[1]张杰,丁权威,张玉柱,等.基于数据挖掘法探讨张玉柱教授治疗神经根型颈椎病的辨证用药规律[J].中医正骨,2021,33(11):41-44.
　ZHANG Jie,DING Quanwei,ZHANG Yuzhu,et al.Clinical medication rules of Professor ZHANG Yuzhu in treatment of nerve-root type cervical spondylosis based on syndrome differentiation principles:a data mining-based study[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2021,33(11):41-44.
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基于数据挖掘法探讨张玉柱教授治疗神经根型颈椎病的辨证用药规律()
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《中医正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第33卷
期数:
2021年11期
页码:
41-44
栏目:
调查研究
出版日期:
2021-11-20

文章信息/Info

Title:
Clinical medication rules of Professor ZHANG Yuzhu in treatment of nerve-root type cervical spondylosis based on syndrome differentiation principles:a data mining-based study
作者:
张杰1; 丁权威1; 张玉柱1; 王人彦2
(1.杭州市富阳中医骨伤医院,浙江 杭州 311400; 2.浙江骨伤医院,浙江 杭州 310015)
Author(s):
ZHANG Jie1; DING Quanwei1; ZHANG Yuzhu1; WANG Renyan2
1.Fuyang TCM Orthopedic-Traumatological Hospital,Hangzhou 311400,Zhejiang,China2.Zhejiang Orthopaedics Hospital,Hangzhou 310015,Zhejiang,China
关键词:
颈椎病;  中药疗法;  方剂分析; 计算机辅助;  数据挖掘
Keywords:
cervical spondylosis;  drug therapy(TCD);  formula anal; comput assist;  data mining
摘要:
目的:探讨张玉柱教授治疗神经根型颈椎病的用药规律。方法:收集2018年6月至2020年12月在张玉柱教授诊室就诊的神经根型颈椎病患者的病例资料,提取患者的诊断信息(包括症状、诊断和中医证型)、处方信息(包括方剂组成、药物剂量)。对原始数据进行规范化处理后,建立药-方-证数据库。采用Clementine12.0软件进行数据挖掘,统计分析处方中药物出现的频次,采用关联规则分析方剂中的组方规律,采用因子分析预测可能的新方组合。结果:①用药频次分析结果。共纳入1000首方剂,使用频次≥116的中药共25味,其中使用频次居于前10位的药物依次为当归、川芎、葛根、地龙、片姜黄、黄芪、炒白芍、豨莶草、羌活、泽兰。②组方规律分析结果。对所有药物进行关联规则分析,共得到15个核心药物组方,分别为当归-地龙-川芎、当归-地龙-川芎-红花、当归-地龙、川芎-地龙-红花、当归-地龙-红花、当归-川芎、红花-葛根-川芎、当归-川芎-红花、红花-葛根-川芎-当归、当归-红花、当归-葛根-川芎、川芎-地龙、当归-葛根、当归-葛根-红花、红花-地龙。③新方预测结果。通过因子分析,共得到5种证型基础方,分别为枸杞子-狗脊-片姜黄-羌活-泽兰-菊花-炒白芍-炒杜仲-天麻-葛根-石斛、淫羊藿-丹参-川芎-豨莶草-水蛭、黄芪-制川乌-桂枝-僵蚕-当归-夏枯草-地龙、桂枝-僵蚕-豨莶草-水蛭-地龙-制川乌、威灵仙-羌活-防风-葛根。结论:张玉柱教授治疗神经根型颈椎病的用药特点为补行兼施、通经活络,常用药物包括补血活血药、活血通络药、补血通络药、补血活血通络药4类。
Abstract:
Objective:To explore the clinical medication rules of Professor ZHANG Yuzhu in treatment of nerve-root type cervical spondylosis(NT-CS).Methods:The medical records of NT-CS patients who were diagnosed and treated by Professor ZHANG Yuzhu from June 2018 to December 2020 were collected,and the diagnostic information(including symptoms,diagnosis and TCM syndrome types)and prescription information(including prescription ingredients and dosages)were extracted and were normalized for building a herb-prescription-syndrome database.The data mining was conducted by using Clementine12.0 software,followed by statistics and analysis on the occurrence