许晨璐 梁建庆 王佳华 董海玉 韩政阳 李斐

【摘 要】 目的：通過文献数据挖掘探讨前列腺癌中医证素及症状/体征分布规律，为辨证论治提供参考。方法：检索中国知网、万方、维普及中国生物医学文献数据库中前列腺癌中医证型、证素及症状/体征相关文献，建立数据库，运用SPSS Statistics 26.0和Gephi 0.9.2软件进行因子、聚类及复杂网络分析，挖掘前列腺癌患者的中医证候特点和分布规律。结果：前列腺癌证型分布以下焦湿热证多见，总体以虚证为主。证素分布显示病位多在肾、脾、肝及下焦，病理性质正虚邪实，正虚以气、阴、阳、血的亏虚为主，实以血瘀、湿、热、毒、痰为主。证素聚类分析结果分为7类：肾阳亏虚证、毒瘀互结证、脾气血两虚证、肝阴亏虚证、下焦湿热证、痰浊内阻证和气机郁滞证。症状/体征复杂网络分析核心症状/体征为尿频尿急、小便不利、神疲乏力、纳呆、腰膝酸软、腰痛、失眠、夜尿多、舌红、腹部胀痛、大便干燥、口干口渴、排尿疼痛、消瘦、畏寒肢冷。症状/体征因子及聚类分析最终聚为5类：气阴亏虚证、肾阳亏虚证、肾虚湿热证、气虚血瘀证、热毒内蕴证。结论：正虚邪实是前列腺癌变化发展的主要病机，肾阳亏虚证、气阴亏虚证、下焦湿热证、毒瘀互结证是前列腺癌的临床常见证型。

【关键词】 前列腺癌；证候；证素；症状/体征；数据挖掘

【中图分类号】R737.25   【文献标志码】 A    【文章编号】1007-8517（2023）08-0107-07

Abstract：Objective To explore the distribution of TCM syndromes and symptoms/signs of prostate cancer by literature data mining， and to provide reference basis for syndrome differentiation and treatment. Method The literatures related to TCM syndrome types， syndrome elements and symptoms/signs of prostate cancer were retrieved from CNKI， Wanfang， VIP and Chinese Biomedical literature database， and the database was established. SPSS Statistics 26.0 and Gephi 0.9.2 software were used for factor， cluster and complex network analysis.Explore the TCM syndrome characteristics and distribution of prostate cancer patients. Results The syndrome type distribution of prostate cancer is mainly damp-heat syndrome of lower coke， and generally deficiency syndrome.The distribution of syndrome elements showed that the disease location was mostly in kidney， spleen， liver and lower coke. The pathological nature of positive deficiency was mainly deficiency of qi， Yin， Yang and blood， while the latter was mainly blood stasis， dampness， heat， poison and phlegm.The results of cluster analysis of syndrome elements were divided into 7 categories： deficiency of kidney-yang syndrome， combination of poison and stasis syndrome， deficiency of spleen-qi and blood syndrome， deficiency of liver-yin syndrome， damp-heat syndrome of lower jiao， obstruction of phlegm and turbidness， and stagnation of qi.Symptoms/Signs Complex network analysis Core symptoms/signs were frequent urination， urination difficulty， fatigue， lethargy， soreness in the waist and knees， lumbago， insomnia， nocturia， red tongue， abdominal distension， dry stool， dry mouth and thirst， painful urination， emaciation， chills and cold limbs.Symptoms/sign factors and cluster analysis finally clustered into five categories：Qi Yin deficiency syndrome，kidney Yang deficiency syndrome，kidney deficiency and heat syndrome，Qi deficiency and blood stasis syndrome，heat poison accumulation syndrome．Conclusion Positive deficiency and pathogenic solid are the main pathogenesis of prostate cancer. Kidney Yang deficiency syndrome，Qi Yin deficiency syndrome，lower coke dampness and heat syndrome，poison and blood stasis mutual junction syndrome are the common clinical syndrome of prostate cancer.

Key words：Prostate Cancer; TCM Syndromes; TCM Pattern Elements; Symptoms/Signs; Data Mining

前列腺癌（prostate cancer，Pca）为泌尿系恶性实体肿瘤，多发于中老年男性，至2020年居西方国家男性癌症发病率第二，死亡率第五［1］。当前西医治疗主要采取手术、内分泌、免疫、放化疗、分子靶向治疗等方法，常导致神经、免疫及内分泌功能紊乱等一系列不良反应。……