山东大学耳鼻喉眼学报 ›› 2022, Vol. 36 ›› Issue (3): 202-208.doi: 10.6040/j.issn.1673-3770.0.2021.420

• 临床研究 • 上一篇    下一篇

基于数据挖掘探究阮岩治疗慢性鼻窦炎的用药规律

刘铮1,2, 方彩珊1, 毛淑娴3, 蓝婉宁1, 金燕1,2, 廖柏霖4, 黄丹琳1, 钟方鉴1, 阮岩5   

  1. 1. 广州中医药大学第一临床医学院, 广东 广州 510405;
    2. 广州中医药大学第一附属医院 治未病科, 广东 广州 510405;
    3. 广州中医药大学第二临床医学院, 广东 广州 510405;
    4. 广州中医药大学第三临床医学院, 广东 广州 510405;
    5. 广州中医药大学第一附属医院 耳鼻喉科, 广东 广州 510405
  • 发布日期:2022-06-15
  • 通讯作者: 阮岩. E-mail:ruanyan63@163.com
  • 基金资助:
    国家自然科学基金面上项目(8197151814);2020年阮岩省名中医传承工作室项目(2100600145);广州中医药大学第一附属医院创新强院耳鼻喉科项目(211010010715)

Exploring the medication pattern of professor Ruan Yan in the treatment of chronic sinusitis based on data mining

LIU Zheng1,2, FANG Caishan1, MAO Shuxian3, LAN Wanning1, JIN Yan1,2, LIAO Bolin4, HUANG Danlin1, ZHONG Fangjian1, RUAN Yan2   

  1. 1. The First Clinical College, Guangzhou University of Chinese Medicine, Guangzhou 510405, Guangdong, China;
    2. Department of Pre-treatment, First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510405, Guangdong, China;
    3. The Second Clinical College, Guangzhou University of Chinese Medicine, Guangzhou 510405, Guangdong, China;
    4. The Third Clinical College, Guangzhou University of Chinese Medicine, Guangzhou 510405, Guangdong, China;
    5. Department of Otolaryngology, First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510405, Guangdong, China
  • Published:2022-06-15

PDF (PC)

122

摘要： 目的 基于中医传承辅助平台系统分析广州中医药大学第一附属医院阮岩教授治疗慢性鼻窦炎的用药规律。 方法 通过收集和整理阮岩教授门诊治疗慢性鼻窦炎患者的有效病历,严格按照纳入与排除标准,遴选符合标准的医案,建立医案数据库,运用频数统计、关联规则分析、聚类分析对医案中的证型分布、药物频数、中药组合等进行统计分析,探讨阮岩教授治疗慢性鼻窦炎的用药特点及组方规律。 结果 共收集阮岩教授治疗慢性鼻窦炎医案159则,包含245个处方,共109味中药(除去甜叶菊)。其中159个医案中脾胃湿热证型占比最大;使用频次≥20的中药有24味;对高频中药进行关联规则分析得到关联药对13个,三味关联中药药组15个,四味关联中药药组4个,并通过聚类分析和因子分析得出7个治疗慢性鼻窦炎的潜在核心基础方及7个核心新处方。 结论 岭南大部分慢性鼻窦炎患者的证型与气候特点相一致,以脾胃湿热证型的患者居多。阮岩教授治疗慢性鼻窦炎有其独特的治法,认为虚实夹杂是其主要病机,擅于运用补脾益气、宣通鼻窍、清热化湿等主要治法,因地制宜,达到标本兼治。其中,苍耳子散是阮岩教授治疗慢性鼻窦炎最常用的基础方。

