基于《中国方剂数据库》挖掘便秘组方配伍规律

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摘要 目的：分析《中国方剂数据库》收录治疗便秘方剂组方用药配伍规律，为临床治疗便秘提供研究依据。方法：选取并筛选《中国方剂数据库》收录治疗便秘方剂，采用频次分析、因子分析、系统聚类、关联规则分析等数据挖掘方法对筛选方剂组方用药进行分析。结果：共筛选287首治疗便秘的方剂，涉及中药211味，出现频数最高的单味药为甘草（109次），其次为大黄（103次）;因子分析可提取出25个主成分;聚类数目为5类时较好，常用药物有大黄、黄芩、当归、芍药、陈皮、木香、地黄、人参等，演化得到核心组合10个;关联分析显示：大黄配伍黄芩、栀子;大黄配伍芒硝;甘草配伍栀子、黄芩;大黄配伍黄连为常用药对。结论：《中国方剂数据库》收录治疗便秘方剂药类以补虚、解表、清热、理气、泻下以及化痰平喘为主。而大黄→槟榔;当归→地黄;甘草→陈皮;羌活→防风;芍药→当归值得进一步讨论。

关键词 数据挖掘;便秘;配伍规律;系统聚类分析;关联规则分析

Abstract Objective：To analyze the compatibility rule of Chinese Prescription Database in the treatment of constipation，and to provide basis for clinical treatment of constipation.Methods：Based on the screening of formula in the treatment of constipation in the Chinese Prescription Database，we collected and analyzed the prescription by frequency analysis，factor analysis，system clustering，association rule analysis and other data mining methods.Results：A total of 287 prescriptions for constipation were screened，involving 211 Chinese herbs，and the most frequent one was Radix Glycyrrhizae（109 times），followed by Radix et Rhizoma Rhei（103 times）.Factor analysis can extract 25 principal components.The cluster number of 5 kinds was good，and commonly used drugs were Radix et Rhizoma Rhei，Radix Scutellariae，Radix Angelicae Sinensis，Paeonia Lactiflora，Pericarpium Citri Reticulatae，Radix Aucklandiae，Radix Rehmanniae Recens，Radix Ginseng，etc.，and 10 core combinations were obtained.The correlation analysis showed that Radix et Rhizoma Rhei combined with Radix Scutellariae and Fructus Gardeniae; Radix et Rhizoma Rhei with Natrii Sulfas; Radix Glycyrrhizae with Fructus Gardeniae and Radix Scutellariae; Radix et Rhizoma Rhei with Rhizoma Coptidis were known drug pair.Conclusion：The drugs of formula for constipation in Chinese Prescription Database were mainly tonifying deficiency，relieving superficies，clearing away heat，regulating qi，purging purgation and eliminating phlegm and relieving wheezing.And Radix et Rhizoma Rhei→ Semen Arecae; Radix Angelicae Sinensis→ Radix Rehmanniae Recens; Radix Glycyrrhizae→ Pericarpium Citri Reticulatae; Rhizoma et Radix Notopterygii→ Radix Saposhnikoviae; Paeonia Lactiflora→Radix Angelicae Sinensis are worthy of further discussion，which will provide some reference for the research and development of new drugs of TCM for constipation.

Key Words Data mining; Constipation; Formulating rules; Hierarchical clustering; Association rules

中圖分类号：R243;R574文献标识码：Adoi：10.3969/j.issn.1673-7202.2019.08.054

便秘是指大肠传导功能失常，导致大便秘结，排便周期延长;或周期不长，但粪质干结，排便困难;或粪质不硬，虽有便意，但排出不畅的病证[1]。《黄帝内经》首载便秘之症，称其为“后不利”“大便难”。汉·张仲景《伤寒杂病论》中将便秘称为“脾约”。刘完素首倡实秘、虚秘之别，《素问病机气宜保命集·泻痢论》载：“凡脏腑之秘，不可一例治疗，有虚秘，有实秘，胃实而秘者，能饮食小便赤……胃虚而秘者，不能饮食，小便清利”。而便秘一名首见于清代沈金鏊的著作《杂病源流犀烛》中，并沿用至今。络脉从经脉分出后，逐级细分为别络至缠络、系络直至其末端孙络。随着络脉分支愈加细窄迁曲，络中气血的运行渐趋缓慢，一旦邪客络脉，络中气血的输布环流将受到影响，易致络脉瘀滞状态。气化功能失常，络气郁滞，或络气虚乏推运无力而滞，气化不利则津凝为痰，气失流畅则血行涩滞，痰瘀阻滞，络脉由滞到瘀，气血瘀塞不通。痰瘀阻络进一步影响气的升降出入运动而加重气滞。大肠传化功能的正常运行以及大便的通畅调合依赖于气机运行的调畅。例如肺主一身之气，与大肠相表里，若肺气失宜，壅滞不降，大肠传导阻滞则发为便秘。中药方剂是中医治疗的主要手段，基于博大而深厚的传统理论，其组成配伍规律庞杂多变。目前，基于数据挖掘技术对中医药方剂的研究主要集中于药证结合、中药组合、方剂配伍以及核心方药的发现方面。