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浙江大学学报(医学版)  2020, Vol. 49 Issue (2): 260-269    DOI: 10.3785/j.issn.1008-9292.2020.03.14
原著     
2019冠状病毒病(COVID-19)基于推荐诊疗方案的中医用药特点分析
范天田1(),陈永灿2,*(),白钰2,马凤岐2,王恒苍2,杨益萍2,陈金旭1,林雨琪1
1. 浙江中医药大学基础医学院, 浙江 杭州 310053
2. 浙江省立同德医院, 浙江 杭州 310007
Analysis of medication characteristics of traditional Chinese medicine in treating COVID-19 based on data mining
FAN Tiantian1(),CHEN Yongcan2,*(),BAI Yu2,MA Fengqi2,WANG Hengcang2,YANG Yiping2,CHEN Jinxu1,LIN Yuqi1
1. College of Basic Medical Sciences, Zhejiang Chinese Medical University, Hangzhou 310053, China
2. Tongde Hospital of Zhejiang Province, Hangzhou 310007, China
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摘要:

目的: 分析国家卫生健康委员会(卫健委)、国家中医药管理局(中管局)及各省市自治区卫健委、中管局通过公开渠道发布的2019冠状病毒病(COVID-19)治疗方案中中医药处方用药特点。方法: 收集自我国COVID-19疫情发生以来至2020年2月19日国家及各省市自治区卫健委、中管局通过公开渠道发布的COVID-19推荐诊疗方案中中医药相关内容,并进行所有数据的频数分析、关联分析和聚类分析。结果: 共收集国家诊疗方案4个,各省市自治区防治方案34个,样本578条,得到有名称的传统方剂84首,中成药60种,涉及单味药230味。高频用药有甘草、黄芩、杏仁、石膏等,常见方剂有麻杏石甘汤、银翘散、宣白承气汤等,常用中成药有安宫牛黄丸、血必净注射液、连花清瘟胶囊等,高频药对有“麻黄,杏仁”“连翘,甘草”等,挖掘出核心药物组合2个,新处方1个。结论: COVID-19卫分证以银翘散、藿朴夏苓汤为基础方,气分证可以麻杏石甘汤、凉膈散、清瘟败毒饮、达原饮等为基础方。用药特点以宣肺清热、解毒祛浊为主,体现中医治疫解毒透邪的处方思路。

关键词: 2019冠状病毒病严重急性呼吸综合征冠状病毒2新型冠状病毒肺炎中医药治疗数据挖掘频数分析关联分析聚类分析    
Abstract:

Objective: To analysis the medication characteristics of the prescriptions issued via open channel by the National and Provincial Health Committee and the State Administration of Traditional Chinese Medicine in treating coronavirus disease 2019 (COVID-19). Methods: We collected the data of traditional Chinese medicine related to treatment plans published by the National and Provincial Health Committee and the State Administration of Traditional Chinese Medicine from the start of COVID-19 outbreak to February 19, 2020. The frequency analysis, cluster analysis and association analysis were performed. Results: The study collected 4 national and 34 regional prevention and treatment plans, 578 items, 84 traditional Chinese formulations, 60 Chinese patent medicines, and 230 Chinese herbs. The high frequently used herbs were Liquorice, Scutellariabaicalensis, Semen armeniacaeamarae, and Gypsum. The commonly used traditional formulations included Maxing Shigan decoction, Yin Qiao powder, and Xuanbai Chengqi decoction. The Chinese patent drugs included Angong Niuhuang pill, Xuebijing injection, and Lianhua Qingwen capsule. The most common paired medications were Ephedra and Semen armeniacaeamarae, Fructusforsythiae and Liquorice. Two core combinations and one novel formula were discovered in the study. Conclusions: Yin Qiao powder and Huopo Xialing decoction are the basic formulations for Weifen syndrome of COVID-19. In addition, Maxing Shigan decoction, Liang Ge powder, Qingwen Baidu decoction and Da Yuan decoction are the basic formulations for Qifen syndrome of COVID-19. The main medication characteristics are clearing heat, entilating lung, removing toxicity and removing turbidity. It shows that removing toxicity and eliminating evil are the prescription thought in treating epidemic disease of traditional Chinese medicine.

