新安王氏内科王仲奇与王任之论治胃脘痛用药特色分析
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摘要
目的对新安王氏内科医家王仲奇及王任之论治胃脘痛用药特色进行分析。方法从《王仲奇医案》《王任之医案》中选取治疗胃脘痛处方74例、160例,提取方药,将符合纳入标准的处方录入Excel中,采用频数分析,计算高频药物,通过SPSS 22.0对高频药物进行相关分析,应用IBM SPSS Modeler 14.1进行Apriori算法,最大频繁关联模式等分析。结果《王仲奇医案》共出现中药888次,频次排名前3位中药为半夏、茯苓、旋覆花;《王任之医案》出现中药2 146次,排名前3的中药为瓜蒌、半夏、枳壳。关联分析得出王仲奇论治胃脘痛主要为瓜蒌→薤白,半夏→薤白,佩兰→陈皮等组合关联;王任之主要为瓜蒌→薤白,半夏→枳壳,半夏→薤白等组合关联。结论 2位王氏医家诊治胃脘痛以通为大法,务在祛除阻塞胃气疏降之因,或疏通气机,或健运脾胃,或活血化瘀,或消食化滞,或温中行气,胃脘痛常兼气滞,以辛开苦降法,用辛香理气之品,和胃止痛。顺应胃腑和降之性,畅通人身元气,促进疾病痊愈。王仲奇与王任之的治疗胃脘痛思路一脉相承,具体用药却各有特色。王任之在王仲奇扶正健脾、通邪止痛基础上,更加重视胃脘痛日久,瘀血、痰邪留滞,常施以通阳泄浊、化瘀通络之法。
Objective To analyze the medication characteristics of Wang Zhongqi and Wang Renzhi(physicians of Xin'an Wang's internal medicine) in treatment of stomach duct pain. Methods The formulas for treating stomach duct pain were chosen from Wang Chongqi's Medical Cases(74 cases) and Wang Renzhi' s Medical Cases(160 cases) and medicinals were selected. The eligible formulas to internalized standard were input into Office 2010 and high-frequency medicinals were calculated by using frequency analysis. SPSS 22.0 software was used to given a correlation analysis on the high-frequency medicinals, and IBM SPSS Modeler 14.1 software was used in the analyses of Apriori algorithm and maximum frequent association pattern. Results There were totally 888 Chinese medicinals appeared in Wang Chongqi's Medical Cases, and top 3 medicinals were Banxia(Pinellia Tuber, Rhizoma Pinelliae), Fuling(Indian Bread, Poria) and Xuanfuhua(Inula Flower, Flos Inulae). There were totally 2146 Chinese medicinals appeared in Wang Renzhi' s Medical Cases, and top 3 medicinals were Gualou(Trichosanthes fruit, Fructus Trichosanthis), Banxia(Pinellia Tuber, Rhizoma Pinelliae) and Zhiqiao(Bitter Orange, Fructus Aurantii). The results of association analysis showed that couplet medicinals for stomach duct pain used by Wang Chongqi were mainly Gualou-Xiebai(Macrostem Onion, Bulbus Allii Macrostemi), Banxia-Xiebai and Peilan(Eupatorium, Herba Eupatorii)-Chenpi(Tangerine Peel, Pericarpium Citri Reticulatae), and couplet medicinals for stomach duct pain used by Wang Renzhi were mainly Gualou-Xiebai, Banxia-Zhiqiao, Zhiqiao-Banxia and Banxia-Xiebai. Conclusion These 2 physicians of Xin'an Wang's internal medicine take unblocking as major therapy in treatment of stomach duct pain to remove the causes of gastric qi obstruction, including dredging qi movement, or improve transportation of spleen and stomach, or activating blood and resolving stasis, or promote digestion and remove food stagnation or warming the middle and move qi. Stomach duct pain is commonly accompanied by qi stagnation, which is treated often with therapies of pungent for opening and bitter for descending by using medicinals with effects of regulating qi with pungent and aroma medicinals for harmonizing stomach and relieving pain. The downward features of stomach should be complied with to free body's original qi and improve recovery of disease. Wang Zhongqi and Wang Renzhi have the same thinking on treatment of stomach duct pain, but they have their own medication characteristics. Wang Renzhi puts more emphasis on long-term stomach duct pain with blood stasis and phlegm retention, and often uses therapies of unblocking yang, discharging turbidity, resolving stasis and freeing collaterals.
