中医药防控新型冠状病毒肺炎方案预防期与医学观察期用药情况分析

Analysis of the Usage of Medicine in the Prevention Period and Medical Observation Period of the Prevention and Control of COVID-19 by Chinese Medicine

关键词:  新型冠状病毒肺炎  中医药  关联规则  聚类分析

Key words:  Corona Virus Disease 2019(COVID-19)  traditional Chinese medicine  association rules  clustering analysis

摘要:

目的 探索全国各地区新型冠状病毒肺炎诊疗方案、中医药防治方案以及中医养生指引中预防期和医学观察期用药规律，为防控新型冠状病毒肺炎提供参考。方法 收集2020年10月11日前全国各地区防控新型冠状病毒肺炎方案，将方案中预防期与医学观察期的适用人群、分期、中成药、方剂名称和方剂组成等录入Excel表中，并将这些数据整理后导入古今医案云平台V2.2.2软件，对方剂进行中药关联规则分析和聚类分析。结果 分析国家及各省颁布的66个新冠肺炎预防期与医学观察期用药方案，使用频次最高的中成药是藿香正气水。预防期使用频次排名前5的中药分别为黄芪、甘草、金银花、白术和藿香；频次分析处方中药多以性寒，味甘、苦、辛，归肺、胃、脾经为主；关联规则分析得到以"白术-防风""防风-黄芪""桔梗-甘草"为主的一系列关联药物组合；聚类分析得到"桔梗-黄芪-白术-防风-甘草"等5个聚类方。医学观察期使用频次排名前5的中药分别为苍术、藿香、金银花、陈皮和甘草；频次分析处方中药多以温，味辛、甘、苦，归肺、脾、胃经为主；关联规则分析得到以"苍术-藿香""藿香-陈皮""生姜-藿香"为主的一系列关联药物组合；聚类分析得到"苍术-生姜-藿香-陈皮"等4个聚类方。结论 预防期用药是以清热药、补气药和化湿药为主，以扶正祛邪为目的，并从固护正气和散寒祛湿2个方面调整体质偏颇状态，达到最佳的预防效果；医学观察期患者是用化湿药、清热药、化痰止咳平喘药和理气药从宣肺散寒、清热解毒和理气化湿3个不同方面祛除湿寒表邪，达到调畅气机的目的，防止疾病进一步传变。

Abstract:

OBJECTIVE To explore the rules of the prevention and medical observation period in the Guidance of treatment for Corona Virus Disease 2019(COVID-19), the guidance of traditional Chinese medicine(TCM) prevention and treatment for COVID-19 and health care guidelines of TCM for COVID-19, so as to provide reference for prevention and control of COVID-19. METHODS Collected the guidance for the prevention and control of COVID-19 in various regions of the country before October 11, 2020, and entered the applicable population, staging, Chinese patent medicines, prescription names and prescription composition of the prevention period and medical observation period into the Excel table, and these after the data was collated, it was imported into the ancient and modern medical case cloud platform V2.2.2 software to analyze the association rules and cluster analysis of TCM prescriptions. RESULTS Analysis of the 66 guidance of prevention and medical observation period medication guidance issued by the country and provinces, the most frequently used Chinese patent medicine was Huoxiangzhengqi liquid. The top 5 TCMs in the prevention period were Astragali Radix, Glycyrrhizae Radix et Rhizoma, Lonicerae Japonicae Flos, Atractylodis Macrocephalae Rhizoma and Pogostemonis Herba. Frequent analysis of prescription TCMs were mostly cold, sweet, bitter and spicy, and were mainly attributed to the lungs, stomach and spleen. Analysis of association rules yields a series of related drug combinations mainly based on "Atractylodis Macrocephalae Rhizoma-Saposhnikoviae Radix" "Saposhnikoviae Radix-Astragali Radix" "Platycodonis Radix-Glycyrrhizae Radix et Rhizoma". Five clustering results were obtained by cluster analysis in the medical period such as "Platycodonis Radix-Astragali Radix-Atractylodis Macrocephalae Rhizoma-Saposhnikoviae Radix-Glycyrrhizae Radix et Rhizoma". The top 5 TCMs in the medical observation period were Atractylodis Rhizoma, Pogostemonis Herba, Lonicerae Japonicae Flos, Citri Reticulatae Pericarpium, Glycyrrhizae Radix et Rhizoma. Frequency analysis of prescription of TCMs was mostly warm, spicy, sweet, and bitter. Analysis of association rules yields a series of related drug combinations mainly based on "Atractylodis Rhizoma-Pogostemonis Herba" "Pogostemonis Herba-Citri Reticulatae Pericarpium" "Zingiberis Rhizoma Recens-Pogostemonis Herba". Four clustering results were obtained by cluster analysis in the medical period such as "Atractylodis Rhizoma-Zingiberis Rhizoma Recens-Pogostemonis Herba-Citri Reticulatae Pericarpium". CONCLUSION The drugs used in the preventive period are mainly heat-clearing drugs, Qi-invigorating drugs and aromatized wet drugs, with the purpose of strengthening the body and eliminating evils, and adjusting the biased state of physique from two aspects of strengthening and protecting righteousness and dispelling cold and dampness to achieve the best preventive effect. During the observation period, the patients were treated with aromatized wet drugs, heat-clearing medicine, the drug of relieving phlegm and relieving cough and the drug of regulating Qi to dispel dampness and cold from three aspects:dispelling lung and cold, clearing heat and detoxification, and regulating qi and dampness.