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| 基于数据挖掘探讨王芳主任医师治疗胃食管反流病的组方用药规律 |
| Exploration of Professor Wang Fang’s medication rules in the treatment of gastroesophageal re?ux disease based on data mining |
| 投稿时间：2025-09-22 修订日期：2025-12-26 |
| DOI： |
| 中文关键词: 王芳 数据挖掘 用药规律 名医经验 胃食管反流病 |
| 英文关键词: |
| 基金项目:浙江省中医药科技计划项目(2024ZF133) |
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| 中文摘要: |
| 目的 运用数据挖掘的方法,总结王芳主任医师治疗胃食管反流病(Gastroesophageal reflux disease, GERD)的诊疗思路及用药规律。方法 收集2020年1月-2023年12月期间王芳主任医师门诊治疗GERD患者的病案,通过Microsoft Excel对药物性味、归经、频次进行统计分析,采用SPSS 26.0进行聚类分析及因子分析,SPSS Modeler 18.0及Cytoscape 3.10.1进行中药关联规则及复杂网络分析。结果 (1)王芳主任医师常用高频药物有柴胡、海螵蛸、甘草、枳壳、姜半夏等20种,其中药性多为温、平、凉,药味以苦、辛、甘味为主,归经多属脾、胃、肺经。(2)王主任治疗本病常用药对有浙贝母＋海螵蛸、枳壳＋旋复花、麦芽＋蒲公英等。(3)王主任治疗中常用柴胡、枳壳、甘草、海螵蛸、浙贝母、姜半夏、麦芽、蒲公英等组成的自拟验方“四逆乌贝散”进行治疗。(4)王主任治疗中的常用药可聚类为4类,因子分析可得出7个公因子,通过对4类药物及7对公因子进行分析,可得出王主任治疗以和中为总法,辅以疏肝理气、健脾燥湿等治疗。结论 王主任治疗GERD以“和中”为纲,认为肝胃不和为基本病理基础,肝郁、气滞、湿阻为重要病理因素,用药以疏肝理气、化痰消食、清热化湿、制酸和中等药物为主,用药时寒热兼顾,尤其注重调理肝、脾、胃,临证善用自拟四逆乌贝散加减治疗GERD。 |
| 英文摘要: |
| Objective To summarize Professor Wang Fang"s diagnostic approach and medication patterns in treating gastroesophageal reflux disease (GERD) by using data mining methods.Methods Medical records of GERD patients treated by Professor Wang Fang in outpatient clinics from January 2020 to December 2023 were collected. Statistical analysis of herb properties, meridian tropisms, and frequency was conducted using Microsoft Excel. Cluster analysis and factor analysis were performed using SPSS 26.0, while association rule mining and complex network analysis of herbs were carried out using SPSS Modeler 18.0 and Cytoscape 3.10.1.Results (1) A total of 20 medicinals were frequently used, including Chaihu (Bupleurum), Haipiaoxiao(Cuttlefish Bone), Gancao(Licorice), Zhiqiao(Bitter Orange), and iangbanxia(Pinellia Rhizoma Praeparatum). These herbs were primarily warm, neutral, or cool in nature, with bitter, pungent, or sweet flavors, and mainly targeted the spleen, stomach, and lung meridians.(2) Commonly used herb pairs included Zhebeimu(Fritillaria Thunbergii) + Haipiaoxiao(Cuttlefish Bone), Zhiqiao(Bitter Orange) + Xuanfuhua(Inula Flower), and Maiya(Malt) + Pugongying(Dandelion).(3) Professor Wang often employed her self-developed empirical formula, "Sini Wubei San"(composed of Chaihu, Zhiqiao, Gancao, Haipiaoxiao, Zhebeimu, Jiangbanxia, Maiya, and Pugongying) for treatment.(4) The commonly used herbs could be clustered into four categories, and factor analysis identified seven common factors. Analysis of these clusters and factors revealed that her treatment strategy primarily focused on harmonizing the middle jiao (和中), supplemented by soothing the liver and regulating qi (疏肝理气), strengthening the spleen and drying dampness(健脾燥湿), and modifications based on syndrome differentiation.Conclusion Professor Wang Fang"s treatment of GERD is centered on harmonizing the middle jiao, with liver-stomach disharmony as the fundamental pathological basis and liver depression, qi stagnation, and damp obstruction as key pathological factors. Her medication emphasizes soothing the liver and regulating qi, resolving phlegm and promoting digestion, clearing heat and transforming dampness, and neutralizing acid to harmonize the middle. Her prescriptions balance cold and heat properties, with particular attention to regulating the liver, spleen, and stomach. Clinically, she skillfully modifies her self-developed “Sini Wubei San” for GERD treatment. |
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