李雨彦　林韦翰　李顺民

摘要 目的：應用数据挖掘技术，总结名老中医李顺民教授诊治慢性肾衰的临床用药经验与规律。方法：收集李顺民教授近5年在医院，临床诊治慢性肾衰（CRF）的处方，并对用药情况进行了整理与分析。结果：研究发现李顺民教授辨治慢性肾衰所使用中药品种多达249种，使用频率大于50%以上的有9种，依次为黄芪（97%）、大黄（94%）、甘草（91%）、山药（86%）、白术（71%）等。配伍用药分析提示，总计有3 946种药对，其中使用频率大于50%以上的27对，主要有黄芪、甘草（87%），黄芪、山药（85%），黄芪、大黄（83%）等。运用方剂词库表检测后，涉及用方总数为539首，其中使用最频繁的方剂为李顺民经验方——健脾益肾方，高达88%。中药性味归经方面，李顺民教授辨治慢性肾衰使用温药最多，其次为平性药和寒性药，热性药物少用。药味以甘味药最多，其次为苦味和辛味药。归经以归脾经药物比例最高，其次为归肺、肾、肝、大肠经。结论：李顺民教授辨治慢性肾衰竭，常用黄芪、大黄、甘草、山药、白术等补益脾肾、调和阴阳，兼攻下、活血、解表、固精的药物。数据挖掘技术是整理中医药名老中医经验的有效工具。

关键词 健脾益肾;数据挖掘;慢性肾衰;中医处方;临床用药; @ 李顺民;个人医案

Abstract Objective：Based on data mining， to summarize clinical medication experience and rules of a famous practitioner in traditional Chinese medicine（TCM）， Professor LI Shunmin， in diagnosis and treatment of chronic renal failure（CRF）.Methods：Clinical prescriptions of Professor LI Shunmin for the diagnosis and treatment of CRF in the hospital in recent 5 years were collected.And the medication was summarized and analyzed.Results：There were 249 kinds of Chinese materia medica in the treatment of CRF by Professor LI Shunmin， but only 9 kinds were used more than 50% frequency， such as Radix Astragali seu Hedysari（97%）， Radix et Rhizoma Rhei（94%）， Radix Glycyrrhizae（91%）， Rhizoma Dioscoreae（86%）and Rhizoma Atractylodis Macrocephalae（71%）.Analysis on compatibility of medication showed that the total number of medicine pairs was 3 946， of which 27 were used more than 50% frequency.They were Radix Astragali seu Hedysari with Radix Glycyrrhizae（87%）， Radix Astragali seu Hedysari with Rhizoma Dioscoreae（85%）， Radix Astragali seu Hedysari with Radix et Rhizoma Rhei（83%）， etc.The total number of formulas used was 539 after checking with the lexicon of formulas.Among them， Jianpi Yishen Formula， also called Lishunmin Jingyan Formula， was the most frequently used， with the frequency of 88%.On properties， flavors and channel tropism of Chinese materia medica， warm medicine was the most frequently used in the treatment of CRF by Professor LI Shunmin.Next were neutral medicine and cold medicine， and hot medicine was used rarely.The most frequently used flavor was sweet， and bitter medicine and acrid medicine followed.Medicine of spleen channel was used the most frequently， followed by medicine of lung， kidney， liver and large intestine channels.Conclusion：Professor LI Shunmin often prescribes medicines with functions of tonfying and benefiting spleen and kidney， regulating yin and yang， purgation， activating blood， releasing exterior and securing essence in the treatment of CRF， such as Radix Astragali seu Hedysari， Radix et Rhizoma Rhei， Radix Glycyrrhizae， Rhizoma Dioscoreae and Rhizoma Atractylodis Macrocephalae.Data mining is an effective tool to sort out the experience of famous TCM practitioners.

Keywords Invigorating spleen and benefiting kidney; Data mining; Chronic renal failure; Prescription in traditional Chinese medicine; Clinical medication; @ LI Shunmin; Personal medical cases

中图分类号：R692.5;249.2./7文献标识码：Adoi：10.3969/j.issn.1673-7202.2020.02.032

慢性肾衰（Chronic Renal Failure，CRF）是一种严重危害人民生命健康的严重疾病，指在慢性肾脏病的基础上，病情进行性进展所引起的肾功能与肾单位不可逆性丧失，进而导致以代谢产物及毒物潴留、酸碱平衡及水电解质紊乱、内分泌失调等为特征的临床综合征[1]。……