基于数据挖掘探讨马骏教授治疗慢性萎缩性胃炎的经验OA

Objective:To explore the rules of prescription medication and clinical experience of Professor Ma Jun in the clinical diagnosis and treatment of chronic atrophic gastritis(CAG)using data mining techniques.Methods:A total of 184 second-visit cases of CAG treated by Professor Ma Jun between January 2024 and December 2024 were collected.From these,164 effective herbal formulas were extracted to construct a database.Statistical analyses were performed on patients'age,gender distribution,and syndrome patterns.The Ancient and Modern Case Records Cloud Platform(Version 2.3.9)was employed to conduct analyses on frequency of herb usage,frequency of herb properties(nature,flavor,and meridian tropism),frequency of therapeutic categories,herb-herb association rules,herb-syndrome association rules,cluster analysis,and complex network analysis.Results:The highest incidence of CAG occurred in patients aged 40～49 years(29.88%),followed by those aged 50～59 years(26.83%).A total of 123 distinct Chinese herbal medicines were used across the 164 prescriptions,with a total usage frequency of 3,027.The top 15 most frequently used herbs were:Chenpi,Ciweipi,Bran-fried Yiyiren,Ezhu,Fuling,Stir-fried Baishao,Bran-fried Zhishi,Stir-fried Jineijin,Banxia,Dangshen,Shaji,Sharen,Doukou,Shanyao and Sanqi powder.In terms of the four properties,warm and neutral herbs predominated;regarding the five flavors,pungent,bitter,and sweet flavors were most common.Most herbs targeted the spleen,lung,stomach,and liver meridians.Six TCM syndrome patterns were identified:liver-stomach disharmony,spleen-stomach weakness,stomach Yin deficiency,dampness-heat of spleen and stomach,deficiency-cold of spleen and stomach,cold and heat in complexity.A total of 20 two-herbs combinations were identified,the top five were:Chenpi-Fuling,Chenpi-Ciweipi,Bran-fried Yiyinren-Chenpi,Bran-fried Yiyinren-Ciweipi,Bran-fried Yiyinren-Fuling.For liver-stomach disharmony,commonly used herbs included Stir-fried Baishao,Shaji,Chenpi,Bran-fried Zhishi,Chaihu,Ezhu,Bran-fried Zhiqiao,Ciweipi,Xiangyuan,Foshou.Among them,Chenpi,Chaihu,Stir-fried Baishao,Bran-fried Zhiqiao together embody the principle of Chaihu Shugan Powder,primarily aiming to soothe and regulate liver Qi.Additionally,Xiangyuan and Foshou are added to enhance the liver-soothing effect.For spleen-stomach deficiency,frequently prescribed herbs were Doukou,Bran-fried Yiyiren,Sharen,Dangshen,Ezhu,Ciweipi,Chenpi,Sanqi powder,Fuling,Shaji,Stir-fried Jineijin,Shan-yao,Stir-fried Baishao,Bran-fried Baizhu.This resembles Shenling Baizhu Powder supplemented with Sanqi powder,Shaji,and Stir-fried Jineijin to reinforce spleen tonification.For stomach Yin deficiency,typical herbs included Ciweipi,Bran-fried Yiyiren,Fuling,Shanyao,Xuanshen,Chenpi,Stir-fried Jineijin,Bran-fried Zhishi,Maidong,Shengdi,Sanqi powder,and Honey-fried Gancao.This is the Modified Zengye Decoction,aimed at nourishing Yin and clearing heat.Shanyao,Fuling,Yiyiren and Chenpi were added to strengthen the spleen,while Sanqi powder,and Honey-fried Gancao were included to tonify deficiency and fortify the body.For dampness-heat of the spleen and stomach,commonly used herbs included Banxia,Fuling,Bran-fried Yiyiren,Chenpi,Danzhuye,Houpu,Zexie,Xingren,Peilan,Baiqian,Shichangpu,and Doukou.This corresponds to a Wu Jutong's Modified Sanren Decoction,with Zexie added to clear and drain dampness-heat,and Banxia and Shichangpu to resolve dampness.For deficiency-cold of spleen and stomach,commonly used herbs were Bran-fried Yiyiren,Sharen,Chenpi,Fuling,Wuzhuyu,Ciweipi,Bran-fried Zhishi,Shanyao,and Blast-fried Gin-ger.For cold and heat in complexity,frequently used herbs included Huanglian,Chenpi,Dangshen,Sharen,Stir-fried Baishao,Bran-fried Zhishi,Dried Ginger,Ezhu,and Fuling-reflecting the Modified Banxia Xiexin Decoction.Cluster analysis yielded five herb combinations:C1:Chenpi,Bran-fried Yiyiren,Fuling,Stir-fried Baishao,Bran-fried Zhishi,Stir-fried Jineijin,Ciweipi,and Ezhu.C2:Shanyao,Doukou,Sanqi powder,Dangshen,and Sharen.C3:Banxia,Huan-glian,Sanleng,Dried Ginger,and Huangqin.C4:Shaji,Haipiaoxiao,Zhebeimu,Honey-fried Gancao,Bran-fried Bai-zhu,Houpu,and Pugongying.C5:Gansong,Xiangyuan,Foshou,Chaihu,and Bran-fried Zhiqiao.Complex network analysis identified the following core herb combination:Chenpi,Ciweipi,Bran-fried Yiyiren,Ezhu,Fuling,Stir-fried Baishao,Bran-fried Zhishi,Stir-fried Jineijin,Banxia,Dangshen,Shaji,Sharen,Doukou,and Shanyao.Conclusion:Professor Ma Jun primarily treats chronic atrophic gastritis(CAG)based on the therapeutic principles of drying dampness and resolving phlegm,eliminating food stagnation and relieving pain,regulating Qi and strengthening the spleen,and pro-moting diuresis to drain dampness,supplemented by strategies such as stoping acid regurgitation to relieve pain,descend-ing rebellious Qi and stopping vomiting,and regulating Qi to break blood stasis.