目的 分析琥珀散加減治療子宮內(nèi)膜異位癥（EMT）的辨證特點(diǎn)及用藥規(guī)律。方法 采用頻次分析、關(guān)聯(lián)規(guī)則分析、聚類分析和因子分析等方法對(duì)北京中醫(yī)藥大學(xué)第三附屬醫(yī)院婦科專家門(mén)診2018年1月1日—2022年12月31日診斷為EMT且使用琥珀散加減的患者真實(shí)世界數(shù)據(jù)進(jìn)行挖掘與分析。結(jié)果 共納入260例EMT患者，675張?zhí)幏剑?種證型，以寒凝血瘀證（58.52%）和腎虛血瘀證（29.63%）為主。涉及240味中藥，藥性以溫、寒、平為多，藥味以辛、苦、甘為主，歸經(jīng)主要在肝、脾、心和腎經(jīng)，功效主要分布在活血化瘀藥、補(bǔ)虛藥、清熱藥和理氣藥，藥物炮制以醋制為主。高頻（>200次）中藥共15味，依序?yàn)闉跛?、?dāng)歸、肉桂等，6味中藥涉及炮制，地黃主用熟地黃，莪術(shù)、三棱、延胡索和五靈脂醋制占比超80%，麥芽生、炒、焦俱用，以生為主。240味中藥共產(chǎn)生3 620條有效的關(guān)聯(lián)規(guī)則。高頻中藥系統(tǒng)聚類分析得出5類，因子分析獲得5個(gè)公因子。除琥珀散原方組成外，生麥芽、陳皮、木香、五靈脂和白芍也被納入。結(jié)論 琥珀散加減治療EMT的真實(shí)世界特征為：證型以寒凝血瘀證最多，其次為腎虛血瘀證，臨床遣方用藥除溫經(jīng)通絡(luò)、活血消癥外，亦須行氣消食、活血止痛、養(yǎng)血調(diào)經(jīng)，為臨床應(yīng)用琥珀散加減治療EMT提供了一定的參考。

Objective To analyze the syndrome differentiation and medication rules of Hupo Powder for endometriosis. Methods Frequency analysis, association rule analysis, cluster analysis, and factor analysis were used to analyze the real-world data of patients with EMT using Hupo Powder from Jan. 1st, 2018 to Dec. 31st, 2022 in the Gynecology Department of Beijing University of Chinese Medicine Third Affiliated Hospital. Results 260 EMT patients, 675 formulas, 240 herbs, and six syndrome types[mainly containing cold coagulation and blood stasis (58.52%) and kidney deficiency and blood stasis (29.63%)] were included in the database. Herbs' medicinal properties were mainly warm, cold, and calm, and the medicinal flavors were mostly spicy, bitter, and sweet. The meridians were mainly distributed in the liver, spleen, heart, and kidney. The function of herbs was mainly distributed in blood-activating and stasis-resolving medicine, tonic medicine, heat-clearing medicine, and qi-regulating medicine. Herbs processing was mainly with vinegar. Six herbs were involved in processing methods among fifteen high-frequency herbs (> 200 times), containing Wuyao[Lindera aggregata (Sims) Kosterm.], Danggui[Angelica sinensis (Oliv.) Diels], and Rougui[Cinnamomum cassia (L.) J. Presl. Rehmannia Libosch]. Dihuang (ex Fisch. & C. A. Mey.) mainly used in cooked form. Ezhu (Curcuma phaeocaulis Valeton), Sanleng[Sparganium stoloniferum (Graebn.) Buch.-Ham. ex Juz.], Yanhusuo[Corydalis yanhusuo (Y.H.Chou & Chun C.Hsu) W.T.Wang ex Z.Y.Su & C.Y.Wu], and Wulingzhi (WLZ, faeces trogopteri) in vinegar accounting for 80%. Maiya (MY, Hordeum vulgare L.) was prepared in raw, fried, and charred form, with raw predominating. A total of 3 620 valid association rules were generated for 240 herbs. Cluster analysis of the high-frequency herbs yielded five classes, and factor analysis obtained five common factors. In addition to the original composition of Hupo Powder, MY, Chenpi (Pericarpium Citri Reticulatae), Muxiang[Saussurea costus (Falc.) Lipsch.], WLZ and Baishao (Paeonia lactiflora Pall.) were also included. Conclusion The realworld characteristics of Hupo Powder for EMT were as follows:the syndrome of cold coagulation and blood stasis was the most common, and the kidney deficiency and blood stasis was the next highest syndrome type. In addition to warming the meridians, activating blood circulation, and eliminating symptoms, the clinical use of the formula must also regulate Qi, eliminate food, invigorate blood to relieve soreness, and nourish the blood to regulate the menstruation cycle, which might be valuable to the clinical application of Hupo Powder in treating EMT.

R285.6

國(guó)家自然科學(xué)基金面上項(xiàng)目（81973895）；北京中醫(yī)藥大學(xué)重點(diǎn)攻關(guān)項(xiàng)目（2020-JYB-ZDGG-143-3）