《孙文垣医案》中含人参处方用药规律研究
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摘要
目的:分析《孙文垣医案》中含人参处方的用药规律。方法:将符合纳入标准的处方录入office 2010中,建立"《孙文垣医案》中含人参处方数据库",通过IBM SPSS Modeler 14. 1,分析含人参处方的药物频次、药类、性味、核心组合与高置信度关联规则等。结果:共收集含人参处方231首,人参与生甘草、白术、茯苓、陈皮、当归出现频次较高,高频药物药类则为补虚药、解表药及清热药居前三位,高频性味为温(87)、甘(83)、辛(82)、苦(75)出现较多,排名前三名的对药为人参、生甘草(172),人参、白术(134),生甘草、白术(117)。排名靠前的角药为人参、白术、生甘草(134),人参、茯苓、白术(116)等。两项关联规则分析得出人参→生甘草,人参→白术,人参→茯苓两两组合使用概率较高,三项关联组合多为四君子汤加减配伍理气养血之剂。含人参处方常用药物组合网络图提示支持度> 50%时,核心药物组合为人参+白术+生甘草+茯苓+陈皮+当归+白芍+柴胡。结论:《孙文垣医案》用人参常以补为本,以通为用,临证法尚温补,慎用温燥,常寒温通用,力荐以辛苦之品,通畅气机。重视脾胃,好彰土德,常以归芍六君子汤加减以健运脾胃,温补气血。
Objective: To study the drug-use law of prescriptions containing ginseng in Sun Wen-yuan Medical Records. Methods:Prescriptions meeting the inclusion criteria were entered into office 2010,and a database of prescriptions containing ginseng in Sun Wen-yuan Medical Records was established. Through IBM SPSS Modeler 14. 1,the frequency,category,nature and flavor,core combination and high-confidence association rules of ginseng prescriptions were analyzed. Results: A total of 231 prescriptions containing ginseng were collected. Renshen( Radix et Rhizoma Ginseng),raw Gancao( Radix et Rhizoma Glycyrrhizae),Baizhu( Rhizoma Atractylodis Macrocephalae),Fuling( Poria),Chenpi( Pericarpium Citri Reticulatae),Danggui( Radix Angelicae Sinensis) appeared frequently. The top three High-frequency drugs were tonic drugs,antipyretic drugs and antipyretic drugs. High-frequency nature and flavors were warming( 87),dryness( 83),pungence( 82),bitterness( 75). The top three drug-pairs were Renshen-Gancao( 172),Renshen-Baizhu( 134),and Gancao-Baizhu( 117). The top three-combination drugs were: RenshenBaizhu-Gancao( 134),Renshen-Fuling-Baizhu( 116). According to the analysis of the two association rules,Renshen-Gancao,Renshen-Baizhu,and Renshen-Fuling had a higher probability of use. The three Association combinations were mostly Four Gentlemen Decoction plus or minus compatibility of qi-regulating and blood-nourishing prescriptions. When the support of drug combination network diagram of common prescriptions containing ginseng was more than 50%,the core drug combination was RenshenBaizhu-Gancao-Fuling-Chenpi-Danggui-Baishao( Radix Paeoniae Alba)-Chaihu( Radix Bupleuri). Conclusion: In Sun Wen-yuan Medical Records,ginseng is often used for supplement and dredging. In clinical practice,warming and supplementing is always adopted. Doctors are cautious in using warm and dry drugs,but often use cold and warm together,advocate to use pungent and bitter drugs to dredge qi activities. The spleen and stomach are often paid attention to. Modified Chinese Angelica and Peony Six Gentlemen Decoction is often used to invigorate the spleen and stomach,warm and nourish qi and blood.
Objective: To study the drug-use law of prescriptions containing ginseng in Sun Wen-yuan Medical Records. Methods:Prescriptions meeting the inclusion criteria were entered into office 2010,and a database of prescriptions containing ginseng in Sun Wen-yuan Medical Records was established. Through IBM SPSS Modeler 14. 1,the frequency,category,nature and flavor,core combination and high-confidence association rules of ginseng prescriptions were analyzed. Results: A total of 231 prescriptions containing ginseng were collected. Renshen( Radix et Rhizoma Ginseng),raw Gancao( Radix et Rhizoma Glycyrrhizae),Baizhu( Rhizoma Atractylodis Macrocephalae),Fuling( Poria),Chenpi( Pericarpium Citri Reticulatae),Danggui( Radix Angelicae Sinensis) appeared frequently. The top three High-frequency drugs were tonic drugs,antipyretic drugs and antipyretic drugs. High-frequency nature and flavors were warming( 87),dryness( 83),pungence( 82),bitterness( 75). The top three drug-pairs were Renshen-Gancao( 172),Renshen-Baizhu( 134),and Gancao-Baizhu( 117). The top three-combination drugs were: RenshenBaizhu-Gancao( 134),Renshen-Fuling-Baizhu( 116). According to the analysis of the two association rules,Renshen-Gancao,Renshen-Baizhu,and Renshen-Fuling had a higher probability of use. The three Association combinations were mostly Four Gentlemen Decoction plus or minus compatibility of qi-regulating and blood-nourishing prescriptions. When the support of drug combination network diagram of common prescriptions containing ginseng was more than 50%,the core drug combination was RenshenBaizhu-Gancao-Fuling-Chenpi-Danggui-Baishao( Radix Paeoniae Alba)-Chaihu( Radix Bupleuri). Conclusion: In Sun Wen-yuan Medical Records,ginseng is often used for supplement and dredging. In clinical practice,warming and supplementing is always adopted. Doctors are cautious in using warm and dry drugs,but often use cold and warm together,advocate to use pungent and bitter drugs to dredge qi activities. The spleen and stomach are often paid attention to. Modified Chinese Angelica and Peony Six Gentlemen Decoction is often used to invigorate the spleen and stomach,warm and nourish qi and blood.
