基于数据挖掘初探自身免疫性肝病中医证候特点及用药规律分析
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国家自然科学基金青年基金项目(81803874)——胆淤方通过PDC-E2调控丙酮酸代谢改善PBC胆管上皮细胞损伤的作用和机制


Traditional Chinese Medicine Symptoms Charateristics and Medication Regularity Analysis of Autoimmune Liver Disease Based on Data Mining
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    目的:回顾分析103例自身免疫性肝炎(AIH)、原发性胆汁性胆管炎(PBC)、原发性胆汁性胆管炎重叠自身免疫性肝炎(AIH/PBC OS)等3种自身免疫性肝病(AILD)的中医证候,并运用中医传承辅助平台(V2.5)对治疗有效的患者挖掘分析其用药规律。方法:选取2005年1月至2013年1月上海中医药大学附属曙光医院收治的AILD患者103例作为研究对象,其中有AIH 20例、PBC45例、AIH/PBC OS 38例,采用中药联合西药,持续治疗大于1年以上,评估患者中医证候特点、肝功能等,并运用频次统计、关联规则、基于熵聚类方法规律分析等方法对其中治疗有效的患者方药的规律及特点挖掘。结果:103例AILD患者的中医证候特点以肝脾肾亏虚最常见(脾气亏虚证和肝肾阴虚证),中医治疗以健脾补肝肾药为主;治疗后3组患者的间接胆红素、谷丙转氨酶、碱性磷酸酶和γ-谷氨酰转移酶较治疗前显著降低(P<0.01)。治疗后3组患者的症状总积分较治疗前显著下降(P<0.001),其中3组患者乏力、两目干涩、口干、胁肋疼痛、纳差、视物模糊、口苦症状较治疗前显著(P<0.05)。结论:肝脾肾亏虚是AILD最常见的病机,培土益肝肾法是AILD的有效中医治疗法则。

    Abstract:

    To conducted retrospective analysis on 103 cases of autoimmune hepatitis (AIH), primary biliary cholangitis (PBC), primary biliary cholangitis and overlapping autoimmune hepatitis (AIH/PBC OS) and other three autoimmune liver diseases (AILD ), and traditional Chinese medicine (TCM) inheritance auxiliary platform (V2.5) was used to find and analyze the medication rules of effective patients. Methods:A total of 103 AILD patients admitted to Shuguang Hospital of Shanghai University of Traditional Chinese Medicine from January 2005 to January 2013 were selected as the research objects, including 20 AIH, PBC45, and 38 AIH/PBC OS. Traditional Chinese medicine combined with Western medicine was used for continuous treatment. For the contious treatment of more than 1 year, the characteristics of TCM syndromes and liver function, etc. were evaluated, and frequency statistics, association rules, entropy-based clustering method law analysis and other methods were used to mine the laws and characteristics of the effective treatment of patients' prescriptions. Results:The characteristics of TCM syndromes in 103 patients with AILD were that the deficiency of liver, spleen and kidney was the most common (spleen-qi deficiency syndrome and liver-kidney yin deficiency syndrome). TCM treatment was mainly based on tonifying spleen and supplementing the liver and spleen. Red pigment, alanine aminotransferase, alkaline phosphatase and γ-glutamyltransferase were significantly lower than before treatment (P<0.01). After treatment, the total symptom score of the 3 groups of patients was significantly lower than that before treatment (P<0.001). Among them, the symptoms of fatigue, dry eyes, dry mouth, flank pain, anorexia, blurred vision, and bitter mouth in the 3 groups were decreased than those before treatment (P<0.05). Conclusion:Deficiency of liver, spleen and kidney is the most common pathogenesis of AILD, and the method of cultivating earth and benefiting the liver and spleen are AILD's effective TCM treatment rules.

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幸鹭,郝娟,邢枫,赵志敏,王静,陶艳艳,刘成海.基于数据挖掘初探自身免疫性肝病中医证候特点及用药规律分析[J].世界中医药,2020,(19).

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  • 收稿日期:2020-09-10
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  • 在线发布日期: 2020-10-23
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