| 引用本文: |
张纯,张书萌,于子璇,周江敏,朱晓颖,陈伶利,李杰.基于数据挖掘和整体观探究活血化瘀法治疗经皮冠状动脉介入术后再狭窄的用药规律[J].湖南中医药大学学报,2024,44(2):295-301[点击复制] |
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| 基于数据挖掘和整体观探究活血化瘀法治疗经皮冠状动脉介入术后再狭窄的用药规律 |
| 张纯,张书萌,于子璇,周江敏,朱晓颖,陈伶利,李杰 |
| (湖南中医药大学, 湖南 长沙 410208) |
| 摘要: |
| 目的 探究活血化瘀法治疗经皮冠状动脉介入（percutaneous coronary intervention， PCI）术后再狭窄的用药规律。方法 检索中英文数据库中相关文献，筛选符合标准的中药处方，构建原始数据库，运用Excel 2021、IBM SPSS 18.0、Cytoscape 3.9.1、SPSS Statistics 26.0等软件进行高频药物、功效主治、性味归经、关联规则、系统聚类分析以总结其用药规律。结果 最终纳入73篇文献、73首中药处方，共涉及125味中药。高频药物有丹参、黄芪、川芎、当归、赤芍、红花等。功效主治以活血化瘀药物最多，其次为补虚药。四气中以温、寒为主，五味以苦、甘、辛为主，归经多入肝、脾经。关联规则分析得到3条对药，红花-桃仁支持度最高，26条角药，以川芎、赤芍、红花、当归、黄芪、桃仁等相互组合为主。系统聚类分析得到5组药物组合。结论 PCI术后再狭窄的基本病机为心气亏虚、心阳不振，瘀血是贯穿疾病全程的关键病理因素，病位累及心、肝、脾等。五脏之气，相互灌溉，以整体观为指导，治疗以活血化瘀为主，兼以调气、化痰、温阳，组方用药多由补阳还五汤、血府逐瘀汤、当归补血汤、瓜蒌薤白半夏汤、二陈汤等经典名方化裁而来。 |
| 关键词: 活血化瘀 经皮冠状动脉介入术 数据挖掘 用药规律 整体观 |
| DOI：10.3969/j.issn.1674-070X.2024.02.017 |
| 投稿时间：2023-08-28 |
| 基金项目:国家自然科学基金项目（81874375）；湖南省自然科学基金项目（2022JJ30430，2023JJ30452）；湖南省中医药科研重点课题项目（C2023002）；湖南省教育厅科学研究项目（22A0278，21A0231）；湖南中医药大学研究生创新项目（CX20230795，2022CX06）；湖南省普通高等学校科技创新团队支持项目。 |
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| Medication rules of blood-circulating and blood stasis-eliminating method in treating restenosis after percutaneous coronary intervention based on data mining and holistic concept |
| ZHANG Chun,ZHANG Shumeng,YU Zixuan,ZHOU Jiangmin,ZHU Xiaoying,CHEN Lingli,LI Jie |
| (Hunan University of Chinese Medicine, Changsha, Hunan 410208, China) |
| Abstract: |
| Objective To explore the medication rules of blood-circulating and blood stasis-eliminating method in treating restenosis after percutaneous coronary intervention(PCI).Methods Relevant literature in the Chinese and English databases was searched, and TCM formulas that met the criterion were included, by which an original database was established. Microsoft Excel2021, IBM SPSS Modeler 18.0, Cytoscape 3.9.1, and IBM SPSS Statistics 26.0 were applied to the analyses of high-frequently used Chinese medicines, and their effects, indications, properties, flavors, and meridian affinity, as well as to the association rule and hierarchical cluster analyses, so as to summarize the medication rules.Results A total of 73 articles and 73 TCM formulas were included, involving 125 Chinese medicines. High-frequently used Chinese medicines included Danshen(Salviae Miltiorrhizae Radix et Rhizoma), Huangqi(Astragali Radix), Chuanxiong(Chuanxiong Rhizoma), Danggui(Angelicae Sinensis Radix), Chishao(Paeoniae Radix Rubra), Honghua(Carthami Flos), etc. Medicines with effects of circulating blood and eliminating blood stasis were the most,followed by those with the effect of tonifying deficiency. Most of the involved medicines were warm and cold in nature, and bitter,sweet, and pungent in flavor, entering the liver and spleen meridians. Association rule analysis yielded 3 medicine pairs, with the highest support in the pair of Honghua(Carthami Flos)-Taoren(Persicae Semen), and 26 triple combinations of medicines, mainly composed of Chuanxiong(Chuanxiong Rhizoma), Chishao(Paeoniae Radix Rubra), Honghua(Carthami Flos), Danggui(Angelicae Sinensis Radix), Huangqi(Astragali Radix), Taoren(Persicae Semen), etc. Five medicine combinations were obtained through hierarchical cluster analysis.Conclusion The basic pathogenesis of restenosis after PCI involves deficiency of heart qi and inactivity of heart yang, and static blood is a key pathological factor throughout the whole course of the disease, with the disease locations involving the heart, liver, and spleen. Qi of the five zang organs irrigates each other. Therefore, guided by the concept of holism, the main treatment focuses on circulating blood and eliminating blood stasis, combined with regulating qi, transforming phlegm, and warming yang. Mostly applied formulas were derived from modified classic formulas such as Buyang Huanwu Decoction, Xuefu Zhuyu Decoction, Danggui Buxue Decoction, Gualou Xiebai Banxia Decoction, and Erchen Decoction. |
| Key words: circulating blood and eliminating blood stasis percutaneous coronary intervention data mining medication rules holistic concept |
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