基于數據挖掘分析易無庸教授治療慢性腎衰隨診6年中藥處方

陳志紅 盧春鍵 袁常健 蔡玉純 易無庸

摘要 目的：基于數據挖掘技術回顧性分析易無庸教授治療慢性腎衰竭隨診6年中藥處方用藥規律。方法：收集2012年1月至2018年8月于易無庸教授門診處隨診6年的慢性腎衰患者所開具的中藥處方及門診病例資料，通過Python進行一維及二維的數據分析、運用FP-growth算法得出頻次前1 000的多維數據分析;使用Gephi軟件分層可視化網絡圖，總結出用藥規律及特點。結果：處方中，共用到中藥飲片267味，使用頻率最高的中藥為黃芪（97.0%）;用藥結構分析顯示，藥性方面溫藥（41.0%）、寒藥（36.0%）使用頻率最高;藥味方面甘味藥（32.4%）、苦味藥（30.2%）使用頻率最高;藥性歸經方面入肝經之藥（19.4%）使用頻率最高;藥物類別方面補虛藥（50.9%）使用頻率最高，其次為活血藥（17.7%）。三維、四維分析組合最高的分別是黃芪、牡丹皮、麩炒枳實;黃芪、牡丹皮、麩炒枳實、熟大黃;黃芪、牡丹皮、麩炒枳實、熟大黃、熟地黃。結論：易無庸教授在慢性腎功能衰竭長期治療上用藥主要遵循寒溫并用，甘苦共調，益氣扶正、補腎活血、疏肝理氣、通腑泄濁、健脾祛濕之法，與中醫治療理論相匹配，可為慢性腎衰竭的中藥治療提供參考。

關鍵詞 數據挖掘;慢性腎衰;中藥處方;用藥分析;@易無庸;隨診

Abstract Objective：To retrospectively analyze the rule of prescription of traditional Chinese medicine（TCM）in chronic renal failure（CRF）with 6 years follow-up treated by Professor Yi Wuyong based on data mining technique.Methods：From January 2012 to August 2018，the prescriptions of traditional Chinese medicine and the data of outpatient cases were collected from the outpatient department of Professor Yi Wuyong for 6 years，and the data of one dimension and two dimensions were analyzed by Python.The FP-growth algorithm was used to get the frequency of the first 1 000 multidimensional data analysis; Gephi software was used to visualize the network diagram，the law and characteristics of drug use were summarized.Results：In the prescription，267 kinds of Chinese medicine pieces were used.The most frequently used Chinese medicine was Radix Astragali seu Hedysari（97.0%），the structure analysis showed that the property of warm medicine（41.0%）and the cold medicine（36.0%）were the most frequently used.In the flavor aspect，sweet medicine（32.4%）and bitter medicine（30.2%）were used most frequently.In the channel tropism，the medicine into the liver channel（19.4%）was the most frequently used.The drugs of tonifying deficiency（50.9%）were the most frequently used，followed by blood activating drugs（17.7%）.The highest three dimensional and four dimensional analysis combinations were Radix Astragali seu Hedysari，Cortex Moutan Radicis，fried Fructus Aurantii Immaturus; Radix Astragali seu Hedysari，Cortex Moutan Radicis，fried Fructus Aurantii Immaturus，Radix et Rhizoma Rhei; Astragali seu Hedysari，Cortex Moutan Radicis，fried Fructus Aurantii Immaturus，Radix et Rhizoma Rhei，Radix Rehmanniae Preparata.Conclusion：Professor Yi Wuyong′s treatment of chronic renal failure is mainly in accordance with the combination of cold and warm，adjustment of sweet and bitter，tonifying qi and strengthening healthy qi，invigorating the kidney and promoting blood circulation，soothing the liver and regulating qi，dredging viscera and removing turbidity，invigorating spleen and removing dampness，which matches the theory of traditional Chinese medicine treatment.It can provide a reference for the treatment of chronic renal failure.

Key Words Data mining; Chronic renal failure; Chinese medicine prescription; Analysis of prescription of traditional Chinese medicine; Yi Wuyong; Follow-up visit

中圖分類號：R256.5文獻標識碼：Adoi：10.3969/j.issn.1673-7202.2019.06.054

慢性腎臟疾病越來越被認為是一個全球性的公共衛生問題，發病率逐年上升[1-2]。慢性腎功能衰竭（簡稱慢性腎衰竭）是一組由各種原發或繼發慢性腎臟病所導致的腎功能受損，不能維持機體內環境穩定而出現的一系列癥狀的臨床綜合征，多為不可逆性，終末期腎臟病只能進行腎臟替代治療或腎臟移植[3]，給家庭和社會造成巨大的經濟負擔。……