摘要
目的:慢性阻塞性肺疾病(Chronic Obstructive Pulmonary Disease,COPD)合并肺动脉高压是严重影响患者生活质量的常见并发症。本研究旨在运用现代数据挖掘技术,系统分析中医复方治疗该病的组方用药规律,揭示其核心药物组合及配伍特点,为临床精准选方用药提供科学依据和理论指导。方法:通过系统检索2000年1月-2023年12月收录于中国知网、维普中文期刊服务平台及万方数据知识服务平台的相关文献,严格筛选出符合标准(中药复方治疗COPD合并肺动脉高压的临床随机对照试验)的处方数据。最终纳入71首有效方剂。利用WPS进行数据整理,并综合运用R语言、SPSS Modeler 18.0及SPSS Statistics 26.0等软件,对纳入方剂中的中药进行多维分析,包括药物使用频次统计、四气五味及归经分布分析、基于关联规则的常用药对挖掘(设置支持度≥15%,置信度≥80%,1≤前项数≤2,提升度≥1.0)、复杂网络分析以识别核心药物群,系统聚类分析探索药物组合模式,及基于主成分因子分析和Bartlett球形检验的高频药物降维与因子结构探索(含因子分析图与碎石图)。结果:共涉及108味中药,累计用药频次达568。频次分析显示,使用频率最高的前5味中药依次为丹参、川芎、黄芪、甘草、当归。关联规则分析在设定阈值下共挖掘出29项强关联组合,其中置信度最高的前3组常用药物组合为丹参-葶苈子、黄芪-茯苓、川芎-赤芍与黄芪,揭示了核心药物间的协同配伍关系。系统聚类分析将高频药物有效聚合成3个特征鲜明的药物组合群。主成分因子分析结合碎石图,进一步提取了反映方剂主要功效维度的公共因子,明确了高频药物的核心作用结构。结论:本研究通过数据挖掘技术系统揭示了中医复方治疗COPD合并肺动脉高压的组方规律。结果表明,该病的中医病机多属“本虚标实”,其核心治则为“标本兼治,扶正祛邪”。具体而言,组方以补气固本(如黄芪、甘草)为主,同时注重宣肺化痰(如葶苈子、茯苓)、活血散瘀(如丹参、川芎、当归、赤芍)以治标。高频药物、核心药对及聚类组合的分析结果,清晰印证了这一治疗理念,为临床针对COPD-肺动脉高压的复杂病机进行精准化、规范化的中药复方应用提供了重要的实证依据和方向性指导。
Objective:Chronic obstructive pulmonary disease(COPD)plus pulmonary arterial hypertension(PAH)is a commoncomplication that significantly affects the quality of life of patients.This study aims to employ modern data mining techniques to systematicallyanalyze the prescription patterns of traditional Chinese medicine(TCM)formulas for treating this disease,reveal the core drug combinationsand compatibility characteristics,and provide scientific basis and theoretical guidance for precise prescription selection and medication inclinical practice.Methods:Through systematic retrieval of relevant literature published from January 2000 to December 2023,which wereincluded in China National Knowledge Infrastructure(CNKI),VIP Chinese Journal Service Platform(CQVIP),and Wanfang Data KnowledgeService Platform(Wanfang database),we strictly screened prescription data that met the criteria(clinical randomized controlled trials of TCM compound therapy for COPD plus PAH).Finally,71 effective prescriptions were included.Data were organized using WPS.And Rlanguage,SPSS Modeler 18.0,and SPSS Statistics 26.0 were comprehensively utilized to conduct multi-dimensional analysis of the TCM inthe included prescriptions,including:statistics of drug usage frequency,drug natures(four Qi),five flavors,and meridian tropisms,miningof common couplet medicinals based on association rules(setting support≥15%,confidence≥80%,1≤number of previous items≤2,and improvement≥1.0),complex network analysis to identify core drug groups,systematic clustering analysis to explore drug combinationpatterns,and high-frequency drug dimension reduction and factor structure exploration based on principal component factor analysisand Bartlett's spherical test(including factor analysis diagrams and fragmentation diagrams).Results:The study involved a total of 108types of TCM,with a cumulative usage frequency of 568 times.The frequency analysis showed that the top 5 most frequently used TCMwere:Danshen(Radix et Rhizoma Salviae Miltiorrhizac),Chuanxiong(Rhizoma Ligustici Chuanxiong),Huangqi(Radix Astragali seuHedysari),Gancao(Radix et Rhizoma Glyeyrrhizae),and Danggui(Radix Angelicae Sinensis).The association rule analysis,under the setthreshold,identified 29 strong association combinations.Among them,the top 3 most frequently used couplet medicinals were:Danshen-Tinglizi(Semen Descurainiae),Huangqi-Fuling(Poria),and Chuanxiong-Chishao(Radix Paeoniae Rubra),revealing the synergisticcompatibility relationships among the core drugs.The system clustering analysis successfully grouped the frequently used drugs into 3distinct drug combination groups each with distinct characteristics.Principal component factor analysis combined with the Scatter Plotfurther extracted the common factors reflecting the main efficacy dimensions of the prescriptions,clarifying their core action structure ofthe frequently used drugs.Conclusion:This study systematically revealed the prescription patterns of TCM formulas for treating COPDplus PAH through data mining techniques.The results showed that the pathogenesis of this disease mostly belongs to"deficiency of theroot and excess of the manifestation",and its core treatment principle is to"treating both the symptoms and the root cause,reinforcing thebody and eliminating the pathogen".Specifically,the prescriptions mainly consist of tonifying Qi and consolidating the foundation(suchas Huangqi and Gancao),while also emphasizing resolving phlegm and relieving cough(such as Tinglizi seed and Fuling),and promotingblood circulation and resolving stasis(such as Danshen,Chuanxiong,Danggui,and Chishao)to treat the symptoms.The analysis resultsof frequently used drugs,core couplet medicinals,and cluster combinations clearly confirmed this treatment concept,providing importantempirical evidence and directional guidance for the precise and standardized application of TCM formulas for the complex pathogenesis of COPD plus PAH in clinical practice.
出处
《中医临床研究》
2025年第35期74-80,共7页
Clinical Journal Of Chinese Medicine
基金
山东省教育厅2022年山东省研究生优质教育教学资源项目(SDYKC2022042)
山东省卫生健康委员会山东省医药卫生科技项目(202302081053)。
关键词
中医
数据挖掘
慢性阻塞性肺疾病合并肺动脉高压
用药规律
Traditional Chinese medicine
Data mining
Chronic obstructive pulmonary disease complicated with pulmonary arterial hypertension
Medication rule
