来源：风湿病与关节炎,2021,10（6）:1-5,28.

刘健教授中医药治疗干燥综合征用药规律的数据挖掘研究（临床研究）

陈瑞莲^1,2，刘　健^1,2，汪　元^1,2，万　磊^1,2，黄　旦¹，忻　凌^1,2，方妍妍¹

　　【摘　要】目的：探讨刘健教授中医药治疗原发性干燥综合征的用药规律。方法：基于数据挖掘技术，对2012年6月至2019年6月刘健教授诊治的原发性干燥综合征患者病历进行分析，采用SPSS 22.0与SPSS Clementine 11.1软件对用药频次及药物的性味归经进行频次分析、聚类分析及关联规则分析。结果：①寒性、温性和平性，苦味、甘味和辛味，以及归脾、肺、肝经药使用最频繁。②使用频次前20味中药为健脾化湿药、养阴生津药、清热解毒药、活血化瘀药。③聚类分析得出，常用中药可聚为5类：桃仁、红花、丹参、甘草、茯苓、山药聚为一类；薏苡仁、陈皮、炒麦芽聚为一类；白芍、麦冬聚为一类；黄精、五味子、生地黄、佛手聚为一类；北沙参、太子参、石斛、芦根、酸枣仁聚为一类。④药物之间关联规则分析得出，健脾化湿药、养阴生津药、清热解毒药、活血化瘀药是相互关联的。⑤药物与实验室指标之间关联规则分析得出，茯苓与补体C3、补体C4、超敏C反应蛋白（hs-CRP）、红细胞沉降率（ESR）下降关联度较高，五味子与免疫球蛋白（Ig）A、IgG、IgM下降关联度较高。茯苓配伍山药与补体C3、补体C4、IgA、IgG、IgM下降关联度较高，茯苓配伍丹参与ESR、hs-CRP下降关联度较高。结论：刘健教授治疗原发性干燥综合征以健脾化湿药为主，配伍养阴生津药、清热解毒药、活血化瘀药，寒温并用，祛邪不忘扶正，标本兼治。

　　【关键词】　干燥综合征；用药规律；数据挖掘；关联规则；聚类分析；经验；刘健

On Professor LIU Jian's Medication Rule in the Treatment of Sjögren's Syndrome with Chinese Medicine by Data Mining

CHEN Rui-lian,LIU Jian,WANG Yuan,WAN Lei,HUANG Dan,XIN Ling,FANG Yan-yan

　　【ABSTRACT】Objective:To explore Professor LIU Jian's medication rule in treating primary Sjögren's syndrome with Chinese medicine.Methods:Based on data mining technology,the cases of primary Sjögren's syndrome diagnosed and treated by Professor LIU Jian from June 2012 to June 2019 were analyzed.Softwares SPSS 22.0 and SPSS Clementine 11.1 were used for frequency analysis,cluster analysis and association rule analysis of medication frequency and drug taste.Results:①Drugs with cold,warm and neutral,bitter,sweet and pungent flavor,and those pass through the spleen,lung and liver channels were used most frequently.②The top 20 drugs in frequency were fortifying the spleen and removing dampness,nourishing yin and promoting fluid production,clearing heat and resolving toxins,invigorating blood and dissolving stasis.③Cluster analysis showed that the commonly used drugs could be clustered into five categories:Taoren（Semen Persicae）,Honghua（Flos Carthami）,Danshen（Radix et Rhizoma Salviae Miltiorrhizae）,Gancao（Radix et Rhizoma Glycyrrhizae）,Fuling（Poria）and Shanyao（Rhizoma Dioscoreae）;Yiyiren（Semen Coicis）,Chenpi（Pericarpium Citri Reticulatae）and Chaomaiya（Fructus Setariae Germinatus）;Baishao（Radix Paeoniae Alba）and Maidong（Radix Ophiopogonis）;Huangjing（Rhizoma Polygonati）,Wuweizi（Fructus Schisandrae Chinensis）,Shengdihuang（Rehmannia glutinosa（Gaertn.）Li-bosch.）and Fushou（Fructus Citri Sarcodactylis）;Beishashen（Radix Glehniae）,Taizishen（Radix Pseudostellariae）,Shihu（Caulis Dendrobii）,Lugen（Rhizoma Phragmitis）and Suanzaoren（Semen Ziziphi Spinosae）.④According to the analysis of association rules between drugs,the drugs of fortifying the spleen and removing dampness,nourishing yin and promoting fluid production,clearing heat and resolving toxins,invigorating blood and dissolving stasis are interrelated.⑤The analysis of association rules between drugs and laboratory indexes showed that Fuling had a high correlation with the decrease of C3,C4,hs-CRP and ESR,while Wuweizi had a high correlation with the decrease of IgA,IgG and IgM.There was a high correlation between the compatibility of Fuling with Shanyao and the decrease of C3,C4,IgA,IgG and IgM.The compatibility of Shanyao with Danshen had a high correlation with the decrease of ESR and hs-CRP.Conclusion:Professor LIU Jian's treatment of primary Sjögren's syndrome is mainly based on drugs of invigorating spleen  and removing dampness,combined with those of nourishing yin and promoting fluid production,clearing heat and resolving toxins,invigorating blood and dissolving stasis,combining cold with warm,eliminating pathogenic factors and strengthening the body,treating the root and branch simultaneously.

　　【Keywords】 Sjögren's syndrome;medication rule;data mining;association rules;cluster analysis;experience;LIU Jian