郑昆+吴嘉瑞+张非非

[摘要] 目的 探讨名老中医治疗冠心病的用药规律。 方法 收集名老中医治疗冠心病的处方，通过中医传承辅助系统软件构建数据库，采用关联规则Apriori算法和复杂系统熵聚类方法，分析处方中各个药物和药对组合的使用频次及药物之间的关联规则、处方规律等。 结果 最终纳入处方985首，分析得出高频药物包括丹参、川芎、茯苓、黄芪、瓜蒌等；高频药物组合包括“川芎，丹参”“丹参，黄芪”“丹参，瓜蒌”等；置信度>0.7的关联规则包括“延胡索->丹参”“丹参，薤白->瓜蒌”“薤白->瓜蒌”“五味子，丹参->麦冬”等；挖掘出核心组合36组，得到新处方18首。 结论 名老中医治疗冠心病多用活血化瘀、益气通络、化痰散结等药物，配伍精巧，符合中医理论中标本兼治的规则，对临床具有参考价值，同时中医传承辅助系统对挖掘名老中医用药规律具有重要价值。

[关键词] 冠心病；名医经验；关联规则；聚类算法；中医传承辅助系统

[中图分类号] R285.5 [文献标识码] A [文章编号] 1673-7210（2017）12（c）-0113-04

[Abstract] Objective To investigate the medication rules of famous senior Chinese physician in the treatment of coronary heart disease. Methods The prescriptions about famous senior Chinese physician in the treatment of coronary heart disease were collected， the database was built based on traditional Chinese medicine （TCM） inheritance assist system software platform. Apriori algorithm and complex system entropy cluster were used to analyze the utilizing frequency of all drugs in the prescription and couplet medicines and the association rules， prescription principles between different medicines. Results Totally 985 drugs were enrolled， the frequently adopted drugs were Salvia Miltiorrhiza， Rhizoma Chuanxiong， Poria Cocos， Radix Astragali， Fructus Trichosanthis， and so on； and the frequently adopted drug combinations were "Rhizoma Chuanxiong， Salvia Miltiorrhiza" "Salvia Miltiorrhiza， Radix Astragali" "Salvia Miltiorrhiza， Fructus Trichosanthis"， and so on. The drug combinations with association rules >0.7 included "Corydalis Rhizoma->Salviae Miltiorrhiza" "Salviae Miltiorrhiza， Longstamen Onion Bulb->Fructus Trichosanthis" "Longstamen Onion Bulb->Fructus Trichosanthis" "Chinese Magnoliavine， Salvia Miltiorrhiza->Dwarf Lilyturf Tuber"， etc. 36 groups of core group were excavated， and 18 new prescriptions were obtained. Conclusion Famous senior Chinese physician in the treatment of coronary heart disease often use the drugs of activating circulation to remove blood stasis， tonifying qi and relaxing vein， reducing phlegm and resolving masses， which reflects a refined and rational compatibility and the principles of TCM to treat symptoms and root causes. This study has reference value for clinic， and TCM inheritance assist system is valuable to explore the medication rules of famous senior Chinese physician.

[Key words] Coronary heart disease； Experience of famous doctors； Association rules； Clustering algorithm； TCM inheritance assist system

冠心病是現代临床常见的心血管疾病，主要分为隐匿型、心绞痛型、心肌梗死型、心力衰竭型、猝死型五个类型。冠心病是全球病死率中排名首位之一的疾病，而随着我国经济的发展，人民生活水平的提高，冠心病发病率也呈逐年增长趋势[1-3]。我国传统中医治疗冠心病立足整体，重视机体的自愈能力，对机体进行综合调理，使之达到平衡，从而达到治疗目的，其在治疗冠心病方面发挥着重要作用。名老中医是我国当前中医临床及学术的杰……