补中益气汤方证相应性研究
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摘要
补中益气汤是金元著名医家李杲所创,由黄芪、人参、白术、甘草、当归、陈皮、升麻、柴胡八味药物组成。主治饮食劳倦、脾胃虚弱、气虚发热、清阳下陷诸证,具有益气健脾、升阳举陷之功。
本文收集整理1990年～2008年补中益气汤现代临床验案217例,对验案中症状体征、药物使用频率及用量、加味药物等进行频次统计分析,并进一步采用黄金分割为分割点、聚类分析、关联规则等方法进行处理分析,以获得方证间的相应关系。
频次统计结果表明,补中益气汤的核心脉症为纳差、倦怠乏力、面色无华、精神不振、舌淡白、苔薄白、脉细;主要脉症为气短懒言、腰腹部以下坠胀感、便溏、眩晕,故本方病机以脾胃气虚为主,兼以气虚下陷。原方八味药物亦均入选为核心药物。
聚类分析结果显示:补中益气汤中补气药的剂量明显高于解表升阳药物,说明补中益气汤以益气健脾为主,兼以升举阳气。通过对第1类群和第4类群分析,二者核心脉症以全身症状表现为主,提示本方病机以脾胃气虚为主;主要脉症稍有变化,均为脾胃虚弱,气机升降失常所致,故第1类群和第4类群的药物剂量上亦有相应变化。
关联规则分析表明,补中益气汤的核心脉症与核心药物之间的置信度均超过61.8%,可见本方的核心脉症与核心药物间具有关联性。
通过对补中益气汤方证关系的探讨,使本方方证间内在稳定的相应关系更加清晰、客观、准确,为进一步规范化、标准化研究提供了相关依据,更好地指导临床遣方用药奠定基础。
Buzhongyiqi tang was created by Lin Dongyuan who was a famous doctor in Jin and Yuan Dynasties, it is composed of eight herbs including Huangqi, Renshen, Gancao, Baizhu, Danggui, Chenpi, Shengma, Chaihu, which can replenish qi to invigorate spleen and treat deficiency of the spleen-stomach and fever caused by deficiency of spleen qi and sinking of qi.
Collected Buzhongyiqi tang 217 modern clinic cases from 1990 to 2008, the patients' information including symptoms and signs frequency and dosage of certain herbs, added herbs are all statistically analyzed, and adopt the golden section as division point, k-mean cluster analysis, association rule to analysis for getting relation of comparation between prescription and syndrome.
The result indicates that:the cores symptoms of the prescription are poor appetite, lassitude, sallow complexion, depression, pale tongue with white coating and threaty pulse. The main symptoms are shortness of breath, the feeling of sinking and distention on the lower lumbus and abdomen, sloppy stools, dizziness. So they are mainly caused by deficiency of spleen qi and sinking of qi and the original of Buzhongyiqi tang are the core ingredients of the 217 prescriptions.
The result also shows that the dosages of replenishing qi herbs are heavier than those of elevating yang herbs, which indicate that their functions are mainly replenishing qi to invigorate spleen. The core symptoms reflect symptoms of everywhere of body, thus the pathogenesis of the prescription is deficiency of spleenic qi. Meanwhile the dosages of category one and four have Slightly changed according to their main symptoms of them, which is caused by Disorder of the spleen's ascending function.
Aassociation rule analysis shows that confidence between core symptoms and the core herbs of Buzhongyiqi tang is all transcend 61.8%, so both the core symptoms and the core herbs have relationship.
By discussing comparation between prescription and syndrome making the relation of both prescription and syndrome more clear、objective and accurate, which can supply related information for further standardization of research and guilding clinical practice.
本文收集整理1990年～2008年补中益气汤现代临床验案217例,对验案中症状体征、药物使用频率及用量、加味药物等进行频次统计分析,并进一步采用黄金分割为分割点、聚类分析、关联规则等方法进行处理分析,以获得方证间的相应关系。
频次统计结果表明,补中益气汤的核心脉症为纳差、倦怠乏力、面色无华、精神不振、舌淡白、苔薄白、脉细;主要脉症为气短懒言、腰腹部以下坠胀感、便溏、眩晕,故本方病机以脾胃气虚为主,兼以气虚下陷。原方八味药物亦均入选为核心药物。
聚类分析结果显示:补中益气汤中补气药的剂量明显高于解表升阳药物,说明补中益气汤以益气健脾为主,兼以升举阳气。通过对第1类群和第4类群分析,二者核心脉症以全身症状表现为主,提示本方病机以脾胃气虚为主;主要脉症稍有变化,均为脾胃虚弱,气机升降失常所致,故第1类群和第4类群的药物剂量上亦有相应变化。
关联规则分析表明,补中益气汤的核心脉症与核心药物之间的置信度均超过61.8%,可见本方的核心脉症与核心药物间具有关联性。
通过对补中益气汤方证关系的探讨,使本方方证间内在稳定的相应关系更加清晰、客观、准确,为进一步规范化、标准化研究提供了相关依据,更好地指导临床遣方用药奠定基础。
Buzhongyiqi tang was created by Lin Dongyuan who was a famous doctor in Jin and Yuan Dynasties, it is composed of eight herbs including Huangqi, Renshen, Gancao, Baizhu, Danggui, Chenpi, Shengma, Chaihu, which can replenish qi to invigorate spleen and treat deficiency of the spleen-stomach and fever caused by deficiency of spleen qi and sinking of qi.
Collected Buzhongyiqi tang 217 modern clinic cases from 1990 to 2008, the patients' information including symptoms and signs frequency and dosage of certain herbs, added herbs are all statistically analyzed, and adopt the golden section as division point, k-mean cluster analysis, association rule to analysis for getting relation of comparation between prescription and syndrome.
The result indicates that:the cores symptoms of the prescription are poor appetite, lassitude, sallow complexion, depression, pale tongue with white coating and threaty pulse. The main symptoms are shortness of breath, the feeling of sinking and distention on the lower lumbus and abdomen, sloppy stools, dizziness. So they are mainly caused by deficiency of spleen qi and sinking of qi and the original of Buzhongyiqi tang are the core ingredients of the 217 prescriptions.
The result also shows that the dosages of replenishing qi herbs are heavier than those of elevating yang herbs, which indicate that their functions are mainly replenishing qi to invigorate spleen. The core symptoms reflect symptoms of everywhere of body, thus the pathogenesis of the prescription is deficiency of spleenic qi. Meanwhile the dosages of category one and four have Slightly changed according to their main symptoms of them, which is caused by Disorder of the spleen's ascending function.
Aassociation rule analysis shows that confidence between core symptoms and the core herbs of Buzhongyiqi tang is all transcend 61.8%, so both the core symptoms and the core herbs have relationship.
By discussing comparation between prescription and syndrome making the relation of both prescription and syndrome more clear、objective and accurate, which can supply related information for further standardization of research and guilding clinical practice.
引文
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