目的 分析琥珀散加减治疗子宫内膜异位症（EMT）的辨证特点及用药规律。方法 采用频次分析、关联规则分析、聚类分析和因子分析等方法对北京中医药大学第三附属医院妇科专家门诊2018年1月1日—2022年12月31日诊断为EMT且使用琥珀散加减的患者真实世界数据进行挖掘与分析。结果 共纳入260例EMT患者，675张处方，6种证型，以寒凝血瘀证（58.52%）和肾虚血瘀证（29.63%）为主。涉及240味中药，药性以温、寒、平为多，药味以辛、苦、甘为主，归经主要在肝、脾、心和肾经，功效主要分布在活血化瘀药、补虚药、清热药和理气药，药物炮制以醋制为主。高频（>200次）中药共15味，依序为乌药、当归、肉桂等，6味中药涉及炮制，地黄主用熟地黄，莪术、三棱、延胡索和五灵脂醋制占比超80%，麦芽生、炒、焦俱用，以生为主。240味中药共产生3 620条有效的关联规则。高频中药系统聚类分析得出5类，因子分析获得5个公因子。除琥珀散原方组成外，生麦芽、陈皮、木香、五灵脂和白芍也被纳入。结论 琥珀散加减治疗EMT的真实世界特征为：证型以寒凝血瘀证最多，其次为肾虚血瘀证，临床遣方用药除温经通络、活血消癥外，亦须行气消食、活血止痛、养血调经，为临床应用琥珀散加减治疗EMT提供了一定的参考。

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

国家自然科学基金面上项目（81973895）；北京中医药大学重点攻关项目（2020-JYB-ZDGG-143-3）