目的应用数据挖掘技术对国医大师刘尚义治疗恶性肿瘤用药规律进行分析,从而总结刘尚义诊治肿瘤的学术经验。方法收集2013年8月至2014年4月就诊于刘尚义国医堂门诊的肿瘤患者1220例,采用中医传承辅助系统V2.5统计药物使用频次,对患者的年龄、性别、恶性肿瘤的种类进行统计,并采用关联规则、复杂系统熵聚类分析。结果 1220例患者共涉及用药234味,使用频次在100次以上的药物共25味,前5位分别是莪术(1207)、鳖甲(1203)、冬凌草(1147)、葎草花(502)、生地黄(345)。药物组合出现频次前5位的分别是鳖甲、莪术(1201),莪术、冬凌草(1129),鳖甲、冬凌草(1126),莪术、鳖甲、冬凌草(1124),冬凌草、葎草花(404)。基于改进的互信息法的药物间关联度前5位依次为熟地黄、薏苡仁(0.023183),熟地黄、黄连(0.016410),生地黄、木香(0.015598),山茱萸、木香(0.015379),玉竹、厚朴(0.015181)。基于复杂系统熵聚类的药物核心组合共计16组,主要有郁金、紫菀、佛手,炙麻黄、蔓荆子、桑白皮,茵陈、茜草、刘寄奴,苍耳子、甘草、桔梗,法半夏、瓜蒌皮、黄连,冬葵子、萆薢、土茯苓,冬凌草、莪术、葎草、鳖甲,熟地黄、黄芪、山茱萸、石斛。结论刘尚义治疗恶性肿瘤以益气养血扶正为主,兼以化瘀抗癌,并通过药物分析印证了刘尚义"引疡入瘤""从膜论治"的学术特点。
Objective To analyze the medication rules of Chinese medicine expert Professor LIU Shangyi treating cancer adopting data mining technology and to summarize the academic experience of Prof. LIU Shangyi diagnosing and treating cancer. Methods One thousand two hundred and twenty cancer patients were collected,who went to Prof. LIU Shangyi' s clinic at Guo Yi Tang(国医堂) from August of 2013 to April of 2014. Herb use frequency,patients' name,gender and the type of cancer were made statistics by Auxiliary System of Chinese Medicine Inheritance V2. 5. Association rules and complex system entropy clustering analysis were adopted. Results Totally,234 herbs were used on 1220 patients. There were 25 herbs in total with use frequency more than 100 times. Top five herbs were Ezhu [Rhizoma Curcumae ]( 1207), Biejia [Carapax Trionycis ]( 1203), Donglingcao [Rabdosiarubescens]( 1147),Lyucaohua [Humulus japonicas flower]( 502) and Shengdihuang [Radix Rehmanniae Recens](345). Top five herb combinations with high use frequency were Biejia-Ezhu(1201),Ezhu-Donglingcao(1129),Biejia-Donglingcao( 1126), Ezhu-Biejia-Donglingcao( 1124) and Donglingcao-Lyucaohua( 404). Based on improved mutual information method,top 5 herbs with high inter herb association were Shudihuang [Radix Rehmanniae Preparata]-Yiyiren [Semen Coicis]( 0. 023183),Shudihuang-Huanglian [Rhizoma Coptidis]( 0. 016410),Shengdihuang-Muxiang [Radix Aucklandiae]( 0. 015598),Shanzhuyu [Fructus Corni]-Muxiang( 0. 015379) and Yuzhu[Rhizoma Polygonati Odorati]-Houpo [Cortex Magnoliae Officinalis](0. 015181). Based on complex system entropy clustering,herb core combinations were 16 groups in total, mainly including Yujin [Radix Curcumae]-Ziwan[Radix Asteris]-Foshou [Fructus Citri Sarcodactylis],Zhimahuang [Herba Ephedrae stir-frying with honey]-Manjingzi [Fructus Viticis]-Sangbaipi [Cortex Mori ],Yinchen [Herba Artemisiae Scopariae]-Qiancao [Radix Rubiae]-Liujinu [anomalous artemisia],Cangerzi [Fructus Xanthi