Comparative Study on the Medication Characteristics of Well-Known Veteran Traditional Chinese Medicine Doctors in the Treatment of Lung Cancer Based on Complex Networks Algorithm
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摘要:
目的 基于复杂网络算法对周仲瑛教授和赵景芳教授治疗肺癌辨证用药的个性差异进行比较,为总结与传承名老中医临床经验提供新的研究思路与数据支撑。 方法 采集周仲瑛教授和赵景芳教授治疗肺癌的门诊电子病历,借助复杂网络算法对两位名老中医的病历数据构建“证-证”和“证-药”复杂网络图谱,以分析两者肺癌辨证用药经验的个性化差异。 结果 通过分析复杂网络图谱,发现两位名老中医对肺癌的辨证均有气阴两虚证, 不同之处为周仲瑛教授还有痰瘀郁肺、热毒痰瘀、癌毒走注、痰瘀互结等证的辨证;而赵景芳教授常辨证型为肺脾气虚、痰热蕴肺、脾虚痰湿、肝郁脾虚等证。周仲瑛教授治疗肺癌的常用药物有北沙参、南沙参、麦冬、山慈菇、泽漆、太子参、仙鹤草、猫爪草、白花蛇舌草、炙僵蚕等;而赵景芳教授常用药物为党参、炒白术、制半夏、茯苓、太子参、南沙参、北沙参、陈皮、薏苡仁、猪苓、谷芽、麦芽、炙枇杷叶等。 结论 周仲瑛教授辨治肺癌从癌毒学说出发,强调癌毒的辨治;赵景芳教授辨治肺癌基于微调平衡理论,以培土生金法为治疗肺癌的主要治法。 Abstract:OBJECTIVE To compare the characteristics of medication based on syndrome differentiation in the treatment of lung cancer between Professor Zhou Zhongying (Professor Zhou) and Professor Zhao Jingfang (Professor Zhao) by complex network algorithm, and to provide a new research idea and data for summarizing and inheriting the clinical experience of well-known veteran traditional Chinese medicine (TCM) doctors. METHODS The lung cancer outpatient electronic medical records diagnosed by Professor Zhou and Professor Zhao were collected, and the complex network algorithm was applied to construct "syndrome-syndrome" and "syndrome-medication" complex network maps based on the two doctors' medical records, so as to analyze the individualized differences between their experience in medication based on syndrome differentiation of lung cancer. RESULTS Through the analysis of the complex network map, it was found that the syndromes of lung cancer identified by the two doctors both included deficiency of qi and yin. As for the differences, Professor Zhou identified syndromes as phlegm stagnation and lung constraint, heat toxin and phlegm stagnation, spreading of cancerous toxin, as well as binding of phlegm and stasis, while Professor Zhao identified syndromes as deficiency of lung and spleen qi, phlegm-heat accumulation in lung, spleen deficiency and phlegm dampness, along with liver constraint and spleen deficiency. The medications commonly used by Professor Zhou in treating lung cancer included Glehniae Radix, Adenophorae Radix, Ophiopogonis Radix, Cremastrae Pseudobulbus Pleiones Pseudobulbus, Herba Euphorbiae Helioscopiae, Pseudostellariae Radix, Agrimoniae Herba, Ranunculi Ternati Radix, Hedyotis diffusa Willd, and processed Bombyx Batryticatus, while Professor Zhao commonly used Codonopsis Radix, stir-fried Atractylodis Macrocephalae Rhizoma, processed Pinelliae Rhizoma, Poria, Pseudostellariae