基于数据挖掘《临证指南医案》遗精病用药规律探讨
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摘要
目的探讨叶天士治疗遗精病用药规律,为当代医家中医临证用药提供参考和借鉴。方法统计《叶天士医学全书·临证指南医案·卷三》中遗精病使用药物,并分别查出其药性、药味、功效及归经,运用Excel、Spss 22.0、Weka 3.8、Cytoscape 3.6.1对数据进行统计分析。结果叶天士治疗遗精病的高频药物为地黄、芡实、茯神、五味子、党参、茯苓、龙骨、远志、湖莲、山药等,多属补虚药和收涩药,药性多温平,药味多甘涩,归经多属肾经、脾经。根据高频药物的关联规则分析,得到药对配伍规则如地黄—芡实、芡实—湖莲、芡实—五味子、五味子—湖莲、茯神—地黄、地黄-芡实-湖莲、五味子-湖莲-地黄等。结论数据挖掘结果发现叶氏治疗遗精病以益肾填精、收敛固涩为主,兼以健脾益气,宁心安神、养阴生津、清热利湿等,对于当代医家在临床上辨证施治用药有着一定的指导意义。
Objective To explore the rule of Ye Tianshi′s medication in treating seminorrhea, in order to provide reference for the clinical medication of contemporary Chinese physicians. Methods Statistical analysis was performed on the rule of drug use in Ye Tianshi′s Medical Complete Book·A Guide to Clinical Practice with Medical Record· Volume 3, and its medicinal properties, medicinal taste, efficacy and meridian tropism respectively. The data were analyzed by Excel, Spss 22.0, Weka 3.8 and Cytoscape 3.6.1. Results Rehmannia glutinosa, Scutellaria, Poria, Schisandra chinensis, Codonopsis pilosula, Poria cocos, Longgu, Polygala tenuifolia, Hulian, Yam and so on were the high-frequency medicines for spermatorrhea. Most of them belonged to deficiency-tonifying drugs and astringent-collecting drugs, which were mild and placid in in nature, sweet and astringent in taste, and belonged to the kidney and spleen meridians. According to the analysis of association rules of high-frequency drugs, the compatibility rules of drug pairs were obtained, such as Rehmannia glutinosa-Scutellaria, Scutellaria baicalensis-Hulian, Scutellaria baicalensis-Schisandra chinensis, Schisandra chinensis-Hulian, Fushen-Rehmannia glutinosa, Rehmannia baicalensis-Hulian, Schisandra chinensis-Hulian-Rehmannia glutinosa and so on. Conclusions Data mining results show that Ye′s treatment of spermatorrhea mainly relies on nourishing kidney and filling essence, astringency and inducing astringency, as well as invigorating spleen and qi, tranquilizing the heart and mind, nourishing yin and promoting body fluid andclearing heat and promoting diuresis, which has certain guiding significance for contemporary physicians in clinical differentiation and treatment.
Objective To explore the rule of Ye Tianshi′s medication in treating seminorrhea, in order to provide reference for the clinical medication of contemporary Chinese physicians. Methods Statistical analysis was performed on the rule of drug use in Ye Tianshi′s Medical Complete Book·A Guide to Clinical Practice with Medical Record· Volume 3, and its medicinal properties, medicinal taste, efficacy and meridian tropism respectively. The data were analyzed by Excel, Spss 22.0, Weka 3.8 and Cytoscape 3.6.1. Results Rehmannia glutinosa, Scutellaria, Poria, Schisandra chinensis, Codonopsis pilosula, Poria cocos, Longgu, Polygala tenuifolia, Hulian, Yam and so on were the high-frequency medicines for spermatorrhea. Most of them belonged to deficiency-tonifying drugs and astringent-collecting drugs, which were mild and placid in in nature, sweet and astringent in taste, and belonged to the kidney and spleen meridians. According to the analysis of association rules of high-frequency drugs, the compatibility rules of drug pairs were obtained, such as Rehmannia glutinosa-Scutellaria, Scutellaria baicalensis-Hulian, Scutellaria baicalensis-Schisandra chinensis, Schisandra chinensis-Hulian, Fushen-Rehmannia glutinosa, Rehmannia baicalensis-Hulian, Schisandra chinensis-Hulian-Rehmannia glutinosa and so on. Conclusions Data mining results show that Ye′s treatment of spermatorrhea mainly relies on nourishing kidney and filling essence, astringency and inducing astringency, as well as invigorating spleen and qi, tranquilizing the heart and mind, nourishing yin and promoting body fluid andclearing heat and promoting diuresis, which has certain guiding significance for contemporary physicians in clinical differentiation and treatment.
引文
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[2] 张永利,黄晓朋,李广森,等.常德贵教授巧用封髓丹加减治疗遗精症经验[J].亚太传统医药,2017,13(23):115-116.
[3] 叶天士.叶天士医学全书[M].太原:山西出版传媒集团山西科学技术出版社,2012:66-69.
[4] 陈蔚文.中药学[M].北京:中国中医药出版社,2008.
[5] 国家药典委员会.中华人民共和国药典:2015年版.一部[M].北京:中国医药科技出版社,2015:6.
[6] 徐新宇,黄磊,刘景,等.傅青主从心肾论治遗精[J].现代中医药,2018,38(6):107-108,111.
[7] 王志江,魏国栋,马思缇.地黄多糖的化学和药理作用研究进展[J].中国实验方剂学杂志,2015,21(16):231-235.
[8] 刘琳,刘洋洋,占颖,等.芡实的化学成分、药理作用及临床应用研究进展[J].中华中医药杂志,2015,30(2):477-479.
[9] 张雪,向瑞平,刘长河.茯神的化学成分和药理作用研究进展[J].郑州牧业工程高等专科学校学报,2009,29(4):19-21.
[10] 姜德友,杜文章.遗精源流考[J].天津中医药大学学报,2015,34(5):257-258.
[11] 阳方,顾雪,娄腾涛,等.常德贵教授运用补肾活血法治疗男科疾病验案举隅[J].中国性科学,2016,25(3):91-93.
[12] 李少峰,兰智慧,张元兵,等.循证医学时代探讨名老中医经验传承模式的关键点[J].时珍国医国药,2017,28(4):930-931.
[13] 戴斌,陈竞纬,张晖.基于数据挖掘的《临证指南医案》痰饮病用药组方规律研究[J].浙江中医药大学学报,2018,42(10):854-857.