Objective To explore the medication combination rules of traditional Chinese medicine (TCM) in the treatment of hepatitis E by using data mining method.

Methods The literatures on the treatment of hepatitis E with TCM from CNKI, WanFang Data and VIP Network from the inception to December 31, 2025 were retrieved, and then the prescription database was constructed. Excel 2023 was used to count the frequency of herbs, categories and meridian tropisms. IBM SPSS Modeler 18.0 and Apriori algorithm were used to analyze the herb association network. Cluster analysis of high-frequency herbs was performed using OriginPro 2024. R language and Gephi were used to visualize the statistical results.

Results A total of 117 prescriptions were collected, involving 136 kinds of herbs, with a total frequency of 1,031 times. Among the distribution of herb categories, heat-clearing herbs, diuresis and dampness-draining herbs, and blood-activating and stasis-resolving herbs accounted for the majority. The four qi were mostly cold, the five flavors were mostly bitter, sweet and pungent, and the liver and spleen meridians were the most. A total of 38 association rules were obtained. Among the two-item and three-item association rules, the highest support was Yinchen & Rhubarb, Yinchen & Gardenia & Rhubarb, respectively. Five new clustering prescriptions were obtained by cluster analysis: clustering prescription I (Artemisia capillaris, Gardenia jasminoides, Rhubarb, Plantaginis Semen, Isatidis Radix, Taraxacum mongolicum), clustering prescription II (Paeoniae Radix Rubra, Curcumae Radix, Salviae Miltiorrhizae Radix et Rhizoma, Lysimachiae Herba, Endothelium Corneum, Puerariae Lobatae Radix, Bupleuri Radix, Angelicae Sinensis Radix, Cortex Moutan), clustering prescription III (Poria cocos, Alisma orientalis, Polyporus umbellatus, Atractylodes macrocephala, Paeoniae Radix Alba, Crataegus pinnatifida), clustering prescription IV (Pericarpium Citri Reticulatae, Polygonum cuspidatum, Glycyrrhizae Radix et Rhizoma), clustering prescription V (Lonicerae Japonicae Flos, Scutellariae Radix).

Conclusion TCM treatment of hepatitis E with dampness, heat, Tongfu, blood circulation as the core treatment principle, prescription medication based on Yinchenhao Decoction, often compatible with dampness, heat, blood circulation herbs, closely linked to the classic theories that jaundice is contracted from dampness and always harms blood, thus blood-activation is essential in its treatment.

1. 中华医学会肝病学分会.戊型肝炎防治共识[J].中华肝脏病杂志,2022,30(8):820-831.Chinese Society of Hepatology, Chinese Medical Association.Consensus on prevention and treatment of hepatitis E[J].Chinese Journal of Hepatology,2022,30(8):820-831.DOI:10.3760/cma.j.cn501113-20220729-00401.

2. European Association for the Study of the Liver.EASL clinical practice guidelines on hepatitis E virus infection[J].J Hepatol,2018,68(6):1256-1271.DOI:10.1016/j.jhep.2018.03.005.

3. WangB,SubramaniamS,TianD,et al.Phosphorylation of Ser711 residue in the hypervariable region of zoonotic genotype 3 hepatitis E virus is important for virus replication[J].mBio,2024,15(11):e0263524.DOI:10.1128/mbio.02635-24.

4. AslanAT,BalabanHY.Hepatitis E virus: epidemiology, diagnosis, clinical manifestations, and treatment[J].World J Gastroenterol,2020,26(37):5543-5560.DOI:10.3748/wjg.v26.i37.5543.

5. MaZ,de ManRA,KamarN,et al.Chronic hepatitis E: advancing research and patient care[J].J Hepatol,2022,77(4):1109-1123.DOI:10.1016/j.jhep.2022.05.006.

6. KamarN,SelvesJ,MansuyJM,et al.Hepatitis E virus and chronic hepatitis in organ-transplant recipients[J].N Engl J Med,2008,358(8):811-817.DOI:10.1056/NEJMoa0706992.

7. TianD,LiW,HeffronCL,et al.Antiviral resistance and barrier integrity at the maternal-fetal interface restrict hepatitis E virus from crossing the placental barrier[J].Proc Natl Acad Sci U S A,2025,122(18):e2501128122.DOI:10.1073/pnas.2501128122.

8. NasirM,WuGY.HEV and HBV dual infection: a review[J].J Clin Transl Hepatol,2020,8(3):313-321.DOI:10.14218/JCTH.2020.00030.

