目的:利用数据挖掘方法分析杨霓芝教授治疗不同原发病所致慢性肾功能衰竭(chronic renal failure,CRF)的用药规律.方法:通过广东省中医院门诊系统收集2019年杨霓芝教授门诊就诊的CRF患者病案资料,按照不同原发病分类总结,利用中医药传承辅助平台进行用药频次、组方规律及聚类分析.结果:收集慢性肾衰患者137例共410个处方,使用频次最高中药分别是泽兰(374)、黄芪(295)、桃仁(293)、丹参(247)、女贞子(231).原发病分别为慢性肾炎71例、糖尿病肾病16例、高血压肾病15例、梗阻性肾病15例,痛风性肾病5例,其他15例.不同原发病中医症状出现频次以疲倦、尺弱、舌淡暗、舌淡红、夜尿、乏力、小便泡沫、脉沉细、舌齿痕、腰酸、脉细、眠差最高;药物组合频次最高为桃仁-泽兰,泽兰-黄芪,丹参-泽兰;共获得治疗CRF新处方5个.结论:杨霓芝教授治疗CRF以益气活血为核心;以辨病-辨证-辨症-用药为体系,慢性肾小球肾炎患者多重用清热利湿之品,糖尿病肾病患者多重用补肾固精缩尿之品,高血压肾病患者偏重活血化瘀.
Objective:To analyze the medication rules of professor Yang Nizhi's treatment of chronic renal failure(CRF)induced by different primary diseases using data mining.Methods:The data of CRF patients in professor Yang Nizhi's outpatient clinic in 2019 were collected via the outpatient system of Guangdong Provincial Hospital of Chinese Medicine,the frequency of use,the rules of prescription composition and cluster analysis were carried out utilizing TCMISS according to the categories of different primary diseases.Results:All 137 CRF patients and 410 prescriptions were collected,Chinese medicines with the highest frequency were Zelan(Lycopi herba,374 times),Huangqi(Astragali radix,295 times),Taoren(Persicae semen,293 times),Danshen(Salviae miltiorrhizae radix et rhizoma,247 times)and Nüzhenzi(Ligustri lucidi fructus,231 times)respectively.Primary diseases contained 71 cases of chronic nephritis,16 diabetic nephritis,15 cases of hypertensive nephropathy,15 cases of obstructive nephropathy,5 cases of gouty nephropathy and 15 cases of other diseases.TCM symptoms with the highest frequency of different primary diseases contained fatigue,weak ulnar pulse,light and dark tongue,light and red tongue,nocturnal enuresis,weakness,urine bubble,deep and thin pulse,tongue with tooth marks,lumbar soreness,thin pulse and poor sleep;the drug combinations with the highest frequency were Taoren and Zelan,Zelan and Huangqi,Danshen and Zelan;five new prescriptions for the treatment of chronic nephropathy were obtained.Conclusion:Professor Yang Nizhi's treatment of CRF takes benefiting Qi and promoting blood circulation as the core;with disease differentiation-syndrome differentiation-symptom differentiation-medication as the system,giving the herbs of clearing heat and removing dampness to patients with chronic nephritis,the herbs of invigorating kidney,consolidating essence and arresting urine to the ones with diabetic nephropathy,and the herbs of promoting blood circulation and removing blood stasis to the ones with hypertensive nephropathy.