檀金川教授治疗膜性肾病的用药经验挖掘

Exploration of clinical experience of Professor TAN Jinchuan in the treatment of membranous nephropathy by data mining method

关键词:  膜性肾病  聚类分析  关联规则  数据挖掘  用药经验

Key words:  membranous nephropathy  cluster analysis  association rules  data mining  medication experience

摘要:

挖掘檀金川教授治疗膜性肾病的用药经验，总结其用药特点及规律。收集檀金川教授治疗膜性肾病的门诊病历，使用EpiData 3.1软件包进行数据录入，使用Excel 2013、SPSS 19.0和R 3.5软件包对纳入病历中的中药方进行统计分析及数据挖掘。最终纳入中药方353首，其中涉及中药163味，出现总频次为5273次。最常使用的中药为黄芪、川芎、当归、茯苓和青风藤，其中黄芪为核心药物。味甘、性温、归肝经的药物最多。补虚药和活血化瘀药使用较多。此外，挖掘檀教授最常用的药对和组方搭配。总结膜性肾病以脾肾两虚为本，水湿、湿热、瘀血为标，治宜健脾益肾、化瘀通络，攻补兼施。针对膜性肾病的病机特点，辩证求因，治病求本，重用黄芪，善用虫药，灵活组方，以提高临床疗效，延缓疾病进展为目的。

Abstract:

To explore Professor TAN Jinchuan's experience in the treatment of membranous nephropathy and summarize its characteristics and rules. The outpatient medical records of treating membranous nephropathy of Professor TAN Jinchuan were collected,the data were input with EpiData 3.1 software package,and the statistical analysis and data mining of traditional Chinese medicine prescriptions included in the medical records were carried out with Excel 2013,SPSS 19.0 and R 3.5 software package. 353 prescriptions of traditional Chinese medicine were finally included,among which 163 were involved,with a total frequency of 5 273. The most commonly used traditional Chinese medicines are Astragali Radix,Chuanxiong Rhizoma,Angelicae Sinensis Radix,Poria,Sinomenii Caulis,of which Astragali Radix is the core drug. The drugs with sweet taste,warm nature and liver meridian tropism are the most. Tonic drugs and promoting blood circulation to remove blood stasis are widely used. In addition,the most commonly used drug pairs and combinations are excavated. It is suggested that the treatment of membranous nephropathy should be based on the deficiency of both spleen and kidney,water dampness,heat dampness and blood stasis. According to the characteristics of pathogenesis of membranous nephropathy,we should dialectically seek the cause,treat the disease and seek the root,reuse astragalus,make good use of insect drugs,and flexibly form prescriptions,so as to improve the clinical efficacy and delay the progress of the disease.