基于“肾络癥瘕”理论探讨王耀献教授治疗慢性肾衰竭的用药规律(1)
摘要 目的：总结基于“肾络癥瘕”理论探讨王耀献教授治疗慢性肾衰竭的用药规律及其学术经验。方法：选取2013年12月至2017年12月王耀献教授于北京中医药大学东直门医院门诊诊治慢性肾衰竭患者共270例，选取其首诊处方共270首。通过关联规则及复杂熵聚类等方法分析其用药规律及组方特点。结果：本研究共纳入处方270首，涉及药物184种;通过关联规则挖掘方法，将支持度设置为“81”，置信度为“0.8”，共得到常用药物组合114个。选择相关系数为8，惩罚系数为2，通过无监督的熵层次聚类算法，通过演化及进一步聚类，获得10个新处方。寒性药、温性药、平性药应用最多，热性药最少。应用味甘者次数最多，味苦、味辛、味咸、味酸者次之，味涩者最少。归肝经者最多，归脾经、肾经次之，其次分别为归胃、肺、心、胆、大肠、小肠、膀胱、心包、三焦等经者。结论：通过数据挖掘方法客观总结了王耀献教授以“肾络癥瘕理论”为核心，治疗多样化、个体化的用药特点。
关键词 肾络癥瘕;中医传承辅助平台; @ 王耀献;慢性肾衰竭;治疗经验;用药规律;关联规则;网络可视化
Abstract Objective：To study the medication rules of professor WANG Yaoxian for chronic renal failure(CRF)based on the theory of miniature mass of renal collateral and to summarize the academic experience.Methods：A total of 270 first prescription by Prof.WANG Yaoxian for treating chronic renal failure were collected.The association rules，complex entropy clustering and other methods were used to analyze the medication rules and the characteristics of the prescriptions.Results：1)A total of 270 prescriptions were included，involving 184 drugs; 2)Through association rule mining，the support was set to“81”and the confidence was“0.8”.A total of 114 commonly used drug combinations were obtained.3)Choose a correlation coefficient of 8 and a penalty coefficient of 2.Through unsupervised entropy hierarchical clustering algorithm，through evolution and further clustering，10 new prescriptions are obtained.4)In terms of four qi，cold medicine，warm medicine and calm medicine are most used，and heat medicine is the least.5)In terms of the five flavors are concerned，those who use sweetness are the most frequently used，followed by bitter，bitter，salty，and sour，and those with astringent least.6)In terms of menstruation，the hepatic meridian is the most，followed by the spleen meridian and the kidney meridian，followed by the stomach，lung，heart，gallbladder，large intestine，small intestine，bladder，pericardium，and Sanjiao etc.Conclusion：The data mining method is used to objectively summarize the characteristics of Professor Wang Yaoxian′s treatment of diversified and individualized medication with“miniature mass of renal collateral”as the core.
Keywords Miniature mass of renal collateral; TCM inheritance auxiliary platform; @ WANG Yaoxian; Chronic renal failure; Treatment experience; Laws of medication; Association rules; Visualization of network
中圖分类号：R249文献标识码：Adoi：10.3969/j.issn.1673-7202.2020.17.013
慢性肾衰竭是各种慢性肾脏病引起的肾功能损害及与此相关的代谢紊乱和临床症状组成的综合征，属中医学“关格”“水肿”“癃闭”“虚劳”“溺毒”等范畴，其病往往累及多个脏腑，迁延日久，病症繁杂，多属本虚标实[1-3]。王耀献教授积累多年肾脏病诊疗经验，提出肾络癥瘕理论为慢性肾脏病的核心病机，临床疗效卓著。我们整理王耀献教授治疗慢性肾衰竭首诊方共270首，运用中医传承辅助平台[4-5](V2.5)，分析其组方用药规律，以期为中医临床治疗慢性肾衰竭提供参考与思路。, 百拇医药(刘梦超 王明哲 肖遥 王梦迪 沈存 赵文景)
关键词 肾络癥瘕;中医传承辅助平台; @ 王耀献;慢性肾衰竭;治疗经验;用药规律;关联规则;网络可视化
Abstract Objective：To study the medication rules of professor WANG Yaoxian for chronic renal failure(CRF)based on the theory of miniature mass of renal collateral and to summarize the academic experience.Methods：A total of 270 first prescription by Prof.WANG Yaoxian for treating chronic renal failure were collected.The association rules，complex entropy clustering and other methods were used to analyze the medication rules and the characteristics of the prescriptions.Results：1)A total of 270 prescriptions were included，involving 184 drugs; 2)Through association rule mining，the support was set to“81”and the confidence was“0.8”.A total of 114 commonly used drug combinations were obtained.3)Choose a correlation coefficient of 8 and a penalty coefficient of 2.Through unsupervised entropy hierarchical clustering algorithm，through evolution and further clustering，10 new prescriptions are obtained.4)In terms of four qi，cold medicine，warm medicine and calm medicine are most used，and heat medicine is the least.5)In terms of the five flavors are concerned，those who use sweetness are the most frequently used，followed by bitter，bitter，salty，and sour，and those with astringent least.6)In terms of menstruation，the hepatic meridian is the most，followed by the spleen meridian and the kidney meridian，followed by the stomach，lung，heart，gallbladder，large intestine，small intestine，bladder，pericardium，and Sanjiao etc.Conclusion：The data mining method is used to objectively summarize the characteristics of Professor Wang Yaoxian′s treatment of diversified and individualized medication with“miniature mass of renal collateral”as the core.
Keywords Miniature mass of renal collateral; TCM inheritance auxiliary platform; @ WANG Yaoxian; Chronic renal failure; Treatment experience; Laws of medication; Association rules; Visualization of network
中圖分类号：R249文献标识码：Adoi：10.3969/j.issn.1673-7202.2020.17.013
慢性肾衰竭是各种慢性肾脏病引起的肾功能损害及与此相关的代谢紊乱和临床症状组成的综合征，属中医学“关格”“水肿”“癃闭”“虚劳”“溺毒”等范畴，其病往往累及多个脏腑，迁延日久，病症繁杂，多属本虚标实[1-3]。王耀献教授积累多年肾脏病诊疗经验，提出肾络癥瘕理论为慢性肾脏病的核心病机，临床疗效卓著。我们整理王耀献教授治疗慢性肾衰竭首诊方共270首，运用中医传承辅助平台[4-5](V2.5)，分析其组方用药规律，以期为中医临床治疗慢性肾衰竭提供参考与思路。, 百拇医药(刘梦超 王明哲 肖遥 王梦迪 沈存 赵文景)