frequency of Chinese herbs in prescriptions.The prescription rules were analyzed based on association rules,and the new prescription combinations were predicted by using factor analysis.Results:①One thousand prescriptions were included in the final analysis,among which 25 herbs displayed a usage frequency of≥116,and the top 10 ones with high usage frequency included Angelica sinensis,Chuanxiong Rhizoma,Puerariae Lobamle Radix,Pheretima,Wenyujin Rhizoma Concisum,Astragalus propinquus,parched Paeoniae Radix Alba,Siegesbeckiae Herba,Notopterygii Rhizoma et Radix and Lycopi Herba in turn.②The association rule analysis on all the included herbs generated 15 core herb combinations,namely Angelica sinensis-Pheretima-Chuanxiong Rhizoma,Angelica sinensis-Pheretima-Chuanxiong Rhizoma-Carthamus tinctorius,Angelica sinensis-Pheretima,Chuanxiong Rhizoma-Pheretima-Carthamus tinctorius,Angelica sinensis-Pheretima-Carthamus tinctorius,Angelica sinensis-Chuanxiong Rhizoma,Carthamus tinctorius-Puerariae Lobamle Radix-Chuanxiong Rhizoma,Angelica sinensis-Chuanxiong Rhizoma-Carthamus tinctorius,Carthamus tinctorius-Puerariae Lobamle Radix-Chuanxiong Rhizoma-Angelica sinensis,Angelica sinensis-Carthamus tinctorius,Angelica sinensis-Puerariae Lobamle Radix-Chuanxiong Rhizoma, Chuanxiong Rhizoma-Pheretima,Angelica sinensis-Puerariae Lobamle Radix,Angelica sinensis-Puerariae Lobamle Radix-Carthamus tinctorius and Carthamus tinctorius-Pheretima.③Five new basic prescriptions were dug out through factor analysis,namely Lycii Fructus-Cibotii Rhizoma-Wenyujin Rhizoma Concisum-Notopterygii Rhizoma et Radix-Lycopi Herba-Chrysanthemi Flos-parched Paeoniae Radix Alba-parched Eucommiae Cortex-Gastrodiae Rhizoma-Puerariae Lobamle Radix-Dendrobii Caulis,Epimedii Folium-Salvia miltiorrhiza-Chuanxiong Rhizoma-Siegesbeckiae Herba-Leeches,Astragalus propinquus-Aconiti Radix Cocta-Cmnamomi Mmulus-Bombyx Batryticatus-Angelica sinensis-Prunellae Spica-Pheretima,Cmnamomi Mmulus-Bombyx Batryticatus-Siegesbeckiae Herba-Leeches-Pheretima-Aconiti Radix Cocta and Clematidis Radix et Rhizoma-Notopterygii Rhizoma et Radix-Saposhnikoviae Radix-Puerariae Lobamle Radix.Conclusion:Professor ZHANG Yuzhu mainly focuses on combinat reinforcing-promoting as well as unblocking meridian and activating collaterals in treatment of NT-CS,and his commonly used herbs include the ones for nourishing and activating blood,activating blood and dredging collaterals,nourishing blood and dredging collaterals as well as nourishing blood,activating blood and dredging collaterals.

