基于数据挖掘探析宫腔粘连的用药规律及组方思路*

作者：尹飞鸿，曾 晶，刘文娥

单位：湖南中医药大学第一附属医院，湖南 长沙 410006

引用：引用：尹飞鸿，曾晶，刘文娥.基于数据挖掘探析宫腔粘连的用药规律及组方思路[J].中医药导报,2025,31(4):161-166.

DOI：10.13862/j.cn43-1446/r.2025.04.028

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摘要：

目的：探索治疗宫腔粘连的中药配伍规律和组方思路，以为临床用药提供参考。方法：检索中国知网（CNKI）、万方数据库、维普中文科技期刊数据库（VIP）、中国生物医学文献服务系统（SinoMed）中关于中药治疗宫腔粘连的文献。检索时限为2000年1月1日至2024年5月31日。使用Excel 2016软件分别建立处方数据表，使用中医传承计算平台V3.0对中医证型、治法及药物使用频次、剂量、分类、性味、归经进行分析，对纳入的所有药物进行关联规则分析及复杂网络分析，对高频药物进行因子分析、聚类分析。结果：共纳入文献103篇，处方134份，包含21个证型，其中以肾虚血瘀证为主，频率为79.85%（107/134），治法77种，以补肾活血化瘀法为主，频率为47.76%（64/134）；共包含中药处方134首，中药198味，使用频次排名前5位的药物依次为当归、川芎、熟地黄、菟丝子、丹参，药物药性多温、平，药味多甘、辛、苦，多归肝、肾、脾经，功效以逐瘀通经止痛、活血祛瘀止痛、补益肝肾为主。通过关联规则分析得出38组关联药物，药物整体呈现出以“当归-川芎-桃仁-红花-熟地黄-菟丝子”为核心的药物组合；聚类分析将药物聚为5类，复杂网络分析得出核心药物为：当归，川芎，熟地黄，菟丝子，桃仁，赤芍，丹参，红花，枸杞子，川牛膝，香附，山药，益母草，山茱萸。结论：宫腔粘连病机以肾虚为本，瘀热为标，中医药治疗本病既注重培补先后天之本以固其基，又强调活血行气、清热除湿以祛其邪，其组方特点是甘温扶阳，脾肾为先、辛行苦泄，行散并通。本研究结果为临床治疗本病提供了用药参考。

关键词：宫腔粘连；数据挖掘；中医证型；用药规律

Abstract：

Objective: To explore the compatibility rules and prescription composition ideas of traditional Chinese medicine for the treatment of intrauterine adhesions, and provide reference for clinical medication. Method: The literatures on the treatment of intrauterine adhesions with traditional Chinese medicines were retrieved from China National Knowledge Infrastructure (CNKI), Wanfang Database, VIP Chinese Science and Technology Journal Database (VIP), and SinoMed Biomedical Literature Service System (SinoMed). The retrieval period was from January 1, 2000 to May 31, 2024. Excel 2016 software was used to establish prescription data tables respectively. The Traditional Chinese Medicine Inheritance Calculation Platform V3.0 was used to analyze the traditional Chinese medicine syndrome types, treatment methods, and the frequency, dosage, classification, properties, flavors, and meridian tropisms of the medicines used. Association rule analysis and complex network analysis were carried out for all the included medicines, and factor analysis and cluster analysis were conducted for the high-frequency medicines. Result: total of 103 literatures and 134 prescriptions were included, involving 21 syndrome types. Among them, the syndrome of kidney deficiency and blood stasis was the main one, with a frequency of 79.85% (107/134). There were 77 treatment methods, with the method of tonifying the kidney, promoting blood circulation and removing blood stasis being the main one, with a frequency of 47.76% (64/134). A total of 134 traditional Chinese medicine prescriptions were included, with 198 kinds of Chinese herbal medicines. The top 5 drugs with the highest frequency of use were Danggui (Angelicae Sinensis Radix), Chuanxiong (Chuanxiong Rhizoma), Shoudihuang (Rehmanniae Radix Praeparata), Tusizi (Cuscutae Semen), and Danshen (Salviae Miltiorrhizae Radix) in order. The medicinal properties are warm and calm, and the flavors are sweet, spicy, and bitter, mainly targeting the liver, kidney, and spleen meridians. The main effects are to promote blood circulation, relieve pain, invigorate blood circulation, remove blood stasis, and nourish the liver and kidneys. Through association rule analysis, 38 groups of associated drugs were identified, and the overall medicines presented a medicine combination with " Danggui (Angelicae Sinensis Radix)-Chuanxiong (Chuanxiong Rhizoma)-Taoren (Persicae Semen)-Honghua (Carthami Flos)-Shoudihuang (Rehmanniae Radix Praeparata)-Tusizi (Cuscutae Semen)" as the core. Cluster analysis grouped the drugs into 5 categories, and complex network analysis identified the core drugs as: Danggui (Angelicae Sinensis Radix), Chuanxiong (Chuanxiong Rhizoma), Shoudihuang (Rehmanniae Radix Praeparata), Tusizi (Cuscutae Semen), Taoren (Persicae Semen), Chishao (Paeoniae Radix Rubra), Danshen (Salviae Miltiorrhizae Radix), Honghua (Carthami Flos), Gouqizi (Lycii Fructus), Chuanniuxi (Cyathulae Radix), Xiangfu (Cyperi Rhizoma), Shanyao (Dioscoreae Rhizoma), Yimucao (Leonuri Herba), and Shanzhuyu (Corni Fructus). Conclusion: The pathogenesis of intrauterine adhesions is based on kidney deficiency, with blood stasis and heat as the criteria. In the treatment of this disease with traditional Chinese medicine, it not only pays attention to nourishing the foundation of congenital and acquired constitution to strengthen the root, but also emphasizes promoting blood circulation and Qi movement, clearing heat and removing dampness to expel the pathogens. The characteristics of its formula composition are Gan Wen Fu Yang, spleen and kidney as the priority, Xin Xing Ku Xie, and Xing San Bing Tong. The results of this study provide a reference for clinical medication in the treatment of this disease.

Key words：intrauterine adhesions; data mining; traditional Chinese medicine syndrome types; medication rules

发布时间：2025-12-20

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