[关键词]
[摘要]
【目的】 采用数据挖掘方法回顾性分析妊娠合并地中海贫血(简称“地贫”)的中医证型及中药用药规律。【方法】 收集 2022年2月至2024年2月期间广州中医药大学第一附属医院门诊收治的、采用中药复方治疗且有效的妊娠合并地中海贫血患者 的病案资料,运用频次分析、关联规则分析、聚类分析等数据挖掘的方法进行中医证型及中药用药规律的分析。【结果】 中 医证型分析结果显示,地贫孕妇多被辨证为气虚证。本研究中共纳入处方64首,涉及中药51味,频次在35次以上的高频中 药为白术、党参、茯苓、黄芪、山药、阿胶、炙甘草。所用药物的性味以甘平为主,归经以归脾经、肺经为主,功效以安 胎为主。关联规则分析显示,“党参-白术”“茯苓-党参,白术”“黄芪-茯苓,党参,白术”为核心药物组合。聚类分析共 得到5组聚类药物。【结论】 地贫孕妇以气虚证多见。中药治疗妊娠合并地中海贫血遵循“气血同补,心脾同治,补而不滞” 的原则,以平性甘味药为主,处方通常在八珍汤或归脾汤的补益基础上,根据虚热、水湿、血瘀以及风寒湿热等内外之邪 兼夹的不同以进行加减,从而保证母体与胎儿的安全。
[Key word]
[Abstract]
Objective To retrospectively analyze the traditional Chinese medicine (TCM) syndrome types of thalassemia in pregnancy and to explore the medication rules of Chinese medicine for its treatment by data mining methods. Methods From February 2022 to February 2024,we collected the case records of pregnant women with thalassemia who were effectively treated with Chinese medicine compound in the outpatient clinic of the First Affiliated Hospital of Guangzhou University of Chinese Medicine. The TCM syndrome types and medication rules of Chinese medicine were analyzed by using data mining methods such as frequency analysis, association rule analysis, and clustering analysis. Results The results of analysis of TCM syndrome types showed that pregnant women with thalassemia were frequently differentiated as qi deficiency syndrome. A total of 64 prescriptions were included in this study, including 51 Chinese herbal medicines. The high-frequency Chinese herbal medicines used more than 35 times were Atractylodis Macrocephalae Rhizoma(Baizhu),Codonopsis Radix(Dangshen), Poria(Fuling), Astragali Radix(Huangqi), Dioscoreae Rhizoma(Shanyao), Asini Corii Colla(Ejiao), Glycyrrhizae Radix et Rhizoma Praeparata cum Melle(Zhigancao). The Chinese herbal medicine used in these prescriptions were mainly sweet and mild in nature,usually had the meridian tropism of spleen meridian and lung meridian,and had the main therapeutic action for preventing miscarriage. The analysis of association rules showed that “Dangshen-Baizhu”,“Fuling-Dangshen,Baizhu”,and “Huangqi -Fuling,Dangshen,Baizhu”were the core Chinese herbal medicine combinations. The cluster analysis yielded a total of five groups of clustered Chinese herbal medicines. Conclusion Pregnant women with thalassemia are frequently differentiated as qi deficiency syndrome. The treatment of thalassemia in pregnancy with Chinese herbal medicine follows the principle of reinforcement of both qi and blood, simultaneous treatment of the heart and spleen, and nourishing without stagnation. Chinese herbal medicines for the treatment are usually mild and sweet, and the prescriptions are formulated usually based on the modification of Bazhen Decoction or Guipi Decoction for tonification,together with the herbs for separately expelling the internal pathogens of deficiency-heat,water - dampness and blood stasis, and the external pathogen of wind,cold,dampness and heat,thus to ensure the safety of the mother and the fetus.
[中图分类号]
R271.41;R255.7
[基金项目]
国家自然科学基金项目(编号:81704111)