Objective To analyze the medication characteristics of Wang Zhongqi and Wang Renzhi(physicians of Xin'an Wang's internal medicine) in treatment of stomach duct pain. Methods The formulas for treating stomach duct pain were chosen from Wang Chongqi's Medical Cases(74 cases) and Wang Renzhi' s Medical Cases(160 cases) and medicinals were selected. The eligible formulas to internalized standard were input into Office 2010 and high-frequency medicinals were calculated by using frequency analysis. SPSS 22.0 software was used to given a correlation analysis on the high-frequency medicinals, and IBM SPSS Modeler 14.1 software was used in the analyses of Apriori algorithm and maximum frequent association pattern. Results There were totally 888 Chinese medicinals appeared in Wang Chongqi's Medical Cases, and top 3 medicinals were Banxia(Pinellia Tuber, Rhizoma Pinelliae), Fuling(Indian Bread, Poria) and Xuanfuhua(Inula Flower, Flos Inulae). There were totally 2146 Chinese medicinals appeared in Wang Renzhi' s Medical Cases, and top 3 medicinals were Gualou(Trichosanthes fruit, Fructus Trichosanthis), Banxia(Pinellia Tuber, Rhizoma Pinelliae) and Zhiqiao(Bitter Orange, Fructus Aurantii). The results of association analysis showed that couplet medicinals for stomach duct pain used by Wang Chongqi were mainly Gualou-Xiebai(Macrostem Onion, Bulbus Allii Macrostemi), Banxia-Xiebai and Peilan(Eupatorium, Herba Eupatorii)-Chenpi(Tangerine Peel, Pericarpium Citri Reticulatae), and couplet medicinals for stomach duct pain used by Wang Renzhi were mainly Gualou-Xiebai, Banxia-Zhiqiao, Zhiqiao-Banxia and Banxia-Xiebai. Conclusion These 2 physicians of Xin'an Wang's internal medicine take unblocking as major therapy in treatment of stomach duct pain to remove the causes of gastric qi obstruction, including dredging qi movement, or improve transportation of spleen and stomach, or activating blood and resolving stasis, or promote digestion and remove food stagnation or warming the middle and move qi. Stomach duct pain is commonly accompanied by qi stagnation, which is treated often with therapies of pungent for opening and bitter for descending by using medicinals with effects of regulating qi with pungent and aroma medicinals for harmonizing stomach and relieving pain. The downward features of stomach should be complied with to free body's original qi and improve recovery of disease. Wang Zhongqi and Wang Renzhi have the same thinking on treatment of stomach duct pain, but they have their own medication characteristics. Wang Renzhi puts more emphasis on long-term stomach duct pain with blood stasis and phlegm retention, and often uses therapies of unblocking yang, discharging turbidity, resolving stasis and freeing collaterals.
引文
[1] 王睿,王键,黄辉,等. 基于关联分析法解析新安王氏内科治疗胃痞/胃痛辨证及用药特色[J]. 辽宁中医药大学学报,2018,20(2):1-3. Wang R, Wang J, Huang H, et al. Analysis of syndrome differentiation and pharmacy characteristics in the treatment of stomach stuffiness stomachache in Xin’an by association analysis[J]. Journal of Liaoning University of TCMe, 2018, 20(2): 1-3.
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[9] 毛斌,吴宏赟,胡志强. 关联规则在方剂数据挖掘中的应用述评[J]. 环球中医药,2013,6(10):791-794. Mao B, Wu HY, Hu ZQ. Commentary: application of association rules in prescriptions data mining[J].Global Traditional Chinese Medicine, 2013, 6(10): 791-794.
[10] 汤尔峰,姜惟. 中医通法浅析[J]. 中国中医急症,2012,21(3):417-418. Tang EF, Jiang W. Analysis of TCM obstruction-removing therapy[J]. J Emerg Tradit Chin Med, 2012, 21(3): 417-418.