Key words: Coronavirus disease 2019    Severe acute respiratory syndrome coronavirus 2    Novel coronavirus pneumonia    Traditional Chinese medicine treatment    Data mining    Frequency analysis    Association analysis    Cluster analysis
收稿日期: 2020-02-22 出版日期: 2020-04-03
:  R243  
基金资助: 浙江省名老中医专家传承工作室建设计划(GZS2017002)
通讯作者: 陈永灿     E-mail: 15735649143@163.com;cyc3123@sina.com
作者简介: 范天田(1990—), 女, 博士研究生, 主要从事中医医家学术思想与诊疗经验研究; E-mail:15735649143@163.com; https://orcid.org/0000-0002-8844-7231
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引用本文:

范天田,陈永灿,白钰,马凤岐,王恒苍,杨益萍,陈金旭,林雨琪. 2019冠状病毒病(COVID-19)基于推荐诊疗方案的中医用药特点分析[J]. 浙江大学学报(医学版), 2020, 49(2): 260-269.

FAN Tiantian,CHEN Yongcan,BAI Yu,MA Fengqi,WANG Hengcang,YANG Yiping,CHEN Jinxu,LIN Yuqi. Analysis of medication characteristics of traditional Chinese medicine in treating COVID-19 based on data mining. J Zhejiang Univ (Med Sci), 2020, 49(2): 260-269.

链接本文:

http://www.zjujournals.com/med/CN/10.3785/j.issn.1008-9292.2020.03.14        http://www.zjujournals.com/med/CN/Y2020/V49/I2/260

单味药 频次
甘草 216
黄芩 188
杏仁 169
石膏 165
连翘 153
麻黄 142
金银花 134
藿香 115
桔梗 98
茯苓 95
半夏 92
大黄 89
白术 88
栀子 88
水牛角 86
厚朴 85
人参 82
陈皮 80
表 1  治疗2019冠状病毒病中医药方案中的高频单味药(频次≥80)
方剂 频次
麻杏石甘汤 29
银翘散 28
宣白承气汤 20
升降散 19
麻杏苡甘汤 18
达原饮 18
黄连解毒汤 16
四逆加人参汤 16
藿朴夏苓汤 16
解毒活血汤 15
清瘟败毒饮 8
参附汤 7
三仁汤 7
小柴胡汤 6
甘露消毒丹 6
竹叶石膏汤 6
二陈汤 5
王氏清暑益气汤 5
白虎汤 5
荆防败毒散 5
表 2  治疗2019冠状病毒病中医药方案中的高频方剂(频次≥5)
中成药 频次
安宫牛黄丸 37
血必净注射液 30
连花清瘟胶囊/颗粒 26
紫雪丹/散 23
藿香正气水/散/胶囊/口服液 21
苏合香丸 19
参附注射液 18
生脉饮/注射液 16
清开灵胶囊/注射液 14
金花清感颗粒 14
疏风解毒胶囊/颗粒 11
防风通圣丸/颗粒 11
喜炎平注射液 10
痰热清注射液 8
热毒宁注射液 7
至宝丹 5
表 3  治疗2019冠状病毒病中医药方案中的高频中成药(频次≥5)
关联药物组合 频次
麻黄,杏仁 124
连翘,甘草 110
甘草,杏仁 109
石膏,麻黄 106
甘草,麻黄 105
石膏,杏仁 104
石膏,甘草 102
石膏,麻黄,杏仁 96
甘草,麻黄,杏仁 94
黄芩,连翘 87
金银花,连翘 86
石膏,甘草,麻黄 84
黄芩,甘草 81
连翘,麻黄 78
连翘,杏仁 78
石膏,甘草,杏仁 77
石膏,连翘 76
甘草,桔梗 76
半夏,茯苓 75
石膏,大黄 74
石膏,甘草,麻黄,杏仁 74
黄芩,栀子 73
黄芩,杏仁 71
黄芩,金银花 71
表 4  治疗2019冠状病毒病中医药方案中的关联药物组合(支持度=70,置信度=0.8)
图 1  治疗2019冠状病毒病中药方案中的核心药物组合展示图
图 2  治疗2019冠状病毒病中药方案中的新方网络图
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