基于复杂网络的曾斌芳治疗慢性乙型肝炎用药规律研究

CJI (Traditional Chinese Medicine) - - Chinese Journal Of Information On Traditional Chin -

郭峰,王晓忠,马燕,王晓波,庄小芳,乐永红,王燕

新疆维吾尔自治区中医医院肝病科,新疆 乌鲁木齐 830000

摘要:目的 分析曾斌芳教授治疗慢性乙型肝炎( CHB)用药规律,为临床提供借鉴。方法 收集曾斌芳教授 2014 年 1月- 2015 年 12月于新疆维吾尔自治区中医医院肝病科门诊和住院治疗的CHB病历。采用复杂网络及点式互信息法等数据挖掘方法,对纳入病历的证候、症状、治法和用药,以及相互间关联进行分析。结果 收集病例 132 例,共计 277 诊次、277首处方。高频症状依次为倦怠乏力、腹胀、胁痛、双下肢水肿等;高频证候依次为肝郁脾虚、湿热内蕴、肝胆湿热、肝郁气滞、气滞血瘀等,其中肝郁脾虚证最为常见,达126诊次( 45.5%);常见治法依次为和血柔肝健脾、清利湿热、滋养肝肾、理气活血、活血运脾等。采用点式互信息法具体分析CHB肝郁脾虚证的“证-症-治-药”关系,结果表明,其辨证要点为倦怠乏力、口干、右胁肋隐痛、纳呆、腹胀,以和血柔肝健脾为主要治法,常用药物为柴胡、党参、黄芩、当归、赤芍、炙甘草、法半夏、生地黄、香附等;复杂网络分析结果表明, CHB 肝郁脾虚证核心处方为小柴胡汤合四物汤。结论 曾斌芳教授治疗CHB注重整体观念及脏腑传变,用药以和血柔肝、疏肝健脾为主,配以滋阴软坚散结、清热解毒利湿之品。

关键词:慢性乙型肝炎;名医经验;数据挖掘;用药规律

DOI: 10.3969/j.issn.1005-5304.2017.02.024

中图分类号: R2-05;R259.126.2 文献标识码: A 文章编号: 1005-5304(2017)02-0094-04

Study on Medication Rules of Professor ZENG Bin-fang’s Treatment for Chronic Hepatitis B Based on Complex Network Analysis Method

GUO Feng, WANG Xiao-zhong, MA Yan, WANG Xiao-bo, ZHUANG Xiao-fang, YUE Yong-hong, WANG Yan (Department of Hepatology, Traditional Chinese Medicine Hospital of Xinjiang Uygur Autonomous Region, Urumqi 830000, China)

Abstract: Objective To analyze the medication rules of Professor ZENG Bin-fang’s treatment for chronic hepatitis B (CHB); To provide references for clinic. Methods Research data came from patients with CHB in outpatient and hospitalization in Department of Hepatology, Traditional Chinese Medicine Hospital of Xinjiang Uygur Autonomous Region. In this study,data mining methods, such as complex network analysis and dot-mode mutual information, were utilized to conduct analysis on the syndromes, symptoms, treatment and medication of included patients, as well as the mutual relations. Results The study collected clinical data of 132 patients with CHB, who accepted 277 times of examination,and 277 prescriptions were included. High-frequency symptoms included: burnout and weakness, abdominal distension, hypochondriac pain, and lower limb edema; Common syndromes included: stagnation of liver qi and spleen deficiency, retention of damp-heat in the interior, liver and gallbladder damp-heat, liver qi stagnation, and qi-stagnation and blood stasis, etc., successively, including 126 times of examination and accounting for 45.5% of all cases. Common therapeutic methods involved in soothing liver and strengthening spleen, eliminating dampness and heat, nourishing liver and kidney, regulating vital energy and promoting blood flow and activating blood and activating spleen, successively. Dot-mode mutual information analysissyndrome-symptom relation: the differentiation point of stagnation of liver qi and spleen deficiency included burnout and weakness, thirst, 基金项目:新疆维吾尔自治区中医民族医药科技人才培养计划项目(2016-03-15)通讯作者:王燕,E-mail:112200141@qq.com

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