基于中医古籍数据挖掘探讨胃食管反流病的用药规律及有毒中药的应用

于佳佳; 刘梦; 王晓强; 仇莎; 张云杰

doi:10.16766/j.cnki.issn.1674-4152.003892

基于中医古籍数据挖掘探讨胃食管反流病的用药规律及有毒中药的应用

doi: 10.16766/j.cnki.issn.1674-4152.003892

1.
康复大学青岛中心医院(青岛市中心医院)中医科，山东青岛 266042
2.
康复大学青岛中心医院(青岛市中心医院)医务科
3.
山东中医药大学附属医院胃肠与疝外科，山东济南 250011

基金项目:

山东省中医药科技项目 2021Z043

青岛市2020年度医药科研指导计划 2020-WJZD070

详细信息

通讯作者:
张云杰，E-mail: zhangyunjie1130@163.com

中图分类号: R571 R573 R2-5
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- 文章访问数: 6
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- PDF下载量: 1
- 被引次数: 0
出版历程
- 收稿日期: 2024-06-19
- 网络出版日期: 2025-03-27

Exploring the medication patterns of gastroesophageal reflux disease and the application of toxic traditional Chinese medicine using data mining of ancient Chinese medicine texts

1.
Department of Traditional Chinese Medicine, Qingdao Central Hospital, University of Health and Rehabilitation Sciences (Qingdao Central Hospital), Qingdao, Shandong 266042, China

摘要

摘要: 目的研究中医古籍治疗胃食管反流病的用药思路及配伍规律，探索中医古籍处方中有毒中药治疗胃食管反流病的应用情况。方法检索《中华医典》筛选出治疗胃食管反流病的古代中医方剂、医案。应用Excel建立数据库并进行药物频次、性味归经、药物功效等的统计分析，运用SPSS Modeler 18软件进行关联规则及复杂网络分析，运用SPSS 27.0统计学软件进行聚类分析。结果搜索文献13 211条，统计处方988份，中药315味，累计用药频次8 375次，频次在80次以上的药物共计28味，涉及有毒中药共计41味，含有毒中药的处方共计598首，占所有处方的60.53%。四气以温为主；五味以辛为主；药物归经以脾、胃为主，肺、心、肝次之；药物功效以补虚药最多，其次为理气药、温里药。关联规则得出5组药对、10组角药，其中陈皮、半夏、生姜、甘草、茯苓、白术、人参是古籍治疗胃食管反流病的核心药物。聚类分析得出6个新处方药组。结论古代医家治疗胃食管反流病用药以辛温为主，治疗方法以益气健脾温中为基础，病理因素上侧重理气畅中、化湿祛痰。疾病的后期、重症期在补虚的基础上，加强有毒中药的应用，以攻毒破积消癥。
- 胃食管反流病 /
- 古代文献 /
- 数据挖掘 /
- 用药规律 /
- 有毒中药
Abstract: Objective To investigate the medicinal concepts and compatibility principles in ancient Chinese medicine for treating gastroesophageal reflux disease, and to explore the application of toxic traditional Chinese medicine (TCM) in the treatment of gastroesophageal reflux disease based on ancient Chinese medicine prescriptions. Methods A total of 13 211 references were reviewed, and 988 prescriptions were selected, including 315 TCM flavors, with a cumulative usage frequency of 8 375. Twenty-eight drugs were used more than 80 times, with 41 drugs in total. Of these, 598 prescriptions containing toxic TCM were used, accounting for 60.53% of all prescriptions. The four qualities (Qi) are mainly warming. The five flavors (Wei) are mainly pungent. The spleen and stomach were the main channels targeted, followed by the lung, heart, and liver. the efficacy of the drugs was the highest in tonifying deficiency drugs, followed by qi-regulating drugs and warming interior drugs. According to the association rules, 5 pairs of medicines and 10 groups of corner medicines were identified, among which Chenpi, Banxia, ginger, licorice, Poria cocos, Atractylodes macrocephala, and ginseng are the core medicines in ancient texts to treat gastroesophageal reflux disease. Cluster analysis identified 6 new drug groups in prescriptions. Conclusion In ancient times, doctors primarily used warming and pungent medications for treating gastroesophageal reflux disease, focusing on tonifying qi, strengthening spleen, and warming the middle. Treatment targeted regulating qi, promoting qi circulation, and eliminating dampness and phlegm. In the later stages of the disease, alongside tonifying deficiency, the application of traditional Chinese medicines for attacking toxins, breaking up accumulation, and eliminating toxic tumors was emphasized.
- Gastroesophageal reflux disease /
- Ancient documents /
- Data mining /
- Medication regularity /
- Toxic traditional Chinese medicine

