基于关联规则和复杂熵聚类研究郑启仲教授治疗儿童抽动障碍用药规律

发布时间：2018-05-18 05:23

本文选题：抽动障碍 + 关联规则　；参考：《河南中医药大学》2016年硕士论文

【摘要】：目的:运用关联规则Apriori算法和复杂熵聚类算法,对郑启仲教授治疗儿童抽动障碍(tic disorders,TD)处方用药进行数据挖掘分析,研究郑启仲教授治疗儿童TD用药规律,提取核心处方,发掘潜在药物组合,为临床治疗儿童TD提供参考依据。方法:收集整理2012年1月1日至2015年12月31日期间,河南中医药大学第一附属医院郑启仲教授门诊治疗的儿童TD患者的就诊资料,以及郑启仲教授治疗儿童TD典型医案。运用中医传承辅助平台系统(traditional Chinese medicine inheritance support system,TCMISS)建立病案数据库。首先进行一般资料统计,包括用药频次、中药四气、五味、归经、症状频次、证型频次等;运用关联规则Apriori算法提取用药模式,总结核心处方并进行网络展示;运用复杂熵聚类对所有处方进行分析,提取常用药物组合;依据出现频次最多的3个症状,分别提取含该症状的病案,对处方用药进行关联规则分析,总结用药加减规律。依据中医证侯分布,提取各证侯使用的处方,进行关联规则分析,提取核心处方。结果:共收集整理病案110个,得到处方395首,涉及199味中药。使用频次在30次以上的药物共40味,前10味分别是:白芍、僵蚕、蝉蜕、甘草、全蝎、天麻、谷精草、白附子、片姜黄、龙骨;以寒、平、温性药物居多;以甘、辛、苦味中药使用最多;归经以肝经最多,肺经、脾经其次。运用关联规则Apriori算法分析处方用药模式,设置支持个数为81(支持度≥20%),置信度为0.6,共得到48组用药模式,出现频次前三位的是:白芍与僵蚕、蝉蜕与僵蚕、白芍与蝉蜕组合。设置信度为0.8,共得到50项置信度较高的用药组合,置信度最高的3个组合是:白芍,蝉蜕,片姜黄→僵蚕(置信度0.94186);白附子,甘草→白芍(置信度0.933333333);白芍,片姜黄→僵蚕(置信度0.929293)。最终得到总核心处方是:白芍、僵蚕、蝉蜕、片姜黄、白附子、甘草、天麻、龙骨、谷精草、全蝎。通过复杂熵聚类提取10个用药组合,功效分别为:滋阴潜阳息风、祛风湿通经络、镇肝息风、清热疏风、活血通络、理气化痰、清热化痰、升清降浊。症状频次分析得到出现最多的3个症状是:眨眼、清嗓子、注意力不集中,分别对含相应症状的病案进行提取,并进行关联规则分析,发现针对不同的症状,用药均有:白芍、僵蚕、蝉蜕、片姜黄、甘草、白附子、全蝎。出现眨眼症状时,多用谷精草清肝明目,柴胡、黄芩调节肝胆气机,升清降浊;出现清嗓子症状多从“痰”论治,注重“调理肝气”;出现注意力不集中症状多从“心、肾”论治,治疗时多以生地黄、牡蛎、炙龟甲滋阴养血,重镇安神。证侯分析发现,病案中风邪犯肺证、痰热动风证、脾虚肝亢证、阴虚阳亢证出现频次较多,各证型使用的处方进行关联规则分析共得到4个核心处方。结论:郑启仲教授认为儿童TD为本虚标实之证,病位在肝,气机失调、升降失常为其基本病机,风、痰浊、热(火)为病理产物;通过关联规则和复杂熵聚类等数据挖掘方法分析,郑启仲教授治疗儿童TD以“僵蚕、蝉蜕、片姜黄、白芍、甘草、白附子、龙骨、全蝎、天麻、谷精草”为核心处方;以和法为大法,升降药物同用,寒温药物并举,旨在升清降浊,调畅气机;临床辨证以痰热动风证为主;该课题的研究结果证实了郑教授治疗儿童抽动障TD“升清降浊”的学术思想。
[Abstract]:Objective: using the association rule Apriori algorithm and the complex entropy clustering algorithm, the data mining analysis of Professor Zheng Qizhong's tic disorders (TD) prescription is carried out, and the rule of Professor Zheng Qizhong's TD medication is studied, the core prescription is extracted and the potential drug combination is excavated, so as to provide the reference basis for the clinical treatment of children's TD. Methods: from January 1, 2012 to December 31, 2015, the data on the treatment of TD patients in the outpatient department of Professor Zheng Qizhong, the First Affiliated Hospital of Henan University of traditional Chinese medicine, and Professor Zheng Qizhong's treatment of children's TD typical medical cases were collected. The traditional Chinese Medicine Inheritance support system, T CMISS) set up a database of medical records. First of all, the general data statistics, including frequency of drug use, traditional Chinese medicine, five flavors, recurrent symptoms, frequency of symptoms, frequency of syndrome, and so on; use the association rule Apriori algorithm to extract the drug pattern, summarize the core prescription and carry on the network display; use the complex entropy clustering to analyze all the prescriptions and extract the commonly used drug combinations; According to the 3 symptoms of the most frequent occurrence, the symptoms were extracted respectively, the rule of association rules was analyzed, and the rule of addition and subtraction was summarized. According to the distribution of TCM syndromes, the prescription of each syndrome was extracted, the association rules were analyzed and the core prescription was extracted. The results were collected and collected in 110 cases, and 395 of the prescriptions were obtained, involving 19. 