基于关联规则和隐结构模型的...治疗喘证方剂的用药规律分析_张庆.pdf

中草药 中草药 2023 年年 3 月月 第第 54 卷卷 第第 5 期期 Chinese Traditional and Herbal Drugs 2023 March Vol.54 No.5 1517 数据挖掘与循证医学数据挖掘与循证医学 基于关联规则和隐结构模型的普济方中治疗喘证方剂的用药规律分析1 张 庆1,2，姬文帅1,2，孔欣欣1,2，杜 琛1,2，王海峰2,3*1.河南中医药大学第一临床医学院，河南 郑州 450000 2.呼吸疾病中医药防治省部共建协同创新中心，河南 郑州 450000 3.河南中医药大学第一附属医院 呼吸与危重症医学科，河南 郑州 450000 摘 要：目的 挖掘普济方中治疗喘证的相关方剂，探索其用药规律，为临床治疗喘证提供借鉴。方法 提取普济方中治疗喘证的方剂信息并使用 Excel 2016 软件建立数据库，应用 IBM SPSS Modeler Subscription 1.0 和 Lantern 5.0 软件进行关联规则分析、隐结构模型分析和综合聚类分析，并结合频数描述，探讨普济方中治疗喘证的方药规律。结果 共收集方剂 721 首，涉及中药 308 味，方剂平均药味数 7.88 味，剂型多为煮散、丸剂，使用频次较高的药物依次为生姜、甘草、苦杏仁、人参、陈皮、肉桂。药物功效主要为止咳平喘、化痰、补虚，药性偏温、寒、平，药味偏辛、苦、甘，归经多归肺、脾、胃经。关联规则分析筛选出 22 条强关联规则，其中 3 项强关联规则 17 条，包括半夏陈皮生姜、麻黄陈皮苦杏仁、半夏茯苓生姜等，4 项强关联规则 5 条，包括半夏陈皮甘草生姜、半夏肉桂甘草生姜、麻黄陈皮苦杏仁甘草等。隐结构分析得到 17 个隐变量，结合专业知识推论得到 8 个综合聚类模型、14 个核心方剂，推断喘证的常见证型有表寒肺热证、外寒内饮证、痰浊阻肺证、痰热壅肺证、饮停胸胁证、上实下虚证、肺气虚证、肺肾气虚证。结论 普济方治疗喘证多用益气养阴、止咳平喘之法，治疗实喘侧重祛邪利气，辨证选用解表散寒、燥湿化痰、清热化痰、泻水逐饮的药物，治疗虚喘侧重培补摄纳，辨证选用理气健脾、补肺益气、补肾纳气的药物。关键词：喘证；普济方；用药规律；关联规则分析；隐结构；生姜；甘草；苦杏仁；人参；陈皮；肉桂 中图分类号：R285 文献标志码：A 文章编号：0253-2670(2023)05-1517-09 DOI:10.7501/j.issn.0253-2670.2023.05.019 Analysis on medication rules of prescription for asthmatic syndrome in Prescriptions for Universal Relief based on association rules and latent structure model ZHANG Qing1,2,JI Wen-shuai1,2,KONG Xin-xin1,2,DU Chen1,2,WANG Hai-feng2,3 1.The First Clinical College,Henan University of Chinese Medicine,Zhengzhou 450000,China 2.Collaborative Innovation Center for Chinese Medicine and Respiratory Diseases Co-constructed by Henan Province&Education Ministry of China,Zhengzhou 450000,China 3.Department of Respiratory and Critical Medicine,The First Affiliated Hospital of Henan University of Chinese Medicine,Zhengzhou 450000,China Abstract:Objective To excavate the relevant prescriptions for asthmatic syndrome in Prescriptions for Universal Relief and explore their medication rules,so as to provide ideas worthy of reference for clinical treatment of asthmatic syndrome.Methods The information of prescription for asthmatic syndrome in Prescriptions for Universal Relief was extracted and the database was established using Excel 2016 software.IBM SPSS Modeler Subscription 1.0 and Lantern 5.0 software were used for association rules analysis,latent structure model analysis and comprehensive clustering analysis,combined with frequency description,the medication rules of prescription for asthmatic syndrome in Prescriptions for Universal Relief was discussed.Results A total of 721 prescriptions were collected,involving 308 traditional Chinese medicines(TCMs),with an average of 7.88 TCMs for each prescription.The dosage forms were mostly boiled powder and pills.The most frequently used TCMs were Shengjiang(Zingiberis Rhizoma Recens),Gancao(Glycyrrhizae Radix et 收稿日期：2022-09-27 基金项目：河南省高校科技创新团队支持计划（22IRTSTHN029）；河南省中医药拔尖人才培养项目（2019ZYBJ05）作者简介：张 庆，硕士研究生，从事中医药防治呼吸系统疾病的临床和基础研究。Tel:15138656985 E-mail:zhang_*通信作者：王海峰，博士，主任医师，教授，博士生导师，从事中医药防治呼吸系统疾病的临床和基础研究。E-mail:wangh_ 1518 中草药 中草药 2023 年年 3 月月 第第 54 卷卷 第第 5 期期 Chinese Traditional and Herbal Drugs 2023 March Vol.54 No.5 Rhizoma),Kuxingren(Armeniacae Semen Amarum),Renshen(Ginseng Radix et Rhizoma),Chenpi(Citri Reticulatae Pericarpium),and Rougui(Cinnamomi Cortex).The efficacy of these TCMs is mainly relieving cough and asthma,resolving phlegm,tonifying deficiency,and warm,cold,flat in nature,and pungent,bitter,sweet in taste,and mostly attributing to lung,spleen,and stomach meridians.A total of 22 strong associations were screened out by association rules analysis,including 17 triplet strong associations such as Banxia(Pinelliae Rhizoma)+Citri Reticulatae Pericarpium Zingiberis Rhizoma Recens,Mahuang(Ephedrae Herba)+Citri Reticulatae Pericarpium Armeniacae Semen Amarum,and Pinelliae Rhizoma+Fuling(Poria)Zingiberis Rhizoma Recens),and five quadruplet strong associations such as Pinelliae Rhizoma+Citri Reticulatae Pericarpium+Glycyrrhizae Radix et Rhizoma Zingiberis Rhizoma Recens,Pinelliae Rhizoma+Cinnamomi Cortex+Glycyrrhizae Radix et Rhizoma Zingiberis Rhizoma Recens,and Ephedrae Herba+Citri Reticulatae Pericarpium+Armeniacae Semen Amarum Glycyrrhizae Radix et Rhizoma.A total of 17 latent variables were obtained by the latent structure analysis,eight comprehensive cluster models and 14 core prescriptions were obtained by professional knowledge inference.The common syndromes of asthmatic syndrome were inferred to be exterior cold and lung heat syndrome,exterior cold interior drink syndrome,phlegm turbidity obstructing lung syndrome,phlegm heat stagnant lung syndrome,drinking stagnation chest and hypochondria syndrome,upper excess and lower deficiency syndrome,lung qi deficiency syndrome,and kidney insufficiency syndrome.Conclusion The prescription for asthmatic syndrome in Prescriptions for Universal Relief mainly uses the methods of benefiting qi and nourishing yin,relieving cough and relieving asthma.In the treatment of excess type asthmatic syndrome,it focuses on eliminating pathogenic factors and benefiting qi,dialectically selecting the medicines t