杨卓欣治疗失眠症用药规律分析
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摘要
目的:总结杨卓欣教授治疗失眠症的用药规律并传承其学术思想。方法:收集杨卓欣教授在临床上治疗失眠症的处方,建立数据库,应用SPSS20.0软件与Celementine12.0软件进行频数分析、高频药物功效归类分析、关联规则分析。结果:共收录处方104首,涉及药物合计84种,使用总频数达1 398次;使用频次≥20的药物有22味,其中频次较高的前5位分别是炙甘草、陈皮、酸枣仁、当归、白术。高频药物功效归类分析前5位为补虚药、理气药、安神药、收涩药、利水渗湿药,关联规则分析得到2味以上药物组合27对。结论:杨卓欣教授善于从脏腑理论出发治疗失眠症,立足于脾、心,以益气健脾、养血安神为大法,临证常以归脾汤为基础方进行化裁,随症辅以疏肝理气药、滋补肝肾药、活血化瘀药等。
Objective:To summarize Professor YANG Zhuoxin's administration rule of treating insomnia and to inherit his academic thoughts. Methods:The prescriptions prescribed by Professor YANG Zhuoxin for the clinical treatment of insomnia were collected to establish a database; SPSS20.0 software and Celementine12.0 software were used for the frequency analysis,the classification of the effect of high-frequency Chinese herbs as well as the association rule analysis. Results:A total of 104 prescriptions were included,involving 84 kinds of Chinese herbs,with a total frequency of use of 1398. There were 22 Chinese herbs with the frequency of use of more than or equal to 20,among which Radix et Rhizoma Glycyrrhizae Praeparata cum Melle, Pericarpium Citri Reticulatae, Semen Ziziphi Spinosae, Radix Angelicae Sinensis and Rhizoma Atractylodis Macrocephalae were the top five. The top five according to the classification of the effect of the high-frequency Chinese herbs were deficiency-supplementing medicine, qi-regulating medicine, mind-calming medicine, astringent medicine and dampness-draining diuretic medicine, and 27 pairs of medicine combinations consisting of more than two Chinese herbs were obtained by association rule analysis. Conclusion:Professor YANG Zhuoxin is good at treating insomnia from the theory of viscera and bowels,focusing on the spleen and the heart,and with the main treatment of replenishing qi and fortifying the spleen as well as tonifying blood and calming the mind. Guipi tang,usually used as the basic prescription,is modified when necessary in clinical practice,and is supplemented by the liver-soothing and qi-regulating medicine,the liver-kidney-tonifying medicine as well as the blood-activating and stasis-resolving medicine according to different symptoms.
Objective:To summarize Professor YANG Zhuoxin's administration rule of treating insomnia and to inherit his academic thoughts. Methods:The prescriptions prescribed by Professor YANG Zhuoxin for the clinical treatment of insomnia were collected to establish a database; SPSS20.0 software and Celementine12.0 software were used for the frequency analysis,the classification of the effect of high-frequency Chinese herbs as well as the association rule analysis. Results:A total of 104 prescriptions were included,involving 84 kinds of Chinese herbs,with a total frequency of use of 1398. There were 22 Chinese herbs with the frequency of use of more than or equal to 20,among which Radix et Rhizoma Glycyrrhizae Praeparata cum Melle, Pericarpium Citri Reticulatae, Semen Ziziphi Spinosae, Radix Angelicae Sinensis and Rhizoma Atractylodis Macrocephalae were the top five. The top five according to the classification of the effect of the high-frequency Chinese herbs were deficiency-supplementing medicine, qi-regulating medicine, mind-calming medicine, astringent medicine and dampness-draining diuretic medicine, and 27 pairs of medicine combinations consisting of more than two Chinese herbs were obtained by association rule analysis. Conclusion:Professor YANG Zhuoxin is good at treating insomnia from the theory of viscera and bowels,focusing on the spleen and the heart,and with the main treatment of replenishing qi and fortifying the spleen as well as tonifying blood and calming the mind. Guipi tang,usually used as the basic prescription,is modified when necessary in clinical practice,and is supplemented by the liver-soothing and qi-regulating medicine,the liver-kidney-tonifying medicine as well as the blood-activating and stasis-resolving medicine according to different symptoms.
