基于數據挖掘的現代湖湘男科流派醫家治療激素難治性前列腺癌用藥規律研究

劉德果 趙姣 蘇藝峰 陳其華 胡金輝 向時竹 林夢姣

〔摘要〕 目的 基于數據挖掘研究現代湖湘男科流派代表醫家譚新華、賀菊喬、陳其華治療激素難治性前列腺癌（hormone refractory prostate cancer， HRPC）的用藥規律。方法 收集2012年5月至2020年8月現代湖湘男科流派醫家譚新華、賀菊喬、陳其華于湖南中醫藥大學第一附屬醫院國醫堂專家門診治療HRPC的處方，采用中醫傳承輔助平臺軟件（V 2.50）對上述處方進行描述性分析、關聯規則分析、復雜系統熵聚類分析。結果 本研究共納入HRPC治療處方241首，涉及藥物99味，頻次>100次的藥物共14味，前5位依次為黃芪、甘草、三棱、莪術、熟地黃。藥物四氣前3位分別為溫、寒、平;藥物五味前3位分別為甘、辛、苦;藥物歸經前3位分別為腎、脾、肝。獲得治療HRPC藥物組合28條;經復雜系統熵聚類分析后，獲得7個核心藥對及4個新藥物組合。結論 “腎虛血瘀”是HRPC發病的主要病機，現代湖湘男科流派醫家治療HRPC遣方用藥側重于益腎溫陽，活血化瘀，可為中醫臨床治療HRPC提供用藥參考。

〔關鍵詞〕 前列腺癌;激素難治性前列腺癌;數據挖掘;用藥規律;男科;醫家

〔中圖分類號〕R277.5? ? ? ?〔文獻標志碼〕A? ? ? ?〔文章編號〕doi：10.3969/j.issn.1674-070X.2021.05.014

Research on the Drug Rule of Modern Huxiang Andrology School in the Treatment of

Hormone-refractory Prostate Cancer Based on Data Mining

LIU Deguo1，2， ZHAO Jiao1， SU Yifeng1， CHEN Qihua2*， HU Jinhui2， XIANG Shizhu1， LIN Mengjiao1

（1. Hunan University of Chinese Medicine， Changsha， Hunan 410008， China; 2. The First Affiliated Hospital of Hunan University of Chinese Medicine， Changsha， Hunan 410208， China）

〔Abstract〕 Objective Based on data mining to study the medication rules of modern Huxiang andrology school representatives Tan Xinhua， He Juqiao， Chen Qihua， etc. in the treatment of hormone refractory prostate cancer （HRPC）. Methods From May 2012 to August 2020， doctors Tan Xinhua， He Juqiao， and Chen Qihua from the modern Huxiang andrology school were collected from the expert clinic of the Traditional Chinese Medicine Hall of the First Affiliated Hospital of Hunan University of Chinese Medicine. The prescriptions for HRPC were collected， and the traditional Chinese medicine inheritance auxiliary platform software （V 2.50） was used to perform descriptive analysis， association rule analysis， and complex system entropy cluster analysis on the above prescriptions. Results A total of 241 prescriptions for HRPC were included in this study， involving 99 drugs， and 14 drugs with a frequency of more than 100 times. The top 5 were Huangqi （Astragali Radix）， Gancao （Glycyrrhizae Radix Et Rhizoma）， Sanleng （Sparganii Rhizoma）， Ezhu （Curcumae Rhizoma）， Shudihuang （Rehmanniae Radix Praeparata）. The top 3 of the four Qi of the drug were warm， cold， and flat; the top 3 of the five flavors of the drug were sweet， pungent， and bitter; the top 3 of the channels of the drug were kidney， spleen， and liver. 28 drug combinations for the treatment of HRPC were obtained through the association rule analysis; after complex system entropy cluster analysis， 7 core drug pairs and 4 new drug combinations were obtained. Conclusion "Kidney deficiency and blood stasis" is the main pathogenesis of the onset of HRPC. Modern Huxiang andrology school doctors used medicines to treat HRPC with a focus on invigorating the kidney and warming Yang， promoting blood circulation and removing blood stasis drugs， which can provide a reference for the clinical treatment of HRPC in traditional Chinese medicine.