王笑民教授运用天人合一理论辨治肺癌的用药规律OA

[Objective]To explore Professor Wang Xiaomin's medication patterns for lung cancer based on the temporal dimensions of the four seasons,Six Qi(six climatic factors),and phases of the lunar cycle.[Methods]Prescription data of lung cancer outpatients treated by Professor Wang Xiaomin from December 2007 to December 2023 were retrospectively collected to establish a database using Excel 2021 software.Within Python 3.8.17 environment,an astronomical library was utilized to calculate and assign temporal labels(four seasons,Six Qi and lunar phases)to each prescription.Pearson's chi-square test,Fisher's exact test and Bonferroni correction were applied for global and pairwise comparisons of Chinese herb efficacies and single herbs across different time dimensions.A random forest classifier was constructed to extract key characteristic herbs distinguishing different temporal phases based on Gini importance scores.Furthermore,an agglomerative hierarchical clustering analysis using Ward's minimum variance method was performed on a multidimensional feature space(comprising total frequency and Six Qi coverage),coupled with the silhouette score for automated optimization,to reveal the clustering and compatibility rules of core herbs.[Results]Significant differences were observed in the distribution of core Chinese herb efficacies and herb usages across varied temporal dimensions.At the local"tumor-eliminating"level,the"three methods for tumor-eliminating"(clearing heat and detoxifying,resolving phlegm and dissipating nodules,promoting blood circulation and removing blood stasis)exhibited the highest application proportion during spring when Yang Qi generates,whereas nodule-dissipating herbs were preferred in winter.At the holistic regulation level,medication demonstrated a dynamic evolution aligned with the four seasons and six Qi:Spring treatments focused on soothing the liver and purging the lung;summer primarily featured heat-clearing and swelling-reducing approaches;late summer centered on dampness-dispelling,stomach-harmonizing,Yang-warming and cold-dispersing therapies;autumn emphasized promoting digestion and harmonizing the stomach;and winter prioritized nourishing Yin,clearing heat and generating fluid.Random forest models indicated that wind heat-dispersing,digestion-promoting,heat-cooling and blood-cooling therapies,and herbs like Herba Dendrobii,Bulbus Lilii,and Radix Rehmanniae contributed highest to temporal feature classification.Furthermore,core herbs were classified into 7 clusters,representing distinct spatiotemporal compatibility patterns,including Qi-tonifying and Yin-nourishing,Yin-nourishing and mind-calming,phlegm-resolving and nodule-dissipating,Qi-tonifying and spleen-strengthening,Yang-returning,heat-clearing and detoxifying,liver-soothing and relieving depression.Regarding the lunar-phase treatment,therapy dynamically adapted to the lunar cycle:the new moon phase mainly featured heat-clearing,Yin-nourishing,and fluid-generating approaches,whereas the full moon phase focused on tranquilizing the mind and calming fright.Random forest models identified heat-cooling and mind-tranquilizing efficacies,alongside herbs like Radix Rehmanniae and Concha Ostreae,as the key characteristic indicators for lunar-phase classification.[Conclusion]Professor Wang Xiaomin has organically combined natural rhythms with the occurrence and development of human tumors,and constructed a dynamic diagnosis and treatment model of lung cancer with"local tumor elimination and holistic regulation"based on the changes of the four seasons,Six Qi and lunar phases.Not only has it enriched the modern clinical practice of the theory of correspondence between heaven and human,but it has also provided new ideas for individualized and precise traditional Chinese medicine treatment of lung cancer.