引文
[1]夏洁楠,徐雯洁,王国为,等.孙一奎学术思想源流及虚劳诊治特点探析[J].中华中医药杂志,2015,30(5):1387-1390.
[2]王巍,苏光悦,胡婉琦,等.近10年人参皂苷对心血管疾病的药理作用研究进展[J].中草药,2016,47(20):3736-3741.
[3]孙一奎.孙文垣医案[M].合肥:安徽科学技术出版社,1995:98-100.
[4]高学敏.中药学[M].北京:人民卫生出版社,2014:1-450.
[5]国家药典委员会.中华人民共和国药典[M].北京:中国医药科技出版社,2010:123.
[6]沈毅,傅萍,孔丽娅.数据挖掘方法在名老中医用药规律研究中的应用[J].中医杂志,2016,57(10):890-893.
[7]徐雯洁,徐世杰.基于护阴理论的汪机、吴澄、叶天士三家脾胃思想研究[J].中华中医药杂志,2017,32(3):1206-1208.
[8]郭锦晨,潘翠群,汪瑶.从《孙文垣医案》浅析孙一奎临证辨治规律[J].山西中医学院学报,2014,15(4):10-11.
[9]张宇鹏,杜松,尹玉芳,等.孙一奎学术思想渊源探析[J].中国中医基础医学杂志,2015,21(5):491-493.
[10]周超,郭锦晨,杨勤军,等.孙一奎《孙文垣医案》胃脘痛从脾论治验案探析[J].陕西中医药大学学报,2017,40(1):90-92.
[11]杨擎,隋欣,石晓征,等.基于Nrf2/Keap1信号通路人参皂苷CK靶向调节Aβ分子机制研究[J].中华中医药杂志,2018,33(5):1840-1845.
[12]刘玉玮.明代医家孙一奎及其思想认识论[J].中国中医药现代远程教育,2010,8(23):1-3.
[13]吴振起,王贵帮,王雪峰,等.从“气血流通”探析通补理论[J].中华中医药学刊,2018,36(2):381-383.
[14]庞婷,麦蓝尹,陈勇,等.中药药对配伍的化学成分变化研究进展[J].中药材,2015,38(11):2429-2434.
[15]郭震浪,苏振宁,王正飞,等.四君子汤加减治疗慢性萎缩性胃炎的Meta分析[J].中国实验方剂学杂志,2015,21(24):204-208.
[16]高兵,郭锦晨,万四妹,等.基于Apriori算法联合多元统计对《舟山医案》内伤杂病临证方药规律的研究[J].新中医,2018,50(2):131-135.
[17]孟春萍,沈华江,丁丰,等.归芍六君子汤联合恩替卡韦对乙型病毒性肝炎患者经阿德福韦酯治疗后肾损伤的改善作用[J].新中医,2017,49(2):48-50.
[2]王巍,苏光悦,胡婉琦,等.近10年人参皂苷对心血管疾病的药理作用研究进展[J].中草药,2016,47(20):3736-3741.
[3]孙一奎.孙文垣医案[M].合肥:安徽科学技术出版社,1995:98-100.
[4]高学敏.中药学[M].北京:人民卫生出版社,2014:1-450.
[5]国家药典委员会.中华人民共和国药典[M].北京:中国医药科技出版社,2010:123.
[6]沈毅,傅萍,孔丽娅.数据挖掘方法在名老中医用药规律研究中的应用[J].中医杂志,2016,57(10):890-893.
[7]徐雯洁,徐世杰.基于护阴理论的汪机、吴澄、叶天士三家脾胃思想研究[J].中华中医药杂志,2017,32(3):1206-1208.
[8]郭锦晨,潘翠群,汪瑶.从《孙文垣医案》浅析孙一奎临证辨治规律[J].山西中医学院学报,2014,15(4):10-11.
[9]张宇鹏,杜松,尹玉芳,等.孙一奎学术思想渊源探析[J].中国中医基础医学杂志,2015,21(5):491-493.
[10]周超,郭锦晨,杨勤军,等.孙一奎《孙文垣医案》胃脘痛从脾论治验案探析[J].陕西中医药大学学报,2017,40(1):90-92.
[11]杨擎,隋欣,石晓征,等.基于Nrf2/Keap1信号通路人参皂苷CK靶向调节Aβ分子机制研究[J].中华中医药杂志,2018,33(5):1840-1845.
[12]刘玉玮.明代医家孙一奎及其思想认识论[J].中国中医药现代远程教育,2010,8(23):1-3.
[13]吴振起,王贵帮,王雪峰,等.从“气血流通”探析通补理论[J].中华中医药学刊,2018,36(2):381-383.
[14]庞婷,麦蓝尹,陈勇,等.中药药对配伍的化学成分变化研究进展[J].中药材,2015,38(11):2429-2434.
[15]郭震浪,苏振宁,王正飞,等.四君子汤加减治疗慢性萎缩性胃炎的Meta分析[J].中国实验方剂学杂志,2015,21(24):204-208.
[16]高兵,郭锦晨,万四妹,等.基于Apriori算法联合多元统计对《舟山医案》内伤杂病临证方药规律的研究[J].新中医,2018,50(2):131-135.
[17]孟春萍,沈华江,丁丰,等.归芍六君子汤联合恩替卡韦对乙型病毒性肝炎患者经阿德福韦酯治疗后肾损伤的改善作用[J].新中医,2017,49(2):48-50.