基于隐结构结合无监督学习探讨郁证的证候特征及用药规律*

作者：秦冰冰1，姚成增2

单位：1.广州中医药大学第一临床医学院，广东 广州 510405； 2.上海中医药大学附属曙光医院，上海 200021

引用：引用：秦冰冰，姚成增.基于隐结构结合无监督学习探讨郁证的证候特征及用药规律[J].中医药导报,2025,31(9):164-170,177.

DOI：10.13862/j.cn43-1446/r.2025.09.028

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摘要：

目的：基于数据挖掘分析当代医家诊疗郁证的证候特征及用药规律。方法:检索中国知网、万方数据知识服务平台和维普中文期刊服务平台，筛选郁证有关文献并建立数据库；基于Lantern5.0软件平台，对证候进行隐结构分析，基于R语言集成开发环境RStudio v4.4.0软件平台，对处方进行规律分析。结果：共纳入证候记录115条，处方192份；隐结构模型分析得到12个隐变量，综合聚类模型4组，主要证候为肝火旺盛、肝肾阴虚、心脾气血两虚和肝郁脾虚兼血瘀；中药多为补虚药、安神药、清热药、活血化瘀药、理气药等，四性以寒、温、平为主，药味多为甘、苦、辛，归经主要涉及心经、肝经、脾经；常用药对有白芍-柴胡、柴胡-郁金、柴胡-甘草等；中药聚类分析得到10组药物组合。综合隐结构分析及聚类分析，得到4个常见证型，并形成4组新方。结论:郁证分型寒热虚实错杂，临床表现多与肝、心、脾、胃等脏腑功能失调相关。常见证型有肝火旺盛、肝肾阴虚、心脾气血两虚、肝郁脾虚兼血瘀；治疗郁证中药多能补虚泻实，兼顾气血阴阳，治法主要为疏肝健脾、养心安神、行气活血、养阴清热等。

关键词：郁证；用药规律；隐结构；无监督学习；数据挖掘；证候特征

Abstract：

Objective: To analyze the syndrome characteristics and medication rules of contemporary doctors' diagnosis and treatment of depression syndrome based on data mining. Methods: Literatures related to Yu Syndrome were retrieved from China National Knowledge Infrastructure (CNKI), Wanfang Data Knowledge Service Platform (Wanfang Data), China Science and Technology Journal Database (CSTJ), and a database was established after screening. Latent structure analysis of syndromes was conducted based on the Lantern 5.0 software platform, and prescription rule analysis was performed based on the R language integrated development environment RStudio v4.4.0 software platform. Results: A total of 115 syndrome records and 192 prescriptions were included. Latent structure model analysis identified 12 latent variables and 4 comprehensive cluster models. The main syndromes were liver-fire hyperactivity, liver-kidney Yin deficiency, heart-spleen Qi-blood deficiency, and liver depression-spleen deficiency complicated with blood stasis. The commonly used Chinese medicine herbs were mainly deficiency-tonifying herbs, mind-tranquilizing herbs, heat-clearing herbs, blood-activating-stasis-removing herbs, and Qi-regulating herbs. The four natures were mainly cold, warm, and neutral. The medicinal flavors were mainly sweet, bitter, and pungent, and the meridian tropisms mainly involved the heart, liver, and spleen meridians. Common medicine pairs included Baishao (Paeoniae Radix Alba)-Chaihu (Bupleuri Radix), Chaihu (Bupleuri Radix)-Yujin (Curcumae Radix), and Chaihu (Bupleuri Radix)-Gancao (Glycyrrhizae Radix). 10 groups of medicine combinations were obtained through Chinese medicine cluster analysis. By integrating latent structure analysis and cluster analysis, 4 common syndrome types were identified, and 4 new prescriptions were formulated. Conclusion: The syndrome types of depression syndrome are complicated with cold, heat, deficiency, and excess, and the clinical manifestations are mostly related to dysfunction of zang-fu organs such as the liver, heart, spleen, and stomach. The common syndrome types include liver-fire hyperactivity, liver-kidney Yin deficiency, heart-spleen Qi-blood deficiency, and liver depression-spleen deficiency complicated with blood stasis. Chinese medicine herbs for depression syndrome mostly tonify deficiency and purge excess, while balancing Qi, blood, Yin, and Yang. The main therapeutic methods are soothing the liver and strengthening the spleen, nourishing the heart and tranquilizing the mind, promoting Qi circulation and activating blood circulation, and nourishing yin and clearing heat.

Key words：depressive syndrome; medication rules; latent structure; unsupervised learning; data mining; syndrome characteristics

发布时间：2026-01-08

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