Radix, Adenophorae Radix, Glehniae Radix, Citri Reticulatae Pericarpium, Coicis Semen, Polyporus, Setariae Fructus Germinatus, Hordei Fructus Germinatus, and honeyed Eriobotryae Folium. CONCLUSION Treatment of lung cancer from Professor Zhou is based on the cancerous toxin theory, and he emphasizes treatment based on syndrome differentiation of cancerous toxin, while treatment of lung cancer from Professor Zhao is based on the theory of maintaining balance with the moderate regulation, and her main treatment method is banking up earth to generate metal. -
Key words:
- well-known veteran TCM doctor /
- lung cancer /
- academic inheritance /
- data mining /
- complex network
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表 1 证型频数分布表
名老中医 病机 频数 周仲瑛 气阴两虚 741 痰瘀郁肺 529 痰瘀互结 337 热毒痰瘀 204 癌毒走注 112 赵景芳 肺脾气虚 552 气阴两虚 457 痰热蕴肺 315 脾虚痰湿 197 肝郁脾虚 89 注: 仅列举频数排名前5证型。 表 2 周老证型-中药分类表
序号 证型 核心中药 1 气阴两虚 太子参(121)、南沙参(119)、北沙参(101)、麦冬(85) 2 痰瘀郁肺 炙鳖甲(111)、山慈菇(104)、泽漆(91)、猫爪草(81) 3 痰瘀互结 半夏(71)、炙僵蚕(56)、制南星(48) 4 热毒痰瘀 红豆杉(91)、白花蛇舌草(74)、半枝莲(51) 5 癌毒走注 露蜂房(82)、炙蜈蚣(67)、肿节风(49) 表 3 赵老证型-中药分类表
序号 证型 核心中药 1 气阴两虚 陈皮(348)、麦冬(76)、五味子(38)、太子参(10) 2 痰热蕴肺 党参(454)、姜半夏(288)、桔梗(259)、北沙参(47)、南沙参(13) 3 痰浊阻肺 枇杷叶(427)、桑白皮(268)、法半夏(173)、枳实(24)、浙贝母(21) 4 肺脾气虚 薏苡仁(317)、茯苓(268)、猪苓(209)、炒麦芽(136)、谷芽(140) 5 肝郁脾虚 炒白术(245)、茯神(182)、枳壳(52)、柴胡(22) 注:药物角标数字为该药物的节点度。 -
[1] World Health Organization (WHO). World cancer report 2020[EB/OL]. (2021-04-03)[2021-09-09]. https://www.doc88.com/p-98073050163594.html?r=1. [2] 崔慧娟. 张代钊教授运用中医药治疗肺癌经验的整理和挖掘[D]. 北京: 中国中医科学院, 2012. [3] 王珊珊. 周仲瑛教授从痰瘀热毒辨治肺癌的临床经验及益肺解毒汤的抗肿瘤实验研究[D]. 南京: 南京中医药大学, 2017. [4] 中医临床诊疗术语·证候部分[S]. 北京: 中国标准出版社, 1997. [5] 国家中医药管理局《中华本草》编委会. 中华本草[M]. 上海: 上海科学技术出版社, 1998. [6] 贾鹰珏. 数据挖掘方法总结张宁治疗慢性肾脏病证治规律及愈肾方机理研究[D]. 北京: 中国中医科学院, 2017. [7] 闫蔷薇, 王至婉. 复杂网络方法在中医药中的应用与思考[J]. 时珍国医国药, 2017, 28(12): 2978-2980. https://www.cnki.com.cn/Article/CJFDTOTAL-SZGY201712058.htm [8] 周雪忠, 刘保延, 王映辉, 等. 复方药物配伍的复杂网络方法研究[J]. 中国中医药信息杂志, 2008, 15(11): 98-100. doi: 10.3969/j.issn.1005-5304.2008.11.055 [9] 程海波. 癌毒病机理论探讨[J]. 中医杂志, 2014, 55(20): 1711-1715. https://www.cnki.com.cn/Article/CJFDTOTAL-ZZYZ201420001.htm [10] 程海波, 周仲瑛, 李柳, 等. 基于癌毒病机理论的中医肿瘤临床辨治体系探讨[J]. 中医杂志, 2015, 56(23): 1989-1992. https://www.cnki.com.cn/Article/CJFDTOTAL-ZZYZ201523004.htm [11] 郭建辉. 周仲瑛教授"癌毒学说"新论[J]. 湖南中医药大学学报, 2010, 30(11): 6-8. https://www.cnki.com.cn/Article/CJFDTOTAL-HNZX201011003.htm [12] 赵景芳. 赵景芳·微调三号方[J]. 江苏中医药, 2013, 45(3): 18. https://www.cnki.com.cn/Article/CJFDTOTAL-JSZY201303011.htm [13] 周留勇, 单珍珠. 赵景芳"微调平衡治癌法"理论及临床运用探讨[J]. 中国中医基础医学杂志, 2016, 22(1): 90-92. https://www.cnki.com.cn/Article/CJFDTOTAL-ZYJC201601035.htm