性肝癌的方剂,运用"中医传承辅助系统(V2.50)"进行数据挖掘,并结合周珉教授临床经验,进行原发性肝癌病机探讨及用药规律分析。[结果]共收集治疗原发性肝癌方剂176首,涉及中药235种,列出方剂中的高频药物及组合规律。[结论]总结原发性肝癌以"湿热痰毒、气阴两伤"为基础病机,"清热化湿、健脾养阴"治则贯穿原发性肝癌治疗始末,同时,根据疾病不同发展阶段及治疗措施,权衡"扶正"与"祛邪"的主次分配,斟酌应用"攻毒散结""行气化瘀"等治法,以达到改善患者生活质量、延缓疾病进展的目的。
[Objective] To analyze the law of traditional Chinese medicine for treating primary liver cancer by Professor ZHOU Min,explore related pathogenesis and summarize the experience. [Methods] The prescriptions for the treatment of primary liver cancer during the visit of Professor ZHOU Min from February 2016 to May 2018 were collected. The data was mined using the "Traditional Chinese Medicine Heritage Support System(V2.50)" and combined with the clinical experience of Professor Zhou Min. The pathogenesis of liver cancer and the drug use patterns were discussed. [Results] A total of 176 prescriptions for primary liver cancer were collected,involving235 kinds of traditional Chinese medicines,and the high-frequency drugs and combination rules in prescriptions were listed.[Conclusion] The primary liver cancer is based on the pathogenesis of "congestion of damp heat and phlegm toxion,consumption of qi and yin". The treatment of "clearing heat and dampness,strengthening spleen and nourishing yin" runs through the beginning and end of treatment of primary liver cancer. At the same time,according to the different stages of development of this disease and the choices of treatment measures,weigh the primary and secondary distribution of "supporting body resistance" and "eliminating pathogenic factors",and consider the application of "eliminating toxic material and dissipating stagnation" and "smoothing qi and removing blood stasis" to achieve the purpose of improving patients' quality of life and delaying disease progression.
[Objective] To analyze the law of traditional Chinese medicine for treating primary liver cancer by Professor ZHOU Min,explore related pathogenesis and summarize the experience. [Methods] The prescriptions for the treatment of primary liver cancer during the visit of Professor ZHOU Min from February 2016 to May 2018 were collected. The data was mined using the "Traditional Chinese Medicine Heritage Support System(V2.50)" and combined with the clinical experience of Professor Zhou Min. The pathogenesis of liver cancer and the drug use patterns were discussed. [Results] A total of 176 prescriptions for primary liver cancer were collected,involving235 kinds of traditional Chinese medicines,and the high-frequency drugs and combination rules in prescriptions were listed.[Conclusion] The primary liver cancer is based on the pathogenesis of "congestion of damp heat and phlegm toxion,consumption of qi and yin". The treatment of "clearing heat and dampness,strengthening spleen and nourishing yin" runs through the beginning and end of treatment of primary liver cancer. At the same time,according to the different stages of development of this disease and the choices of treatment measures,weigh the primary and secondary distribution of "supporting body resistance" and "eliminating pathogenic factors",and consider the application of "eliminating toxic material and dissipating stagnation" and "smoothing qi and removing blood stasis" to achieve the purpose of improving patients' quality of life and delaying disease progression.
引文
[1]中华人民共和国国家卫生和计划生育委员会.原发性肝癌诊疗规范(2017年版)[J].临床肝胆病杂志,2017,33(8):1419-1431.
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[2] El-Serag HB. Hepatocellular carcinoma[J].N Engl J Med,2011,365(12):1118-1127.
[3] Llovet JM,Di Bisceglie AM,Bruix J,et al. Design and endpoints of clinical trials in hepatocellular carcinoma[J].J Natl Cancer Inst,2008,100(10):698-711.
[4] Llovet JM,BrúC,Bruix J. Prognosis of hepatocellular carcinoma:the BCLC staging classification[J].Semin Liver Dis,1999,19(3):329-338.