基于數據挖掘探討治療失眠的處方規律

[摘要] 目的 通過數據挖掘技術分析吳子輝治療失眠的用藥規律。方法 整理2020年6月至2024年3月廣西中醫藥大學附屬國際壯醫醫院吳子輝門診收治并診斷為失眠的131份醫案，運用古今醫案云平臺V2.3.9對錄入醫案數據標準化處理后分別對處方藥物進行統計分析，采用聚類分析及復雜網絡分析總結處方用藥經驗及組方規律。結果 131份醫案共涉及143味中藥，歸納出藥性以寒、平為主，藥味以甘、苦為主，歸經以肝、心二經為主及高頻藥物為白芍、白術、女貞子等；聚類分析得出5個聚類處方；中藥證型及藥物進行復雜網絡分析得出失眠實證的兩個核心中藥處方。結論 在治療失眠時注重心、肝、脾、腎的治療，應以疏肝解郁、清熱瀉火、養心安神并兼以補益脾腎為治療原則。

[關鍵詞] 失眠；處方規律；數據挖掘

[中圖分類號] R256.23" """"[文獻標識碼] A """""[DOI] 10.3969/j.issn.1673-9701.2025.20.012

Based on data mining to explore the prescription rules for treating insomnia

LING Zhenwei， WU Zihui， LU Lintao， KE Liang， YUAN Fang， WANG Kaihua

Department of Neurology， International Zhuang Medicine Hospital Affiliated to Guangxi University of Chinese Medicine， Nanning 530201， Guangxi， China

[Abstract] Objective To analyze Wu Zihui’s medication rules for treating insomnia through data mining technology. Methods A total of 131 medical cases diagnosed with insomnia and admitted to the Outpatient Department of Wu Zihui at the International Zhuang Medicine Hospital Affiliated to Guangxi University of Chinese Medicine from June 2020 to March 2024 were sorted out. After standardizing the entered medical case data using the Gujin Medical Case Cloud Platform V2.3.9， statistical analysis， cluster analysis and complex network analysis of the prescription drugs were conducted respectively to summarize the experience of prescription drug use and the rules of formula composition. Results A total of 131 medical cases involved 143 traditional Chinese medicines. It was concluded that the properties were mainly cold and neutral， the flavors were mainly sweet and bitter， the meridians were mainly liver and heart meridians， and high-frequency drugs， Baishao Baizhu， Nyuzhenzi etc. Cluster analysis yielded 5 clustering prescriptions. Complex network analysis of traditional Chinese medicine syndrome types and drugs can result in two core traditional Chinese medicine prescriptions for insomnia syndrome. Conclusion In the treatment of insomnia， attention should be paid to the treatment of heart， liver， spleen and kidney. The treatment principle should be to relieve liver depression， clear heat and purge fire， nourish heart and calm the mind， and supplement spleen and kidney.

[Key words] Insomnia; Prescription rules; Data mining

失眠主要表現為入睡困難、睡眠維持障礙、早醒、睡眠質量下降和總睡眠時間減少，癥狀每周至少出現3次，且伴有日間功能障礙或日間的痛苦體驗^[1]。失眠患病率高，常在女性、老年人中多見^[2]。失眠持續5年概率為40%，失眠與焦慮障礙、精神障礙等心理問題顯著相關，可導致身體患病率增高，如高血壓、糖尿病在失眠癥患者中比無失眠患者更常見^[3]。研究表明失眠易誘發心血管事件如急性心肌梗死和冠心病等^[4]。目前西醫藥物治療失眠易產生認知功能損害、藥物依賴及停藥反跳等不良反應^[5]。中醫治療失眠安全性高，無依賴性，效果顯著，能產生持久的收益?！?br>