| 王峰,程锦国.基于数据挖掘探究程锦国教授辨治膜性肾病的用药规律[J].浙江中西医结合杂志,2026,36(6): |
| 基于数据挖掘探究程锦国教授辨治膜性肾病的用药规律 |
| Exploring the medication pattern of Professor Cheng Jinguo's dialectical treatment of membranous nephropathy based on data mining |
| 投稿时间：2025-04-19 修订日期：2026-04-21 |
| DOI： |
| 中文关键词: 膜性肾病 证型 数据挖掘 用药规律 |
| 英文关键词:Membranous nephropathy, Type of syndrome, Data mining, Drug use rule |
| 基金项目:第六批全国老中医药专家学术经验继承工作(国中医药人教函〔2021〕270号)；浙江省中医药科技计划项目(2025ZR201)；温州市基础性科研项目(Y20240906) |
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| 中文摘要: |
| 目的 基于数据挖掘方法，总结第六批全国老中医药专家学术经验继承工作指导老师、浙江省名中医程锦国教授治疗膜性肾病（MN）的用药规律，以期为临床服务。方法 收集2021年1月至2024年12月温州市中医院门诊及住院程锦国教授治疗MN的患者资料，将处方数据录入中医传承辅助平台V2.5中，分析中医证型、药物四气五味归经。对前4高频证型的药物进行关联规则分析和聚类分析。结果 共纳入152例患者，378首处方。经频次统计发现最常见证型为脾肾阳虚兼水湿证、湿热内蕴兼气滞证、气阴两虚证、气虚血瘀证。共涉及138味中药，出现药物频次6201次，高频药物有32味，排名前5位分别是黄芪、茯苓、白术、甘草、桂枝。四气分析显示药物以温、寒、平为主，五味分析显示以甘、苦、辛为主，归经分析显示多归于脾、肝、肾经，功效分析显示以补虚药、清热药、利水渗湿药类为主。对排名前4位证型中药关联规则和系统聚类分析得到四个证型的核心药物组合分别为真武汤与水陆二仙丹加减、黄连温胆汤合半夏泻心汤加减、六味地黄丸加减、补阳还五汤加减。结论 程锦国教授治疗MN用药温润而不燥烈，力倡通补并用大法，中药治疗早期以益气健脾，温肾利水为主，中期以益气滋阴通络；清利湿热、疏利气机，后期迁延不愈以益气活血化瘀为治疗手段，得出的组方规律不仅可为临床实践提供理论依据，同时能启发创新药物研发方向。 |
| 英文摘要: |
| Objective Based on the data mining method, this paper summarizes the medication rules of Professor Cheng Jinguo, the sixth batch of national old Chinese medicine experts in the treatment of MN (MN), the instructor of the inheritance of academic experience and a famous traditional Chinese medicine doctor in Zhejiang Province, in order to provide clinical services. Methods From January 2021 to December 2024, the outpatient and inpatient data of Professor Cheng Jinguo of Wenzhou Hospital of Traditional Chinese Medicine for the treatment of MN were collected, and the prescription data were entered into the TCM inheritance auxiliary platform V2.5 to analyze the TCM syndrome types and the four qi and five flavors of drugs. Association rule analysis and cluster analysis were performed on the drugs of the top four high-frequency syndrome types. Results A total of 152 patients with 378 prescriptions were included. According to frequency statistics, the most common syndrome types were spleen and kidney yang deficiency and water dampness pattern, damp heat and internal accumulation and qi stagnation pattern, qi and yin deficiency syndrome, and qi deficiency and blood stasis pattern. A total of 138 flavors of traditional Chinese medicine were involved, with a frequency of 6201 drug occurrences, and 32 high-frequency drugs, and the top 5 were Astragalus, Poria cocos, Atractylodes, Licorice, and Cinnamon Branch. The analysis of the four qi showed that the drugs were mainly warm, cold and flat, the analysis of the five flavors showed that the drugs were mainly sweet, bitter and pungent, the analysis of the meridians showed that most of them were attributed to the spleen, liver and kidney meridians, and the efficacy analysis showed that the drugs were mainly deficiency tonics, heat-clearing drugs and water dilution and dampness drugs. Based on the association rules and systematic cluster analysis of the top four syndrome types, the core drug combinations of the four syndrome types were Zhenwu Tang and Shuilu Erxian Dan, Huanglian Wen Bile Tang and Banxia Xingxin Tang, Liuwei Dihuang Pill and Buyang Huanwu Tang. Conclusion Professor Cheng Jinguo's treatment of MN is warm but not dry, and advocates the combination of tonic and Dafa, which is mainly used to nourish qi and strengthen the spleen, warm the kidney and improve water in the early stage, and nourish qi and nourish yin and channel in the middle stage. The formula can not only provide a theoretical basis for clinical practice, but also inspire the direction of innovative drug research and development. |
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