基于数据挖掘探讨刘春莹治疗频复发和激素依赖型儿童肾病综合征的用药规律*

作者：金亚妮1，刘春莹2，张 晨2，韩 媛2，王 夏2

单位：1.陕西中医药大学，陕西 咸阳 712046； 2.陕西中医药大学附属医院，陕西 咸阳 712000

引用：引用：金亚妮，刘春莹，张晨，韩媛，王夏.基于数据挖掘探讨刘春莹治疗频复发和激素依赖型儿童肾病综合征的用药规律[J].中医药导报,2026,32(5):180-187.

DOI：10.13862/j.cn43-1446/r.2026.05.029

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摘要：

目的：运用数据挖掘技术剖析刘春莹治疗频复发型儿童肾病综合征（FRNS）和激素依赖型肾病综合征（SDNS）的中医药处方用药规律，总结临床经验，为传承与优化诊疗方案提供依据。方法：收集刘春莹2014年4月1日至2024年8月31日在陕西中医药大学附属医院门诊治疗儿童FRNS和SDNS的医案信息，筛选出符合纳入标准的有效处方，录入R语言数据挖掘软件，采用频数统计、关联规则分析、聚类分析等方法，对药物频数、性味归经、组方配伍关联等关键信息进行深度挖掘与可视化呈现。结果：共纳入261份处方，涉及中药110味，多为补虚药、清热药。其中，有27味中药的使用频数＞26，前3位药物是黄芪、麸炒白术、防风；药性以温、寒、平为主；药味以甘、苦、辛为主，归经侧重肝、脾、肺、肾经；关联规则揭示麸炒白术-黄芪、防风-麸炒白术等常见药对组合紧密关联，聚类分析得到5个核心聚类方。结论：刘春莹深谙小儿“肺脾肾常不足”生理特性与FRNS、SDNS本虚标实的病机，秉持扶正祛邪、标本兼治之则，用药善以健脾温肾、补肺顾卫之策，固本培元，增强患儿免疫力，预防感染、减少复发、减轻西药副作用、改善机体状态。依核心药对、聚类方组方灵活化裁，精准契合病机，其用药规律彰显中医优势，可为临床治疗提供参考依据。

关键词：肾病综合征；儿童；频复发型；激素依赖型；数据挖掘

Abstract：

Objective: To analyze the medication rules of traditional Chinese medicine (TCM) prescriptions used by LIU Chunying in the treatment of frequently relapsing nephrotic syndrome (FRNS) and steroid-dependent nephrotic syndrome (SDNS) in children by using data mining technology, summarize her clinical experience, and provide a basis for inheriting and optimizing diagnosis and treatment schemes. Methods: Medical records of children with FRNS and SDNS treated by LIU Chunying in the outpatient department of the Affiliated Hospital of Shaanxi University of Chinese Medicine from April 1, 2014 to August 31, 2024 were collected. Valid prescriptions meeting the inclusion criteria were screened and entered into R language data mining software. Methods such as frequency statistics, association rule analysis and cluster analysis were used to conduct in-depth mining and visual presentation of key information including drug frequency, nature, flavor, meridian tropism and prescription compatibility correlation. Results: A total of 261 prescriptions were included, involving 110 kinds of Chinese medicines, most of which were tonic medicines and heat-clearing medicines. Among them, 27 kinds of Chinese medicines were used more than 26 times, and the top three were Huangqi (Astragali Radix), Fuchao Baizhu (Atractylodis Macrocephalae Rhizoma stir-fried with bran) and Fangfeng (Saposhnikoviae Radix). The medicinal properties were mainly warm, cold and neutral. The medicinal tastes were mainly sweet, bitter and pungent, and the meridian tropism focused on the liver, spleen, lung and kidney meridians. Association rules showed that common drug pairs such as Fuchao Baizhu (Atractylodis Macrocephalae Rhizoma stir-fried with bran)- Huangqi (Astragali Radix) and Fangfeng (Saposhnikoviae Radix)- Fuchao Baizhu (Atractylodis Macrocephalae Rhizoma stir-fried with bran) had close correlations, and 5 core cluster prescriptions were obtained by cluster analysis. Conclusion: LIU Chunying has a profound understanding of the physiological characteristic of children that "the lung, spleen and kidney are often insufficient" and the pathogenesis of FRNS and SDNS characterized by root deficiency and branch excess. She adheres to the principles of strengthening healthy qi to eliminate pathogenic factors and treating both principal and secondary aspects. Her medication is characterized by invigorating the spleen and warming the kidney, tonifying the lung and consolidating defensive Qi to consolidate the constitution and nourish primordial Qi, so as to enhance children's immunity, prevent infection, reduce recurrence, alleviate side effects of Western medicine and improve body condition. She flexibly modifies prescriptions according to core drug pairs and cluster prescriptions to accurately fit the pathogenesis. Her medication rules highlight the advantages of TCM and can provide a reference for clinical treatment.

Key words：nephrotic syndrome; children; frequently relapsing type; steroid-dependent type; data mining

发布时间：2026-05-24

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