[11] 刘涛.略论通法治疗胃脘痛[J]. 云南中医中药杂志,2016,37(10):10-13. Liu T. A brief discussion on treatment of stomach duct pain with freeing therapy[J]. Yunnan Journal of Traditional Chinese Medicine and Materia Medica, 2016, 37(10): 10-13.
[12] 聂多锐,刘兰林,郭锦晨,等. 201例新安王氏内科脾胃病医案组方用药规律及数据挖掘研究[J]. 西南医科大学学报,2017,40(5):484-487. Nie DR, Liu LL, Guo JC, et al. Prescription rule and datamining of medical records of spleen and stomach diseases in Xin’an Wang’s internal medicine: an analysis of 201 cases[J]. Journal of Southwest Medical University, 2017, 40(5): 484-487.
[13] 魏本君,陈恒文,郭丽丽,等.辛开苦降法探析[J]. 中医杂志,2016,57(1):81-83. Wei BJ, Chen HG,Guo LL, et al. Analysis on pungent-opening and bitter-downbearing therapy[J]. Journal of Traditional Chinese Medicine, 2016, 57(1): 81-83.
[14] 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. Gao B, Guo JC, Wan SM, et al. Law study on clinical prescriptions for endogenous diseases in Zhoushan Medical Case Records based on Aprior algorithm combined with multivariate statistics[J]. Journal of New Chinese Medicine, 2018, 50(2): 131-135.
[15] 王键,黄辉,蒋怀周. 新安固本培元派[J].中医药临床杂志,2013,25(12):2341-2349. Wang J, Huang H, Jiang HZ. Xin’an academic school of root-securityand original qi-tonifying[J]. Clinical Journal of Traditional Chinese Medicine, 2013, 25(12): 2341-2349
[16] 聂多锐,刘兰林,郭锦晨,等.基于《王仲奇医案》探析王仲奇“运脾”辨治胀满特色[J].甘肃中医药大学学报,2017,34(4):17-19.Nie DR, Liu LL, Guo JC, et al. Characteristics of differentiation and treatment of distention and fullness by Wang Zhongqia’s therapy of transporting spleen based on Wang Zhongqi’s Medical Cases[J]. Journal of Gansu University of Chinese Medicine, 2017, 34(4): 17-19.
[17] 李涵,熊磊,陈柏君,等.刍议芳香醒脾法与小儿厌食[J].中国中西医结合儿科学,2016,8(5):489-491. Li H, Xiong L, Chen BJ, et al. Discussion on the method of aroma invigorating spleen and infantile anorexia[J]. Chin Pediatr Integr Tradit West Med, 2016, 8(5): 489-491.
[18] 张声生,周强.胃脘痛中医诊疗专家共识意见(2017)[J]. 中医杂志,2017,58(13):1166-1170. Zhang SS, Zhou Q. Consensus opinion of TCM experts on diagnosis and treatment of stomach duct pain (2017)[J]. Journal of Traditional Chinese Medicine, 2017, 58(13): 1166-1170.
[2] 王禄. 胃脘痛临床辨治经验[J].中国中医基础医学杂志,2010,16(3):226-228. Wang L. Experiences in clinical differentiation and treatment of stomach duct pain[J]. Chinese Journal of Basic Medicine in Traditional Chinese Medicine, 2010, 16(3): 226-228.
[3] 王金杰. 王仲奇医案[M]. 合肥:安徽科学技术出版社,1992:1-440. Wang JJ. Wang Zhongqi’s Medical Cases[M]. Hefei: Anhui Science and Technology Publishing House, 1992: 1-440.
[4] 王任之. 王任之医案[M]. 合肥:安徽科学技术出版社,1998:1-521. Wang RZ. Wang Renzhi’s Medical Cases[M]. Hefei: Anhui Science and Technology Publishing House, 1998: 1-521.
[5] 薛博瑜,吴伟. 中医内科学[M]. 北京:人民卫生出版社,2016:153-161. Xue BY, Wu W. Internal Medicine of Traditional Chinese Medicine[M]. Beijing: People’s Medical Publishing House, 2016: 153-161
[6] 高学敏.中药学[M].北京:人民卫生出版社,2014:1-450. Gao XM. Chinese Materia Medica[M]. Beijing: People’s Medical Publishing House, 2014: 1-450.