引文
[1]中国睡眠研究会.中国失眠症诊断和治疗指南[J].中华医学杂志,2017,97(24):1844-1856.
[2]苏亮,陆峥.2017年中国失眠症诊断和治疗指南解读[J].世界临床药物,2018,39(4):217-222.
[3]中华医学会神经病学分会睡眠障碍学组.中国成人失眠诊断与治疗指南[J].中华神经科杂志,2012,45(7):534-540.
[4]陆峥.失眠症的诊断和药物治疗现状[J].世界临床药物,2011,32(4):193-199.
[5]陈贵海.失眠的研究进展[J].中国临床医生杂志,2017,45(8):1-6.
[6]陈懿.中医药治疗失眠症的研究进展[J].中医临床研究,2017,9(7):138-141.
[7]皮敏,缑燕华,丘凤贤,等.调任通督针刺法治疗失眠症主穴处方优化的临床研究[J].中医药临床杂志,2012,24(6):506-508.
[8]蔡昕宏.针药结合治疗肝郁脾虚型失眠的临床研究[D].广州:广州中医药大学,2013.
[9]中医中医科学院失眠症中医临床实践指南课题组.失眠症中医临床实践指南(WHO/WPO)[J].世界睡眠医学杂志,2016,3(1):8-25.
[10]汪娅蓓.中医治疗失眠症的研究进展[J].内蒙古中医药,2017,36(13):139-140.
[11]闫兵,皮敏,缑燕华,等.杨卓欣教授从肝论治失眠验案举隅[J].新中医,2014,46(8):250-251.
[12]缑燕华,皮敏,杨卓欣.杨卓欣教授治疗失眠症经验简介[J].新中医,2011,43(7):177-178.
[13]杜建强,聂斌.数据挖掘在中医药领域应用研究进展[J].中国中医药信息杂志,2013,20(6):109-112.
[14]朱彦,朱玲,崔蒙.论中医药数据挖掘[J].中华中医药杂志,2016,31(8):2932-2935.
[2]苏亮,陆峥.2017年中国失眠症诊断和治疗指南解读[J].世界临床药物,2018,39(4):217-222.
[3]中华医学会神经病学分会睡眠障碍学组.中国成人失眠诊断与治疗指南[J].中华神经科杂志,2012,45(7):534-540.
[4]陆峥.失眠症的诊断和药物治疗现状[J].世界临床药物,2011,32(4):193-199.
[5]陈贵海.失眠的研究进展[J].中国临床医生杂志,2017,45(8):1-6.
[6]陈懿.中医药治疗失眠症的研究进展[J].中医临床研究,2017,9(7):138-141.
[7]皮敏,缑燕华,丘凤贤,等.调任通督针刺法治疗失眠症主穴处方优化的临床研究[J].中医药临床杂志,2012,24(6):506-508.
[8]蔡昕宏.针药结合治疗肝郁脾虚型失眠的临床研究[D].广州:广州中医药大学,2013.
[9]中医中医科学院失眠症中医临床实践指南课题组.失眠症中医临床实践指南(WHO/WPO)[J].世界睡眠医学杂志,2016,3(1):8-25.
[10]汪娅蓓.中医治疗失眠症的研究进展[J].内蒙古中医药,2017,36(13):139-140.
[11]闫兵,皮敏,缑燕华,等.杨卓欣教授从肝论治失眠验案举隅[J].新中医,2014,46(8):250-251.
[12]缑燕华,皮敏,杨卓欣.杨卓欣教授治疗失眠症经验简介[J].新中医,2011,43(7):177-178.
[13]杜建强,聂斌.数据挖掘在中医药领域应用研究进展[J].中国中医药信息杂志,2013,20(6):109-112.
[14]朱彦,朱玲,崔蒙.论中医药数据挖掘[J].中华中医药杂志,2016,31(8):2932-2935.