关键词: 慢性鼻窦炎, 数据挖掘, 用药规律, 组方规律, 苍耳子散

Abstract: Objective To analyze the medication patterns of Professor Ruan Yan of the First Affiliated Hospital, Guangzhou University of Traditional Chinese Medicine, for the treatment of chronic sinusitis, based on the Traditional Chinese Medicine(TCM)inheritance aid platform system. Methods Valid medical records of patients with chronic rhinosinusitis from Professor Ruan Yan's outpatient clinic were collected and collated. The medical cases that met the criteria were selected strictly according to the inclusion and exclusion criteria, and a medical case database was established. Subsequently, frequency statistics, association rule analysis, and cluster analysis were used to statistically analyze the distribution of evidence types, frequency of drugs, and combinations of Chinese medicines in the medical case repertoire. This was done to explore the characteristics of Professor Ruan Yan's treatment of chronic rhinosinusitis and the rules of prescription grouping. Results We collected 159 medical records of patients treated for chronic sinusitis by Professor Ruan Yan, containing 245 prescriptions with 109 Chinese herbs(except Stevia rebaudiana). The statistical analysis showed that the largest proportion of all cases was the spleen and stomach damp-heat evidence type; 24 herbs were used ≥20 times. The association rule analysis of high-frequency herbs yielded 13 associated pairs, 15 groups of three associated herbs, and four groups of four associated herbs. Additionally, seven potential core basic prescriptions and seven core new prescriptions for the treatment of chronic sinusitis were derived using cluster and factor analyses. Conclusion Most patients with chronic rhinosinusitis in Lingnan have evidence patterns consistent with climatic characteristics, with the majority of patients having the damp-heat evidence pattern of the spleen and stomach. Professor Ruan Yan considers deficiency and reality as the main pathogenesis based on his unique treatment method for chronic sinusitus. Additionally, Professor Ruan Yan is good at using the main treatment methods such as benefiting qi and strengthening the spleen, promoting nasal circulation, and clearing heat and dampness to achieve both the symptoms and the root cause of the disease according to local conditions. What'more, Xanthium Powder is the basic prescription of Professor Ruan Yan for treating chronic sinusitis.

Key words: Chronic sinusitis, Data mining, Medication pattern, Prescription pattern, Xanthium Powder

中图分类号: 