[7] 南京中医药大学.中药大辞典[M].上海:上海科学技术出版社,2006. Nanjing University of Chinese Medicine. Dictionary of Chinese Materia Medica [M]. Shanghai: Shanghai Scientific and Technical Publishers, 2006.
[8] 刘明芝,周仁郁.中医药统计学与软件应用[M].北京:中国中医药出版社,2006:245. Liu MZ, Zhou RY. Statistical for Traditional Chinese Medicine and Software Application[M]. Beijing: China Press of Traditional Chinese Medicine, 2006: 245.
[9] 毛斌,吴宏赟,胡志强. 关联规则在方剂数据挖掘中的应用述评[J]. 环球中医药,2013,6(10):791-794. Mao B, Wu HY, Hu ZQ. Commentary: application of association rules in prescriptions data mining[J].Global Traditional Chinese Medicine, 2013, 6(10): 791-794.
[10] 汤尔峰,姜惟. 中医通法浅析[J]. 中国中医急症,2012,21(3):417-418. Tang EF, Jiang W. Analysis of TCM obstruction-removing therapy[J]. J Emerg Tradit Chin Med, 2012, 21(3): 417-418.
[11] 刘涛.略论通法治疗胃脘痛[J]. 云南中医中药杂志,2016,37(10):10-13. Liu T. A brief discussion on treatment of stomach duct pain with freeing therapy[J]. Yunnan Journal of Traditional Chinese Medicine and Materia Medica, 2016, 37(10): 10-13.
[12] 聂多锐,刘兰林,郭锦晨,等. 201例新安王氏内科脾胃病医案组方用药规律及数据挖掘研究[J]. 西南医科大学学报,2017,40(5):484-487. Nie DR, Liu LL, Guo JC, et al. Prescription rule and datamining of medical records of spleen and stomach diseases in Xin’an Wang’s internal medicine: an analysis of 201 cases[J]. Journal of Southwest Medical University, 2017, 40(5): 484-487.
[13] 魏本君,陈恒文,郭丽丽,等.辛开苦降法探析[J]. 中医杂志,2016,57(1):81-83. Wei BJ, Chen HG,Guo LL, et al. Analysis on pungent-opening and bitter-downbearing therapy[J]. Journal of Traditional Chinese Medicine, 2016, 57(1): 81-83.
[14] 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. Gao B, Guo JC, Wan SM, et al. Law study on clinical prescriptions for endogenous diseases in Zhoushan Medical Case Records based on Aprior algorithm combined with multivariate statistics[J]. Journal of New Chinese Medicine, 2018, 50(2): 131-135.
[15] 王键,黄辉,蒋怀周. 新安固本培元派[J].中医药临床杂志,2013,25(12):2341-2349. Wang J, Huang H, Jiang HZ. Xin’an academic school of root-securityand original qi-tonifying[J]. Clinical Journal of Traditional Chinese Medicine, 2013, 25(12): 2341-2349
[16] 聂多锐,刘兰林,郭锦晨,等.基于《王仲奇医案》探析王仲奇“运脾”辨治胀满特色[J].甘肃中医药大学学报,2017,34(4):17-19.Nie DR, Liu LL, Guo JC, et al. Characteristics of differentiation and treatment of distention and fullness by Wang Zhongqia’s therapy of transporting spleen based on Wang Zhongqi’s Medical Cases[J]. Journal of Gansu University of Chinese Medicine, 2017, 34(4): 17-19.
[17] 李涵,熊磊,陈柏君,等.刍议芳香醒脾法与小儿厌食[J].中国中西医结合儿科学,2016,8(5):489-491. Li H, Xiong L, Chen BJ, et al. Discussion on the method of aroma invigorating spleen and infantile anorexia[J]. Chin Pediatr Integr Tradit West Med, 2016, 8(5): 489-491.
[18] 张声生,周强.胃脘痛中医诊疗专家共识意见(2017)[J]. 中医杂志,2017,58(13):1166-1170. Zhang SS, Zhou Q. Consensus opinion of TCM experts on diagnosis and treatment of stomach duct pain (2017)[J]. Journal of Traditional Chinese Medicine, 2017, 58(13): 1166-1170.