基于数据挖掘“求同存异”探讨子宫内膜异位性疾病证治规律
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首都卫生发展科研专项项目(首发2018-1-4151)


Law of Patterns and Treatment of Endometriosis Disease Based on Data Mining for “Seeking Common Ground While Reserving Differences”
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    摘要:

    目的:基于古今医案云平台比较探讨现代医家论治子宫内膜异位性疾病的规律。方法:选取国家知识基础设施数据库(CNKI)、中国学术期刊数据库(CSPD)、中文科技期刊数据库(CCD)3个中文期刊数据库建库至2020年4月30日辨证论治子宫内膜异位症(EM)、子宫腺肌病(AM)文献,对其证型、处方进行收集、筛选,建立并规范数据库。使用古今医案云平台对中医证型进行频次统计,对中药处方进行频次、性味归经、关联规则、聚类分析、复杂网络分析的挖掘。结果:1)中医证型:气滞血瘀型为子宫内膜异位症(EM)最常见证型,子宫腺肌病(Adenomyosis,AM)以寒凝血瘀、肾虚血瘀型最常见。2)用药规律:治疗EM的高频药物是当归、川芎、赤芍等,治疗AM的高频药物是延胡索、茯苓、赤芍等;二者用药皆以温性、平性和微寒药常见,归经均主归肝、脾、肾、心经。EM以苦味药为主,AM以甘、苦、辛味为主。EM常见药对为当归配川芎等,AM是桂枝配茯苓等。核心处方都是以桂枝茯苓丸合三棱丸为基础加减:EM配伍当归、川芎等理气活血药,AM多加黄芪等补益之品。结论:当代医家论治子宫内膜异位性疾病立足于活血化瘀,在此基础上各有侧重。治疗EM以理气化瘀为法,多用行气活血之品,重视情志。治疗AM在活血消癥的基础上,重视止血补虚,多配伍补肾益气,化瘀止血之品。

    Abstract:

    To explore the treatment laws of endometriosis disease treated by contemporary doctors based on the Ancient and Modern medical Case Cloud Platform.Methods:The papers on the syndrome differentiation and treatment of endometriosis(EM) and adenomyosis(AM) were collected from China National Knowledge Infrastructure(CNKI),China Science Periodical Database(CSPD),and Chinese Citation Database(CCD) from the establishment of the database to April 30,2020.The Syndrome types and prescriptions of traditional Chinese medicine(TCM) were collected and screened out to establish and standardize the database.The Ancient and Modern medical Case Cloud Platform was used to carry out frequency statistics of TCM syndrome types.The frequency,nature-flavor meridian,association rules,cluster analysis,and complex network analysis of TCM prescriptions were mined.Results:1)TCM syndrome types:Qi stagnation and blood stasis type was the most common type of EM,and cold coagulation and blood stasis type and kidney deficiency and blood stasis type were the most common in AM. 2)Medication rules:The high-frequency drugs for EM were Angelicae Sinensis Radix,Chuanxiong Rhizoma,Paeoniae Radix Rubra,etc.,and the high-frequency drugs for AM were Corydalis Rhizoma,Poria,Paeoniae Radix Rubra,etc.The properties of both drugs for EM and AM were warm,mild,and mildly cold,and meridian tropism was mainly distributed in the liver,spleen,kidney,and heart meridian.The drugs for EM were mainly bitter in flavor,and those for AM were mainly sweet,bitter,and pungent in flavor.Angelicae Sinensis Radix-Chuanxiong Rhizoma was the commonly-used compatibility for the treatment of EM,and Cinnamomi Ramulus-Poria was the commonly-used compatibility for AM.The core prescriptions were all based on the modification of Guizhi Fuling Pillls and Sanling Pills.Angelicae Sinensis Radix,Chuanxiong Rhizoma,and other qi-regulating and blood-activating drugs were commonly combined to treat EM,and Astragali Radix and other tonifying products were mainly added to treat AM.Conclusion:The treatment of endometriosis disease by contemporary doctors is based on promoting blood circulation and removing blood stasis with different emphases.The treatment of EM is mainly based on regulating qi and removing blood stasis,paying attention to emotional factors,and using qi-promoting and blood-activating drugs.Based on activating blood and resolving mass,the treatment of AM pays attention to hemostasis and tonic deficiency and should be compatible with drugs for tonifying kidney and qi and removing blood stasis and hemostasis.

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孙文杰,侯睿捷,孙伟伟,赵瑞华.基于数据挖掘“求同存异”探讨子宫内膜异位性疾病证治规律[J].世界中医药,2022,(19).

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  • 收稿日期:2020-09-09
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  • 在线发布日期: 2022-11-14
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