基于数据挖掘的国医大师翁维良治疗慢性冠脉综合征用药规律研究*

作者：赵梦杰1，李梦璇1，张菀桐1,2,3，陆 芳2,3,4，李秋艳1，翁维良1

单位：1.中国中医科学院西苑医院，北京 100091； 2.中国中医科学院临床药理研究所，北京 100091； 3.中国中医科学院西苑医院中药临床研究与评价重点实验室，北京 100091； 4.国家中医心血管病临床医学研究中心，北京 100091

引用：引用：赵梦杰，李梦璇，张菀桐，陆芳，李秋艳，翁维良.基于数据挖掘的国医大师翁维良治疗慢性冠脉综合征用药规律研究[J].中医药导报,2025,31(8):171-177.

DOI：10.13862/j.cn43-1446/r.2025.08.027

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摘要：目的：分析国医大师翁维良教授治疗慢性冠脉综合征（CCS）的用药规律。方法：收集翁教授门诊治疗CCS的医案资料，共纳入5 161次诊疗记录。基于冠心病中医证候积分表评价处方的临床疗效。应用Microsoft Excel 2021对中药频数、性味、归经进行统计分析。应用IBM SPSS Modeler 18.0软件的Apriori算法对有效处方进行关联规则分析、聚类分析及复杂网络分析。结果：4 474份有效处方中高频药物包括丹参、郁金、赤芍、延胡索、红花。有效处方特有3味药物（炙黄芪、玄参、党参），无效处方特有3味药物（天麻、白术、煅瓦楞子）。在性味、归经方面，有效处方和无效处方均以温、平、微寒性药物为主，五味以苦、辛、甘为主，归经则以肝、脾、肺经为主。关联规则分析显示，有效处方中的药物组合主要针对活血祛瘀、益气扶正等功效，体现了“治心必通瘀”的治疗理念。核心处方网络分析确定了15味核心药物，并通过聚类分析揭示了中医药治疗CCS的多层次、多靶点组方特点，既包括活血化瘀类药物的分层干预，也包括补气扶正、调和寒热及身心同治等策略。结论：翁维良治疗CCS以益气活血、行气化瘀为主要治疗原则，建立了三级干预体系——以三棱、莪术为核心化瘀通络，太子参、黄芪益气推动血行，辅以安神药物身心共治，体现了“分层祛瘀、气血同调”的组方规律。

关键词：慢性冠脉综合征；复杂网络分析；数据挖掘；用药规律；核心处方；翁维良

Abstract：

Objective: To analyze the medication rules of traditional Chinese ncedicine master WENG Weiliang in the treatment of chronic coronary syndrome (CCS). Methods: Medical records of CCS treated by professor WENG in outpatient services were collected, with a total of 5,161 diagnosis and treatment records included. The clinical efficacy of prescriptions was evaluated based on the traditional Chinese medicine (TCM) Syndrome Score Scale for Coronary Heart Disease. Microsoft Excel 2021 was used for statistical analysis of the frequency, nature-flavor, and meridian tropism of Chinese herbs. The Apriori algorithm in IBM SPSS Modeler 18.0 software was applied to conduct association rule analysis, cluster analysis, and complex network analysis on effective prescriptions. Results: Among 4,474 effective prescriptions, high-frequency herbs included Danshen (Salviae Miltiorrhizae Radix), Yujin (Curcumae Radix), Chishao (Paeoniae Radix Rubra), Yanhusuo (Corydalis Rhizoma), and Honghua (Carthami Flos). Effective prescriptions had 3 unique herbs: Zhihuangqi (Astragali Radix cum Liquido Fricta), Xuanshen (Scrophulariae Radix), and Dangshen (Codonopsis Radix), while ineffective prescriptions had 3 unique herbs: Tianma (Gastrodiae Rhizoma), Baizhu (Atractylodis Macrocephalae Rhizoma), and Duanwalengzi (Arcae Concha Calcinata). In terms of herb properties, flavors, and meridian tropism, both effective and ineffective prescriptions predominantly used warm, neutral, and slightly cold herbs. The five flavors are mainly bitter, acrid, and sweet, while meridian tropism is mainly based on the liver, spleen, and lung meridian. Association rule analysis revealed that herb combinations in effective prescriptions focused on activating blood circulation, removing stasis, replenishing Qi, and strengthening vital energy, reflecting the therapeutic principle of "treating the heart by resolving stasis". Core network analysis identified 15 key herbs, while cluster analysis demonstrated the multi-level and multi-target characteristics of TCM in treating CCS, including layered interventions with blood-activating and stasis-resolving herbs, strategies for replenishing Qi, harmonizing cold-heat balance, and integrated mind-body therapy. Conclusion: WENG Weiliang's treatment of CCS is mainly based on the principles of tonifying Qi and activating blood circulation, promoting Qi circulation and removing blood stasis. A three-level intervention system has been established, with Sanleng (Sparganii Rhizoma) and Ezhu (Curcumae Rhizoma) as core herbs to resolve stasis and unblock collaterals. Taizishen (Pseudostellariae Radix) and Huangqi (Astragali Radix) to boost Qi and promote blood flow, and auxiliary calming herbs for holistic mind-body therapy. This approach embodies the prescription principles of "layered stasis resolution and simultaneous regulation of Qi and blood".

Key words：chronic coronary syndrome; complex network analysis; data mining; medication rules; core prescription; WENG Weiliang

发布时间：2026-01-06

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