顾志荣 许爱霞 陈其章 萨日娜 杨军彦 李芳 葛斌

摘要：目的 探討灰色-模糊系统数学模型在中医治疗特发性肺纤维化（IPF）组方用药规律研究中的应用，为临床用药及同类型研究提供参考。方法 计算机检索中国知识资源总库（CNKI）、中国学术期刊数据库（万方数据）、中国生物医学文献数据库（CBM）、中文科技期刊数据库（维普网）建库至2017年8月发表于核心期刊的中医治疗IPF相关文献，采用灰色关联度分析、灰色聚类分析及模糊聚类分析等灰色-模糊系统数学模型，挖掘组方规律及用药特点。结果 纳入处方191首，涉及药物227味，使用频次>5%的药物有48味，包括黄芪、丹参、当归等；灰色关联度分析及灰色聚类分析均表明，补虚药（黄芪、冬虫夏草、北沙参、党参、白芍等）、化痰止咳平喘药（浙贝母、川贝母、桑白皮、紫菀等）及活血化瘀药（川芎、三七、红花、水蛭等）对中医治疗IPF的方剂评价系统的影响较大；模糊聚类分析得到核心药物组合10组，新处方4首。结论 中医治疗IPF用药以补虚、化痰止咳平喘及活血化瘀为主；采用基于灰色-模糊系统的数学模型可较客观、全面地反映其用药特点和规律。

关键词：中医；特发性肺纤维化；灰色关联度；灰色聚类；模糊聚类；用药规律

DOI：10.3969/j.issn.1005-5304.2018.12.022

中图分类号：R2-05；R259.63 文献标识码：A 文章编号：1005-5304（2018）12-0092-05

Abstract： Objective To explore the application of mathematical model based on gray-fuzzy system in the study of TCM in the treatment of idiopathic pulmonary fibrosis （IPF）； To provide references for clinical medication and similar research. Methods Literature published in the core journals about TCM prescription for IPF from the databases of CNKI， CBM， VIP and Wanfang Data was searched from the establishment to August 2017. The gray correlation analysis， gray clustering analysis and fuzzy clustering analysis based on gray-fuzzy system mathematical model were used to dig the rules of prescription and medication characteristics. Results Totally 191 prescriptions were included in the study， involving 227 kinds of Chinese materia medica. 48 kinds of Chinese materia medica showed frequency > 5%， including Astragali Radix， Salviae Miltiorrhizae Radix et Rhizoma and Angelicae Sinensis Radix， etc. Gray correlation analysis and gray clustering analysis showed that tonifying deficiency medicine （Astragali Radix， Cordyceps， Glehniae Radix， Codonopsis Radix and Paeoniae Radix alba）， resolving phlegm and relieving cough and asthma medicine （Fritillariae Thunbergii Bulbus， Fritillariae Cirrhosae Bulbus， Mori Cortex and Asteris Radix et Rhizoma） and activating blood circulation to dissipate blood stasis medicine （Chuanxiong Rhizoma，Notoginseng Radix et Rhizoma， Carthami Flos and Hirudo） had obvious effects on evaluation system of TCM treatment for IPF prescription. Fuzzy clustering analysis obtained ten core medicine groups and four new prescriptions. Conclusion TCM for the treatment of IPF mainly use medicine with efficacy of tonifying deficiency， relieving cough and asthma and activating blood circulation to dissipate blood stasis. The mathematical model based on gray-fuzzy system can reflect the characteristics and rules of medication objectively and comprehensively.

Keywords： TCM； idiopathic pulmonary fibrosis； gray correlation； gray clustering； fuzzy clustering； medication rules

特发性肺纤维化（idiopathic pulmonary fibrosis，IPF）是一种慢性、不可逆、进行性、纤维化型的间质性肺炎。其发病原因不明，多发生于成人[1]，且预后差、死亡率高，明确诊断后中位生存期仅2～3年，5年生存率不足40%，现代医学除肺移植及长期氧疗外，尚无有效治疗手段[2]。I……