基于数据挖掘分析中医药诊疗新冠肺炎的经络辨治思路

郑凯腾 姚惠仪 曾慧妍 郑丹文 奚小土

〔摘要〕 目的 基于數据挖掘技术分析中医药治疗新型冠状病毒肺炎（corona virus disease 2019，COVID-19，以下简称“新冠肺炎”）不同阶段中药处方用药的归经规律，归纳经络辨治思路，以期为今后中医药抗击新发突发传染病提供参考。方法 收集2020年1月16日至2020年11月11日国家及各省、自治区、直辖市卫生健康委、中医药管理局所发布的新冠肺炎诊疗方案，建立数据库，对所收集处方的中药归经进行描述性分析、关联规则分析和聚类分析。结果 （1）药物归经情况统计显示，新冠肺炎初期药物归经频率最高的经络为肺经，极期为心经，恢复期为肺经;（2）关联规则分析显示，初期核心归经为肺、脾、胃经，极期为心、肝、脾、胃、肺经，恢复期为肺、脾、胃经;（3）聚类分析结果显示，初期药物归经可分为肺、脾、胃经和其他经，极期可分为心、脾经和其他经，恢复期可分为肺、脾、胃经和其他经。结论 中医治疗新冠肺炎初期以肺、脾、胃经为主，治宜宣肺化痰止咳、化湿运脾和胃;极期以心、脾经为主，兼顾肺、胃、肝经，治宜开窍醒神、扶正固脱，兼化痰止咳平喘、行气通腑、平肝息风;恢复期以肺、脾、胃经为主，治宜益气养阴、健脾和胃、清肺透邪，兼顾心经以调心安神。

〔关键词〕 新型冠状病毒肺炎;中医药诊疗;中药归经;经络辨治;数据挖掘

〔中图分类号〕R259       〔文献标志码〕A       〔文章编号〕doi：10.3969/j.issn.1674-070X.2021.07.018

〔Abstract〕 Objective To summarize the ideas of channels syndrome differentiation and treatment， and to provide treatment references for Chinese medicine to fight emerging infectious diseases in the future， through analyzing the rule of channel tropism of traditional Chinese medicine （TCM） prescriptions for the treatment of corona virus disease 2019 （COVID-19） in different stages， based on data mining technology. Methods The database was established by collecting COVID-19 diagnosis and treatment guidelines issued by the state， provinces， autonomous regions， and municipalities' health commissions and TCM Administration from January 16 to November 11， 2020. Descriptive analysis， association rule analysis and cluster analysis were performed on the channel tropism of collected prescriptions of TCM. Results （1） Statistics of the herbs channel tropism demonstrated that the channel with the highest frequency of channel tropism in the initial stage of COVID-19 was the lung channel， the extreme stage was heart channel， and the recovery stage was lung channel. （2） Association rule analysis showed that the core channels at the initial stage were the lung， spleen， and stomach channels; the extreme stage were the heart， liver， spleen， stomach， and lung channels; and the recovery stage were the lung， spleen， and stomach channels. （3） The results of cluster analysis indicated that the herbs channel tropism in the initial stage could be divided into lung， spleen， stomach and other channels， and the extreme stage could be divided into heart， spleen and other channels， the recovery stage could be divided into lung， spleen， stomach and other channels. Conclusion In the initial stage of treatment for COVID-19， TCM mainly focuses on lung， spleen and stomach channels. It is suitable for ventilating lung and dissipating phlegm， removing dampness for regulating spleen and stomach. The extreme stage mainly focuses on heart， spleen channels， as well as lung， stomach， liver channels. It is suitable for inducing resuscitation， strengthening vital Qi and relieving desertion， and giving consideration to dissipating phlegm and relieving cough for relieving dyspnea， activating Qi and catharsis， suppressing hyperactive liver for calming endogenous wind. The recovery stage is mainly based on the lung， spleen， and stomach channels. The treatment is suitable for benefiting Qi and nourishing Yin， invigorating spleen and regulating stomach， clearing lung and expelling the pathogens， and taking the heart channel into consideration to regulating heart for tranquilization.

〔Keywords〕 corona virus disease 2019; diagnosis and treatment of traditional Chinese medicine; channel tropism; channels syndrome differentiation and treatment; data mining

新型冠状病毒肺炎（corona virus disease 2019，COVID-19，以下简称“新冠肺炎”）是一种传染性极强的呼吸系统疾病，初起以发热、干咳、乏力为主要表现，病情发展迅速，人群普遍易感。……