  • R276.1
[1] Fokkens WJ, Lund VJ, Hopkins C, et al. European position paper on rhinosinusitis and nasal polyps 2020[J]. Rhinology, 2020, 58(Suppl S29): 1-464. doi:10.4193/Rhin20.600.
[2] Cosway B, Tomkinson A, Owens D. The European positional paper on rhinosinusitis and nasal polyps: has the introduction of guidance on the management of sinus disease affected uptake of surgery and acute admissions for sinusitis? [J]. Eur Arch Oto Rhino Laryngol, 2013, 270(3): 889-892. doi:10.1007/s00405-012-2027-2.
[3] 田勇泉. 耳鼻咽喉头颈外科学[M]. 7版. 北京: 人民卫生出版社, 2008.
[4] 张宇, 宋西成. 慢性鼻窦炎伴鼻息肉与哮喘的相关性机制及治疗策略研究进展[J]. 山东大学耳鼻喉眼学报, 2019, 33(1): 49-52. doi: 10.6040/j.issn.1673-3770.1.2018.033. ZHANG Yu, SONG Xicheng. Advances in interaction mechanisms and treatment strategy between chronic rhinosinusitis with nasal polyp and asthma[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2019, 33(1): 49-52. doi: 10.6040/j.issn.1673-3770.1.2018.033.
[5] 杨钦泰, 孙悦奇, 吴庆武, 等. 2020年欧洲鼻窦炎和鼻息肉意见书解读[J]. 中华耳鼻咽喉头颈外科杂志, 2020, 55(3): 304-308. doi:10.3760/cma.j.issn.1673-0860.2020.03.024. YANG Qintai, SUN Yueqi, WU Qingwu, et al. Interpretation of 2020 European position paper on rhinosinusitis and nasal polyps[J]. Chinese Journal of Otorhinolaryngology Head and Neck Surgery, 2020, 55(3): 304-308. doi:10.3760/cma.j.issn.1673-0860.2020.03.024.
[6] 邓晗薇, 朱镇华. 朱镇华教授运用皂角刺治疗慢性鼻窦炎经验[J]. 亚太传统医药, 2020, 16(8): 91-93. doi:10.11954/ytctyy.202008027.
[7] 张蓉, 王旭. 基于现代文献的鼻-鼻窦炎中医证型及证候要素分布研究[J]. 湖南中医杂志, 2020, 36(9): 149-151. doi:10.16808/j.cnki.issn1003-7705.2020.09.062.
[8] 李莹. 慢性鼻窦炎的辨证论治[J]. 山东大学耳鼻喉眼学报, 2018, 32(3): 27-30. doi: 10.6040/j.issn.1673-3770.1.2017.056. LI Ying. Syndrome differentiation of chronic sinusitis[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2018, 32(3): 27-30. doi: 10.6040/j.issn.1673-3770.1.2017.056.
[9] 鄢宁, 朱镇华. 中医药治疗儿童慢性鼻窦炎研究进展[J]. 亚太传统医药, 2021, 17(5): 204-207. doi: 10.11954/ytctyy.202105056. YAN Ning, ZHU Zhenhua. Research progress of traditional Chinese medicine in the treatment of chronic rhinosinusitis in children[J]. Asia-Pacific Traditional Medicine, 2021, 17(5): 204-207. doi: 10.11954/ytctyy.202105056.
[10] 张辛群, 马金香, 史剑波, 等. 广州市社区居民慢性鼻窦炎家庭聚集性分析[J]. 中国公共卫生, 2015, 31(2): 168-171. doi:10.11847/zgggws2015-31-02-11. ZHANG Xinqun, MA Jinxiang, SHI Jianbo, et al. Family aggregation of chronic nasosinusitis among community residents in Guangzhou City[J]. Chinese Journal of Public Health, 2015, 31(2): 168-171. doi:10.11847/zgggws2015-31-02-11.
[11] 詹坚宏, 阮岩. 阮岩辨治慢性鼻窦炎经验[J]. 广州中医药大学学报, 2020, 37(11): 2219-2222. doi:10.13359/j.cnki.gzxbtcm.2020.11.030. ZHAN Jianhong, RUAN Yan. Experience of RUAN Yan in differentiating and treating chronic sinusitis[J]. Journal of Guangzhou University of Traditional Chinese Medicine, 2020, 37(11): 2219-2222. doi:10.13359/j.cnki.gzxbtcm.2020.11.030.
[12] 阮岩. 中西医结合耳鼻咽喉科学[M]. 广州: 广东高等教育出版社, 2007.
[13] 张勤修, 陈文勇. 中西医结合耳鼻咽喉科学[M]. 4版. 北京: 中国中医药出版社, 2021.
[14] 钟赣生. 中药学[M]. 北京: 人民卫生出版社, 2006.
[15] 韩慧莹, 刘桂荣. 张志远临证运用甘草经验[J]. 中医杂志, 2021, 62(2): 101-103, 113. doi:10.13288/j.11-2166/r.2021.02.003. HAN Huiying, LIU Guirong. ZHANG zhiyuan's experience in using Gancao(Radix et rhizoma glycyrrhizae)[J]. Journal of Traditional Chinese Medicine, 2021, 62(2): 101-103, 113. doi:10.13288/j.11-2166/r.2021.02.003.
