基于数据挖掘探析裘氏妇科治疗崩漏的用药规律分析

蒋军 吴燕平 应翩

【摘 要】 目的：遴選并整理浙江裘氏妇科诊疗中所记录的崩漏医案，探究裘氏妇科治疗崩漏的用药规律。方法：运用Microsoft Excel 2010进行频数分析、SPSS clementine 12.0进行关联规则分析，SPSS 22.0进行聚类分析和因子分析。结果：纳入经筛选后获得医案108个，治疗崩漏处方249首。中药频次统计共得中药86种，得到高频（≥20）中药60种，以补虚药、清热药和止血药为主，得到药对关联规则19条，聚类分析得到药组13个，因子分析提取出17个公因子（元件）。裘氏妇科以脏腑学说指导临床辨证，责之于肝脾肾三脏功能失常，谨守病机，治病求本，或健脾补气，或补肾固本，或调肝养血，其临床验方“三黄忍冬汤”“参芪胶艾汤”“生地黄龙牡汤”颇有见效，流派特色鲜明，疗效显著，值得研究和学习。结论：运用数据挖掘手段能较为全面的对名老中医及学术流派用药规律进行探究，有助于学术经验传承和临床实践。

【关键词】 崩漏;名老中医;学术流派;数据挖掘;用药规律

【中图分类号】R271.12   【文献标志码】 A    【文章编号】1007-8517（2020）10-0016-06

Abstract：ObjectiveTo explore the medication rules of famous veteran traditional Chinese medicine practitioners in treating uterine bleeding based on medical cases collected from clinic department.Methods Researchers extracted the information of prescriptions from these cases according to the inclusion and exclusion criteria. Then， Excel 2010， SPSS Clementine （ver.12.0） and SPSS （ver.22.0） were adopted respectively for frequency analysis， association rules analysis， cluster analysis and factor analysis.Results Finally， 108 medical cases and 249 prescriptions were included in total. A total of 60 kinds of frequently used herbs were identified according to the results of frequency analysis for medication， they were mainly used for tonifying，clearing heat and hemostasis respectively. There were extracted out 19 drug pair association rules， 13 medicine groups and 19 common factors by analysis respectively. Qius gynecology school uses the theory of organs and viscera to guide clinical syndrome differentiation， and blame the liver， spleen and kidney for dysfunction of the three internal organs.It adhere to the pathogenesis， searching for the primary cause of disease in treatment， whether invigorating the spleen and invigorating qi， invigorating the kidney or strengthening the liver. Its clinical prescriptions “Sanhuang Lonicera Decoction”， “Shenqijiao Ai Decoction” and “Shengdi Longmu Decoction” are quite effective. Qius gynecological school treating uterine bleeding has obvious features， with marked cure effect， worth research and study. Conclusion The use of data mining methods can more comprehensively explore the medication rules of famous veteran traditional Chinese medicine practitioners and academic schools， which is conducive to the transfer of academic experience and clinical practice in treating uterine bleeding.

Keywords：Uterine Bleeding; Famous Veteran Traditional Chinese Medicine Doctor;TCM Academic School;Data Mining;Medication Rules

崩漏是指经血非时暴下不止或淋漓不尽，前者谓之崩中，后者谓之漏下。崩首见于《素问·阴阳别论》“阴虚阳搏谓之崩”，漏首见于《金匮要略·妇人杂病脉证并治》“妇人陷经漏下，黑不解，胶姜汤主之”。二者虽有区别，但在临床中常胶着并现，故常合而称之。崩漏作为常见妇科血症，也是疑难病症，难在求因、辨治、更难在获效。裘笑梅等完成“名老中医裘笑梅诊治闭经、崩漏电脑双系统QXM87”的医理设计及归纳总结工作，笔者将用药规律以数据挖掘的形式予以报道。……