参考文献/References:

[1] 李建垒,宋永伟.神经根型颈椎病的中西医治疗概况[J].中国医药导刊,2020,22(6):381-384.
[2] 孙奇,杨力,王人彦,等.基于数据挖掘的张玉柱治疗老年退行性腰痛的用药规律的研究[J].中华中医药学刊,2016,34(2):277-279.
[3] TZENG Y S,CHEN S G,CHEN T M.Herniation of the cervical disk in plastic surgeons[J].Ann Plast Surg,2012,69(6):672-674.
[4] XIONG W,LI F,GUAN H.Tetraplegia after thyroidectomy in a patient with cervical spondylosis:a case report and literature review[J].Medicine(Baltimore),2015,94(6):e524.
[5] INOUE S,MORIYAMA T,TACHIBANA T,et al.Risk factors for intraoperative lateral mass fracture of lateral mass screw fixation in the subaxial cervical spine[J].J Neurosurg Spine,2014,20(1):11-17.
[6] 曾庆.神经根型颈椎病的中医药治疗近况[J].中医临床研究,2017,9(16):132-133.
[7] 张宏翔,付小勇.高效用挖掘算法在处方数据中的应用[J].信息与电脑,2017(18):39-41.
[8] 王东,王益民,张伯礼.方剂“组方配伍网络”分析方法研究—以名老中医门诊处方数据为例[J].天津中医药大学学报,2019,38(1):1-5.
[9] 白扬,林江,任素剑,等.数据挖掘在方剂学研究中的应用与发展[J].山东中医药大学学报,2019,43(1):24-27.
[10] 毛卓鹏,刘红宁,熊延熙,等.数据挖掘在方剂配伍规律研究中的应用述评[J].江西中医药大学学报,2017,29(6):118-121.
[11] 白扬,林江,任素剑,等.数据挖掘在方剂研究中的应用与发展[J].山东中医药大学学报,2019,43(1):24-27.
[12] 蒋志滨.基于数据挖掘的方剂配伍规律研究方法探讨[D].南京:南京中医药大学,2015.
[13] 班圆圆,彭欣.数据挖掘技术在方剂学研究中的应用进展[J].山东中医杂志,2016,35(11):1002-1004.
[14] 毛卓鹏,刘红宁,熊延熙,等.数据挖掘在方剂配伍规律研究中的应用评述[J].江西中医药大学学报,2017,29(6):118-121.
[15] 雷金星.基于大数据下的空间数据挖掘分析[J].内蒙古科技与经济,2016,20(3):156-158.
[16] 曹毅,季聪华.临床科研设计与分析[M].杭州:浙江科学技术出版社,2015:189.
[17] 吴磊,李舒.中医方剂数据库文本挖掘数据预处理的尝试[J].中国中医药图书情报杂志,2015,39(3):8-11.
[18] 郝怀宇,闫立民,王守利,等.观察分析神经根型颈椎病手术治疗的临床疗效[J].系统医学,2017,2(9):45-47.
[19] 孟光强.神经根型颈椎病手术治疗的疗效观察[J].临床医药文献电子杂志,2019,6(31):43.
[20] 胥少汀,葛宝丰,卢世璧.实用骨科学:第4版修订本[M].北京:人民军医出版社,2019:1974.
[21] 罗芳.神经根型颈椎病的诊断研究进展[J].癫痫与神经电生理学杂志,2017,26(2):113-115.
[22] 中华医学会.临床诊疗指南:骨科分册[M].北京:人民卫生出版社,2009:87.
[23] 钟赣生.中药学[M].北京:中国中医药出版社,2013.
[24] 国家中医药管理局.中医病证诊断疗效标准[M].南京:南京大学出版社,1994:189.
[25] 季聪华,曹毅,张颖,等.基于SPSS Clementine 软件的关联规则算法的应用[J].中医药管理杂志,2014,22(1):31-33.
[26] 徐雪琪.数据挖掘方法与应用[M].北京:清华大学出版社,2020:22.
[27] 郭曙光,李晓艳,张中青.肢体经络病证的特征与通经活络法[J].中国民族民间医药,2010,19(2):54-55.

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备注/Memo

备注/Memo:
基金项目:全国名老中医药专家传承工作室建设项目(国中医药人教发〔2013〕47号)
通讯作者:张杰 E-mail:784724528@qq.com
更新日期/Last Update: 1900-01-01