9. DebingY,GisaA,DallmeierK,et al.A mutation in the hepatitis E virus RNA polymerase promotes its replication and associates with ribavirin treatment failure in organ transplant recipients[J].Gastroenterology,2014,147(5):1008-1011. e7.DOI:10.1053/j.gastro.2014.08.040.

10. DebingY,MoradpourD,NeytsJ,et al.Update on hepatitis E virology: implications for clinical practice[J].J Hepatol,2016,65(1):200-212.DOI:10.1016/j.jhep.2016.02.045.

11. TodtD,MeisterTL,SteinmannE.Hepatitis E virus treatment and ribavirin therapy: viral mechanisms of nonresponse[J].Curr Opin Virol,2018,32:80-87.DOI:10.1016/j.coviro.2018.10.001.

12. WuJ,LingB,GuoN,et al.Immunological manifestations of hepatitis E-associated acute and chronic liver failure and its regulatory mechanisms[J].Front Med (Lausanne),2021,8:725993.DOI:10.3389/fmed.2021.725993.

13. 刘红杨,赵景民.戊型肝炎的肝内外临床表现与治疗进展[J].中华肝脏病杂志,2023,31(5):471-476.LiuHY,ZhaoJM.Intrahepatic and extrahepatic clinical manifestations and treatment progress for hepatitis type E[J].Chinese Journal of Hepatology,2023,31(5):471-476.DOI:10.3760/cma.j.cn501113-20230301-00088.

14. 张鑫兰,艾湘君,刘如石,等.戊型肝炎的流行、诊断与预防[J].生命科学研究,2025,29(4):317-325, 338. [ZhangXL,AiXJ,LiuRS,et al.Epidemiology, diagnosis, and prevention of hepatitis E[J].Life Science Research,2025,29(4):317-325,338.DOI:10.16605/j.cnki.1007-7847.2025.01.0115.

15. 姚超,俞冲,朱琦琦.退高黄汤治疗戊型肝炎(瘀热互结证)的临床观察[J].中国中医急症,2025,34(2):314-317.YaoC,YuC,ZhuQQ.Clinical study of Tuigaohuang decoction in the treatment of hepatitis E (syndrome of intermingled phlegm and blood stasis)[J].Journal of Emergency in Traditional Chinese Medicine,2025,34(2):314-317.DOI:10.3969/j.issn.1004-745X.2025.02.033.

16. 豆晓云.基于国医大师周仲瑛病机辨证理论研究现代中医辨治消化道传染病证治规律[D].南京中医药大学,2025.

17. 李秀惠,杨华升,李丰衣,等.病毒性肝炎中医辨证标准[J].临床肝胆病杂志,2017,33(10):1839-1846.LiXH,YangHS,LiFY,et al.The standards of traditional Chinese medicine syndrome differentiation for viral hepatitis[J].Journal of Clinical Hepatology,2017,33(10):1839-1846.DOI:10.3969/j.issn.1001-5256.2017.10.002.

18. 武哲丽,何浩.何浩治疗病毒性肝炎经验介绍[J].新中医,2018,50(12):281-282.WuZL,HeH.Experience introduction of HE Hao treating viral hepatitis[J].New Chinese Medicine,2018,50(12):281-282.DOI:10.13457/j.cnki.jncm.2018.12.087.

19. 朱芳红,杨伟宁,李锋.茵陈五苓汤加减对甲型急性黄疸型肝炎(阳黄湿重于热证)患者肝功能和炎性因子指标的影响评价[J].吉林中医药,2020,40(11):1465-1469.ZhuFH,YangWN,LiF.Effect of Yinchen Wuling decoction on liver function and inflammatory factors in patients with acute icteric hepatitis A (Yang Jaundice with syndrome of dampness predominating over heat)[J].Jilin Journal of Chinese Medicine,2020,40(11):1465-1469.DOI:10.13463/j.cnki.jlzyy.2020.11.019.

20. 北京中医医院, 编.关幼波临床经验选[M].北京:人民卫生出版社,2006.

21. 裴永清.论“黄疸必伤血,治黄要活血”—学习《伤寒论》《金匮要略》体会[J].山东中医学院学报,1981, (1):21-26.DOI:10.16294/j.cnki.1007-659x.1981.01.006.

22. 胡文涵,马重阳,姜雪娇,等.基于数据挖掘研究钱英辨治慢性乙型肝炎用药规律[J].中国中医药信息杂志,2024,31(4):59-64.HuWH,MaCY,JiangXJ,et al.Study on medication law of Qian Ying for the treatment of chronic hepatitis B based on data mining[J].Chinese Journal of Information on Traditional Chinese Medicine,2024,31(4):59-64.DOI:10.19879/j.cnki.1005-5304.202211923.