1175份病历的孤独症谱系障碍处方规律及核心中药的数据挖掘研究

Research on prescription patterns of autism spectrum disorders based on 1 175 medical records and data mining of core traditional Chinese medicine

关键词:  孤独症谱系障碍  用药规律  数据挖掘  层次聚类  Phi相关系数

Key words:  autism spectrum disorders  medicine rule  data mining  hierarchical clustering  phi correlation coefficient

摘要:

目的 通过对临床实际诊疗孤独症谱系障碍（ASD）患者的病历资料进行数据挖掘分析其中药治疗的组方用药规律，为临床方案的优化提供参考。方法 对1 175份ASD患者病历中中药处方的数据进行提取，采用Microsoft Excel 2019建立中药组方数据表，利用R语言（4.3.3版本）、SPSS Modeler 18.0及Cytoscape对其进行关联规则分析和聚类分析及核心处方的可视化。结果 共收集4 724剂中药，共计用药频数66 381次。所有患者中药处方中共包含283味中药，其中高频使用药物（≥700次）28味，最常用的药物为：远志、白术、石菖蒲、陈皮、炙甘草；药性多属温、寒；常使用的药物为补虚药及清热药；药味多甘、苦，归经以脾、心经为主；常见药对包括“石菖蒲-远志”、“白术-远志”；常用角药组合包括“白术-远志-石菖蒲”；聚类分析结果可将中药治疗ASD的高频中药分为5类。第1类：甘草、枳实、半夏、陈皮；第2类：龙骨、牡蛎、白芍、柴胡、桂枝、黄芩；第3类：五味子、茯神、酸枣仁、石菖蒲、远志、熟地黄、益智、炙甘草；第4类：太子参、麦冬、生地黄；第5类：当归、白术、黄芪、六神曲、党参、茯苓、山药。结论 中药复方治疗ASD多以补虚药为主，多从脾经、心经入手，其核心中药为“石菖蒲-远志-陈皮-白术-炙甘草-茯苓”，治疗以健脾益气，化痰开窍为主，可为ASD临床中医药治疗提供参考。

Abstract:

Objective To explore and analyze the medication patterns of traditional Chinese medicine treatment for patients with autism spectrum disorder(ASD) through data mining and analysis of their medical records, in order to provide reference for optimizing clinical plans. Methods The data of traditional Chinese medicine prescriptions from 1 175 ASD patient medical records were extracted and a traditional Chinese medicine formula data table was established using Microsoft Excel 2019. Association rule analysis, cluster analysis, and visualization of core prescriptions were performed using R 4.3.3, SPSS Modeler 18.0, and Cytoscape. Results A total of 4 724 pairs of traditional Chinese medicine were collected, with a total frequency of medication of 66 381 times. All patients Chinese medicine prescriptions contain a total of 283 traditional Chinese medicines, including 28 frequently used medicines(≥700 times). The most commonly used medicines are: Polygala, Atractylodes macrocephala, Acorus calamus, Chenpi, and roasted licorice; The medicinal properties are mostly warm and cold; The commonly used drugs are tonifying deficiency medicine and clearing heat medicine; The medicinal taste is sweet and bitter, with the spleen and heart meridians being the main meridians; Common medicinal pairs include "Acorus tatarinowii Yuanzhi" and "Atractylodes macrocephala Yuanzhi"; The commonly used combination of horn medicine includes "Atractylodes macrocephala, Polygala tenuifolia, and Acorus calamus"; The clustering analysis results can classify high-frequency traditional Chinese medicine for treating ASD into 5 categories. Category 1:Licorice, Fructus Aurantii, Pinellia ternata, and Chenpi; Category 2:Dragon bones, oysters, white peonies, Chaihu, Guizhi, and Huangqin; Category 3:Schisandra chinensis, Poria cocos, sour jujube kernels, Acorus calamus, Polygala, Rehmannia glutinosa, Yizhi, roasted licorice; Category 4:Pseudoginseng, Ophiopogon japonicus, and Rehmannia glutinosa; Category 5:Angelica sinensis, Atractylodes macrocephala, Astragalus membranaceus, Liu Shen Qu, Codonopsis pilosula, Poria cocos, and yam. Conclusion Traditional Chinese medicine compound therapy for ASD mainly focuses on tonifying deficiency, starting from the spleen and heart meridians. The core traditional Chinese medicine is "Shichangpu Yuanzhi Chenpi Baizhu Zhilicorice Poria cocos". The treatment mainly focuses on strengthening the spleen and tonifying qi, resolving phlegm and opening the orifices, which can provide reference for the clinical treatment of ASD with traditional Chinese medicine.