[16] 樊青, 关建红. 5种临床常用辛味中药饮片急性毒性初探: 探讨毒性中药界定与分级标准的不足[J]. 世界中西医结合杂志, 2021, 16(8): 1443-1446, 1452. doi:10.13935/j.cnki.sjzx.210813. FAN Qing, GUAN Jianhong. A preliminary study on the acute toxicity of five kinds of pungent herbs commonly used in clinic-discuss the insufficiency of the definition and grading standards of toxic traditional Chinese medicines[J]. World Journal of Integrated Traditional and Western Medicine, 2021, 16(8): 1443-1446, 1452. doi:10.13935/j.cnki.sjzx.210813.
[17] 盛天露, 张祖良, 陈冠宜, 等. 苍耳草与苍耳子的研究进展[J]. 广州中医药大学学报, 2021, 38(12): 2812-2816. doi:10.13359/j.cnki.gzxbtcm.2021.12.044. SHENG Tianlu, ZHANG Zuliang, CHEN Guanyi, et al. Progress in the research of herba xanthii and fructus xanthii[J]. Journal of Guangzhou University of Traditional Chinese Medicine, 2021, 38(12): 2812-2816. doi:10.13359/j.cnki.gzxbtcm.2021.12.044.
[18] 冯彦. 丹参的现代药理研究及临床应用[J]. 中医临床研究, 2017, 9(30): 46-47. FENG Yan. Modern pharmacological study and clinical application of Radix salviae miltiorrhizae[J]. Clinical Journal of Chinese Medicine, 2017, 9(30): 46-47.
[19] 封若雨, 朱新宇, 邢峰丽, 等. 路路通的药理作用研究概述[J]. 中国中医基础医学杂志, 2019, 25(8): 1175-1178. FENG Ruoyu, ZHU Xinyu, XING Fengli, et al. Review of the research on the pharmacological effects of fructus liquidambaris[J]. Chinese Journal of Basic Medicine in Traditional Chinese Medicine, 2019, 25(8): 1175-1178.
[20] 陈李. 医碥全本校注与研究(精)/岭南珍本古医籍校注丛书[M]. 广州: 广东科技出版社, 2018.
[21] (清)叶桂. 温热论[M]. 上海: 第二军医大学出版社, 2012.
[22] (清)张隐庵集注,孙国中,方向红点校. 黄帝内经素问集注[M]. 北京: 学苑出版社, 2002.
[23] 周建辉, 张耀锋. 研究五指毛桃药理作用并与黄芪的益气作用相对比[J]. 中医临床研究, 2015, 7(33): 145-147. doi:10.3969/j.issn.1674-7860.2015.33.072. ZHOU Jianhui, ZHANG Yaofeng. Comparison of pharmacological studies of Radix fici hirtae Yiqi and Huangqi[J]. Clinical Journal of Chinese Medicine, 2015, 7(33): 145-147. doi:10.3969/j.issn.1674-7860.2015.33.072.
[1] 敖天, 程雷. 慢性鼻窦炎伴鼻息肉的内型研究及其指导下的精准控制与治疗[J]. 山东大学耳鼻喉眼学报, 2022, 36(3): 7-14.
[2] 熊攀辉,沈暘,杨玉成. 基于表型和内在型的慢性鼻窦炎诊治进展[J]. 山东大学耳鼻喉眼学报, 2022, 36(3): 15-19.
[3] 姚爽,娄鸿飞. 慢性鼻窦炎的内在型研究进展及精准医疗[J]. 山东大学耳鼻喉眼学报, 2022, 36(3): 20-29.
[4] 石帅,郑泉,程雷. 度普利尤单抗在慢性鼻窦炎伴鼻息肉治疗中的研究进展[J]. 山东大学耳鼻喉眼学报, 2022, 36(3): 36-42.
[5] 王欢,胡俐,余洪猛. 慢性鼻窦炎相关嗅觉功能障碍研究进展[J]. 山东大学耳鼻喉眼学报, 2022, 36(3): 43-49.
[6] 宜若男,陈福权. 嗜酸性粒细胞与嗅觉功能障碍[J]. 山东大学耳鼻喉眼学报, 2022, 36(3): 50-55.
[7] 谷钰,万鑫,肖自安. 中性粒细胞和嗜酸性粒细胞在慢性鼻窦炎中的相互影响及临床治疗思考[J]. 山东大学耳鼻喉眼学报, 2022, 36(3): 56-63.
[8] 林海,朱莹,张维天. 慢性鼻窦炎发病中离子通道作用研究进展[J]. 山东大学耳鼻喉眼学报, 2022, 36(3): 64-70.
[9] 乔新杰,赵玉林. 慢性鼻窦炎中上皮间质转化信号转导通路及其他相关因子的研究进展[J]. 山东大学耳鼻喉眼学报, 2022, 36(3): 71-77.
[10] 黄丹怡,张婷,陈静,张薇. 上皮屏障在慢性鼻窦炎伴鼻息肉中的研究进展[J]. 山东大学耳鼻喉眼学报, 2022, 36(3): 78-83.
[11] 李佳倪,朱冬冬,孟粹达. 表观遗传学在慢性鼻窦炎伴鼻息肉发病机制中的作用[J]. 山东大学耳鼻喉眼学报, 2022, 36(3): 84-91.
[12] 曹轩,肖旭平,李云秋. 透明质酸在慢性鼻窦炎中的研究进展[J]. 山东大学耳鼻喉眼学报, 2022, 36(3): 104-109.
[13] 刘一潼,周穗子,邱前辉. NLRP3炎症小体在慢性鼻窦炎和变应性鼻炎中的研究进展[J]. 山东大学耳鼻喉眼学报, 2022, 36(3): 142-146.
[14] 刘厚军,张倩,程友,薛飞,许莉,吴明海. 慢性鼻窦炎伴双侧鼻息肉的发病与RANTES基因多态性的关系分析[J]. 山东大学耳鼻喉眼学报, 2022, 36(3): 165-170.
[15] 李琳,高正文,崔楠,孙健平,黄贤明,崔静. 儿童慢性鼻窦炎基因表达谱的生物信息学分析[J]. 山东大学耳鼻喉眼学报, 2022, 36(3): 171-180.
Viewed
Full text