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图 1 关联规则网络图

Figure 1. Association rule network diagram

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图 2 药物聚类分析谱系图

Figure 2. Cluster analysis dendrogram

下载: 全尺寸图片幻灯片

表 1 古籍治疗胃食管反流病高频用药统计

Table 1. Statistical analysis of high-frequency medication usage for the treatment of gastroesophageal reflux disease in ancient books

排序	中药	频次(次)	频率(%)	排序	中药	频次(次)	频率(%)
1	陈皮	470	5.61	15	香附	133	1.59
2	生姜	399	4.76	16	吴茱萸	129	1.54
3	甘草	395	4.72	17	青皮	128	1.53
4	半夏	378	4.51	18	干姜	125	1.49
5	茯苓	354	4.23	19	当归	113	1.35
6	白术	261	3.12	20	炮姜	113	1.35
7	人参	249	2.97	21	槟榔	112	1.34
8	木香	196	2.34	22	白芍	110	1.31
9	黄连	179	2.14	23	枳壳	97	1.16
10	丁香	166	1.98	24	附子	97	1.16
11	厚朴	160	1.91	25	大枣	96	1.15
12	神曲	148	1.77	26	白豆蔻	95	1.13
13	肉桂	147	1.76	27	苍术	86	1.03
14	砂仁	145	1.73	28	枳实	84	1.00

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表 2 古籍治疗胃食管反流病的高频有毒中药统计

Table 2. Statistics of high frequency toxic traditional Chinese medicine in the treatment of gastroesophageal reflux disease in ancient books

排序	中药	频次(次)	频率(%)	排序	中药	频次(次)	频率(%)
1	半夏	378	4.51	6	牵牛子	28	0.33
2	吴茱萸	129	1.54	7	川楝子	24	0.29
3	附子	97	1.16	8	朱砂	24	0.29
4	巴豆	42	0.50	9	硇砂	24	0.29
5	杏仁	39	0.47	10	天南星	22	0.27

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表 3 二阶药物关联表

Table 3. Second-order drug correlation table

序号	后项	前项	实例	支持度 (%)	置信度 (%)	增益
1	陈皮	厚朴	154	15.59	71.43	1.49
2	陈皮	神曲	140	14.17	72.14	1.50
3	陈皮	砂仁	136	13.77	74.26	1.55
4	陈皮	青皮	122	12.35	72.13	1.50
5	生姜	大枣	101	10.22	79.21	1.86

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表 4 三阶药物关联表

Table 4. Third-order drug correlation table

序号	后项	前项	实例	支持度 (%)	置信度 (%)	增益
1	陈皮	半夏-茯苓	208	21.05	76.92	1.60
2	陈皮	甘草-茯苓	167	16.90	79.04	1.65
3	陈皮	甘草-半夏	162	16.40	76.54	1.60
4	陈皮	白术-茯苓	160	16.19	70.63	1.47
5	陈皮	甘草-生姜	156	15.79	73.08	1.52
6	茯苓	白术-甘草	136	13.77	70.59	2.03
7	陈皮	白术-甘草	136	13.77	77.94	1.62
8	白术	人参-茯苓	119	12.04	71.43	2.67
9	茯苓	白术-半夏	106	10.73	74.53	2.15
10	陈皮	白术-半夏	106	10.73	81.13	1.69

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表 5 高频药物聚类分析药组

Table 5. High-frequency drug groups from cluster analysis

药组	药物
C1	木香、青皮、槟榔、丁香、白豆蔻、砂仁、肉桂、炮姜
C2	枳壳
C3	黄连、枳壳、神曲、苍术、香附
C4	生姜、大枣、厚朴、白术、人参、半夏、茯苓、陈皮、甘草
C5	当归、白芍
C6	干姜、附子、吴茱萸

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