基于数据挖掘的吕仁和教授治疗高尿酸血症医案用药经验研究

李娜 王世东 邵凡 王宣权 南赫 姜淼 肖永华 赵进喜 吕仁和

摘要 目的：分析吕仁和教授治疗高尿酸血症的医案处方，总结吕仁和教授治疗高尿酸血症的相关用药规律。方法：运用频数分析、聚类分析、关联规则分析对177份处方进行分析。结果：177份处方中，共涉及单味药物124味;用药频率靠前的依次为丹参（98.39%）、猪苓（76.61%）、川芎（65.32%），常用剂量分别为20～60 g、20～30 g、10～15 g;将药物归类后依据用药频率排序，依次为补虚药（22.95%）、清热药（16.39%）、活血化瘀药（14.75%）;聚类分析和关联规则分析得到5对常用药物组合，依置信度排序依次为当归-黄芪、牡丹皮-赤芍、茵陈-栀子、威灵仙-土茯苓、川芎-丹参。结论：吕仁和教授临床治疗高尿酸血症常用补虚药、清热药、活血化瘀药，重视高尿酸血症虚损、内热、血瘀病机，并采用针对性药物配伍治疗。

关键词 数据挖掘;高尿酸血症;用药经验;频数分析;聚类分析;关联规则

Research on Professor LYU Renhe′s Experience of Medical Records and Medication in the Treatment of Hyperuricemia Based on Data Mining

LI Na1，WANG Shidong1，SHAO Fan2，WANG Xuanquan1，NAN He1，JIANG Miao3，XIAO Yonghua1，ZHAO Jinxi1，LYU Renhe1

（1 Dongzhimen Hospital of Beijing University of Chinese Medicine，Beijing 100700，China; 2 Life Qidian Technology Co.Ltd，Beijing 100089，China; 3 Institute of Basic Research In Clinical Medicine，China Academy of Chinese Medical Sciences，Beijing 100700，China）

Abstract Objective：To analyze Professor LYU Renhe′s prescription in treating hyperuricemia，and summarize the relevant medication rules for the treatment of hyperuricemia.Methods：Frequency analysis，cluster analysis，and association rule analysis were used to analyze the 177 prescriptions.Results：Among the 177 prescriptions，124 single-flavored drugs were involved.The most frequently used drugs were Radix Salviae Miltiorrhizae（98.39%），Polyporus Umbellatus（76.61%），Rhizoma Ligustici Chuanxiong（65.32%），and their doses are 20～60 g，20～30 g，10～15 g.After classifying the drugs，they were sorted according to the frequency of medication，in order：tonic medicine（22.95%），heat-clearing medicine（16.39%），blood-activating stasis medicine（14.75%），etc.Cluster analysis and association rule analysis yielded 5 pairs of commonly used drug combinations，sorted by confidence，they were Angelica-Astragalus，Moutan Cortex-Red Peony，Yinchen-Gardenia，Weilingxian-Smilax，Chuanxiong-Salvia.Conclusion：Professor LYU Renhe commonly use tonic medicine，clearing heat medicine and activating blood and removing blood stasis medicine in clinical treatment of hyperuricemia，attach importance to pathogenesis of deficiency loss，internal heat and blood stasis of hyperuricemia，and use targeted drug compatibility treatment.

Keywords Data mining; Hyperuricemia; Medication experience; Frequency analysis; Cluster analysis; Association rules

中圖分类号：R259;R249.2文献标识码：Adoi：10.3969/j.issn.1673-7202.2021.17.023

高尿酸血症（Hyperuricemia，HUA）是机体嘌呤代谢紊乱，尿酸分泌过多或排泄障碍使血液中尿酸积聚，引起的一种代谢性疾病[1]。HUA患病率持续升高，中国成人的患病率为8.4%～13.3%[2-3]。HUA与代谢综合征、慢性肾病、高血压、心脑血管疾病、2型糖尿病等疾病的发生发展密切相关，且是导致死亡的独立风险因素，中医根据症状将其归为“历节”“痛风”“痹证”的范畴[4-8]。国医大师吕仁和教授在临床上诊治HUA经验丰富，用药简约精当，疗效明显。为了进一步探索吕仁和教授诊治HUA的经验，本研究运用数据挖掘技术对吕仁和教授诊治HUA的医案处方进行分析，总结吕教授治疗HUA用药经验，为HUA的治疗提供思路和方法。……