9 traditional Chinese medicine. The use of the frequency of more than 30 times a total of 40 flavors, the first 10 flavors are: white peony, silkworm, cicada, licorice, scorpion, gastrodia, valleys, white aconite, turmeric, keel; cold, flat, warm medicine most of the use of Gansu, symplectic, bitter Chinese medicine most; the liver meridian most, lung meridian, splenic meridian next. Use the association rules Apriori algorithm analysis Prescription medication model, set up the number of support 81 (support degree more than 20%), confidence of 0.6, a total of 48 groups of drugs, the first three are: white peony and silkworm, cicada and silkworm, white peony and cicada. The reliability is 0.8, a total of 50 high reliability of the combination, the highest confidence of the 3 combinations are: Paeonia Paeoniae, cicada, tablets, tablets. Turmeric and silkworm (confidence degree 0.94186); white aconite, licorice and Paeonia lactiflora (confidence degree 0.933333333); Paeonia lactiflora, turmeric and silkworm (confidence level 0.929293). The ultimate core prescription is: Paeonia lactiflora, silkworm, cicadas, turmeric, white aconite, licorice, Gastrodia elata, keel, cereal, scorpion. 10 combinations are extracted by complex entropy clustering, the efficacy is as follows: Nourishing yin and nourishing the wind, removing wind and damp through the meridian, the town liver and the wind, the heat and the wind, the circulation of blood and the collaterals, the Qi and the phlegm, the heat and the phlegm, the rise of the clear and the turbidity. The most 3 symptoms of the symptom frequency analysis are: blinking, clearing the throat, and not concentrating on the symptoms. The symptoms of the medicine are: Paeonia lactiflora, silkworm, cicada, Curcuma, licorice, white aconite, scorpion. When there is a blink of the eye, it is used to clear the liver and liver, and to adjust the liver and gallbladder Qi by the Radix Bupleuri and Scutellaria baicalensis. The symptoms of the clear throat are mostly treated from "phlegm" and pay attention to "regulating the liver qi", and the symptoms of attention are not concentrated mostly from "heart and kidney". During the treatment, there were 4 key prescriptions in the analysis of the prescription of each type of syndrome. Zheng Qizhong thought that children's TD was a virtual standard. In fact, the disease position is the basic pathogenesis of the disease in the liver, the maladjustment of the Qi machine and the disorder of the ascending and descending, the wind, the phlegm and the heat (fire) are the pathological products. Through the analysis of the data mining methods such as the association rules and the complex entropy clustering, Professor Zheng Qizhong treats the children with "silkworm, cicada, Curcuma, white peony, licorice, white aconite, keel, scorpion, gastrodia, and valley grass" as the core prescription; Using the method as the great law, the ascending and descending drugs are used in the same use and the cold and warm drugs are used simultaneously. The purpose of the study is to raise the clear and reduce the turbidity and adjust the Qi Qi. The clinical syndrome differentiation is based on the phlegm thermal wind syndrome, and the research results of this subject confirm the academic thought of Professor Zheng's treatment of children's TD "lift the clear and reduce the turbidity".
【学位授予单位】：河南中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R277.7

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