Abstract

Cited
  Shared   
  Discussed   
[1] 马宝峰,党光福 . 折叠式人工晶状体经巩膜缝线固定术16例[J]. 山东大学耳鼻喉眼学报, 2008, 22(4): 376 -378 .
[2] 封新荣,张红霞,许贞姬,曲君君 . 射频消融术治疗慢性肥厚性鼻炎[J]. 山东大学耳鼻喉眼学报, 2006, 20(3): 225 -226 .
[3] 张秋贵,何海燕 . 青岛地区变应性鼻炎常见变应原调查分析[J]. 山东大学耳鼻喉眼学报, 2006, 20(6): 520 -521 .
[4] 李海燕,赵秋良,韩晓攀,于丽 . 阻塞性睡眠呼吸暂停综合征患者自由基损伤与高血压的关系[J]. 山东大学耳鼻喉眼学报, 2006, 20(6): 527 -529 .
[5] 宋西成,张华,张庆泉 . 血循环DNA的检测与头颈部肿瘤的诊断[J]. 山东大学耳鼻喉眼学报, 2006, 20(5): 385 -387 .
[6] 詹善强,孔凡俐,操文娟,汤杰,沈菊,詹文波 . 电刀切除扁桃体236例[J]. 山东大学耳鼻喉眼学报, 2006, 20(6): 559 -560 .
[7] 张 虎,艾 琴 . 甲状腺癌再手术15例[J]. 山东大学耳鼻喉眼学报, 2007, 21(2): 166 -167 .
[8] 胡 明,李招娜,李云杰,陶祥臣 . 硬性透气性角膜接触镜对圆锥角膜的塑形作用[J]. 山东大学耳鼻喉眼学报, 2007, 21(2): 171 -173 .
[9] 娄 锋 . 喉上神经阻滞预防喉显微手术心血管反应[J]. 山东大学耳鼻喉眼学报, 2008, 22(2): 173 -175 .
[10] 陈伟雄 王跃建 曾勇 何发尧 张剑利 郑立岗 汤苏成. 胸骨上小切口无注气内镜甲状腺手术的临床体会[J]. 山东大学耳鼻喉眼学报, 2009, 23(4): 24 -26 .
网站版权所有 © 2018 《山东大学耳鼻喉眼学报》编辑部　
地址：山东省济南市山大南路27号（250100）电话：+86-0531-88366912 E-mail: ebhxb@sdu.edu.cn
本系统由北京玛格泰克科技发展有限公司设计开发