基于数据挖掘的《临证指南医案》治疗咳嗽用药规律研究
|
摘要
目的分析《临证指南医案》治疗咳嗽处方用药规律,为临床辨治提供思路。方法整理《临证指南医案》治疗咳嗽医案,采用SPSS22.0对其处方用药进行频次、关联规则和聚类分析,变量间相似性测度采用Pearson相关系数。结果纳入247案,涉及19种证型、180味药物,共用药1654频次。高频药物有大枣、麦冬、炙甘草、苦杏仁,用药重在健脾益气、润肺、降气止咳。挖掘得到关联规则28条(2味药18条、3味药10条),包括"北沙参→麦冬""生姜→大枣""桂枝-大枣→炙甘草""南沙参-桑叶→苦杏仁"等;聚类分析得到9类药物,包括"大枣-炙甘草""桑叶-南沙参-玉竹""石斛-北沙参-白扁豆"等多种药物组合。结论叶氏临证辨治咳嗽尤重肺、脾、胃,善用甘温之品益气补脾,甘润之品滋养肺胃。
Objective To analyze medication rules of prescriptions for cough treatment in Lin Zheng Zhi Nan Yi An; To provide thoughts for clinical treatment based on syndrome differentiation. Methods Medical cases of cough treatment in Lin Zheng Zhi Nan Yi An were sorted out. Frequency, association rules and cluster analysis were analyzed by using SPSS22.0. The correlation between variables was measured by Pearson correlation coefficient. Results Totally 247 medical cases were involved, including 19 syndromes and 180 kinds of Chinese materia medica, with a total of 1654 frequency times. The high-frequency Chinese materia medica were Jujubae Fructus, Ophiopogonis Radix, Glycyrrhizae Radix et Rhizoma Praeparata cum Mella, and Armeniacae Semen Amarum. The medication focused on tonifying spleen and qi, moistening lung, and reducing qi and relieving cough. Data mining obtained 28 association rules(18 for 2 kinds of Chinese materia medica and 10 for 3 kinds of Chinese materia medica), including "Glehniae Radix→Ophiopogonis Radix", "Zingiberis Rhizoma Recens→Jujubae Fructus", "Cinnamomi Ramulus-Jujubae Fructus→Glycyrrhizae Radix et Rhizoma Praeparata cum Mella", "Adenophorae Radix-Mori Folium→Armeniacae Semen Amarum". Cluster analysis obtained 9 groups of Chinese materia medica, including "Jujubae Fructus-Glycyrrhizae Radix et Rhizoma Praeparata cum Mella", "Mori Folium-Adenophorae Radix-Polygonati Odorati Rhizoma", and "Dendrobii Caulis-Glehniae Radix-Lablab Semen Album". Conclusion The clinical treatment of cough with YE Tianshi shows particular emphasis on the lung, spleen and stomach, making good use of sweet and warm medicines for invigorating spleen and qi, sweet and moistening medicines for nourishing the lung and stomach.
Objective To analyze medication rules of prescriptions for cough treatment in Lin Zheng Zhi Nan Yi An; To provide thoughts for clinical treatment based on syndrome differentiation. Methods Medical cases of cough treatment in Lin Zheng Zhi Nan Yi An were sorted out. Frequency, association rules and cluster analysis were analyzed by using SPSS22.0. The correlation between variables was measured by Pearson correlation coefficient. Results Totally 247 medical cases were involved, including 19 syndromes and 180 kinds of Chinese materia medica, with a total of 1654 frequency times. The high-frequency Chinese materia medica were Jujubae Fructus, Ophiopogonis Radix, Glycyrrhizae Radix et Rhizoma Praeparata cum Mella, and Armeniacae Semen Amarum. The medication focused on tonifying spleen and qi, moistening lung, and reducing qi and relieving cough. Data mining obtained 28 association rules(18 for 2 kinds of Chinese materia medica and 10 for 3 kinds of Chinese materia medica), including "Glehniae Radix→Ophiopogonis Radix", "Zingiberis Rhizoma Recens→Jujubae Fructus", "Cinnamomi Ramulus-Jujubae Fructus→Glycyrrhizae Radix et Rhizoma Praeparata cum Mella", "Adenophorae Radix-Mori Folium→Armeniacae Semen Amarum". Cluster analysis obtained 9 groups of Chinese materia medica, including "Jujubae Fructus-Glycyrrhizae Radix et Rhizoma Praeparata cum Mella", "Mori Folium-Adenophorae Radix-Polygonati Odorati Rhizoma", and "Dendrobii Caulis-Glehniae Radix-Lablab Semen Album". Conclusion The clinical treatment of cough with YE Tianshi shows particular emphasis on the lung, spleen and stomach, making good use of sweet and warm medicines for invigorating spleen and qi, sweet and moistening medicines for nourishing the lung and stomach.
引文
[1]叶天士.临证指南医案[M].苏礼,整理.北京:人民卫生出版社,2006.
[2]国家中医药管理局.中医病证诊断疗效标准[M].南京:南京大学出版社,1994.
[3]国家药典委员会.中华人民共和国药典:一部[M].北京:中国医药科技出版社,2015.
[4]邓中甲.方剂学[M].北京:中国中医药出版社,2010.
[5]高学敏.中药学[M].北京:人民卫生出版社,2014.
[6]中华中医药学会内科分会肺系病专业委员会.咳嗽中医诊疗专家共识意见(2011版)[J].中医杂志,2011,52(10):896-899.
[7]薛博瑜,吴伟.中医内科学[M].北京:人民卫生出版社,2016:37-43.
[8]谢敏德,卢建军,甘正佩.辛开苦降益肺法治疗冬季急性咳嗽52例[J].河南中医,2014,34(6):1122-1123.
[9]魏鹏草,苗青,张文江,等.叶天士治疗慢性咳嗽的学术思想探讨[J].江苏中医药,2010,42(4):12-13.
[10]赵志恒,穆超超.基于数据挖掘的《理虚元鉴》用药规律研究[J].中国中医药信息杂志,2018,25(7):92-94.
[2]国家中医药管理局.中医病证诊断疗效标准[M].南京:南京大学出版社,1994.
[3]国家药典委员会.中华人民共和国药典:一部[M].北京:中国医药科技出版社,2015.
[4]邓中甲.方剂学[M].北京:中国中医药出版社,2010.
[5]高学敏.中药学[M].北京:人民卫生出版社,2014.
[6]中华中医药学会内科分会肺系病专业委员会.咳嗽中医诊疗专家共识意见(2011版)[J].中医杂志,2011,52(10):896-899.
[7]薛博瑜,吴伟.中医内科学[M].北京:人民卫生出版社,2016:37-43.
[8]谢敏德,卢建军,甘正佩.辛开苦降益肺法治疗冬季急性咳嗽52例[J].河南中医,2014,34(6):1122-1123.
[9]魏鹏草,苗青,张文江,等.叶天士治疗慢性咳嗽的学术思想探讨[J].江苏中医药,2010,42(4):12-13.
[10]赵志恒,穆超超.基于数据挖掘的《理虚元鉴》用药规律研究[J].中国中医药信息杂志,2018,25(7):92-94.