施杞教授治疗颈腰综合征用药经验及学术思想传承  

Professor Shi Qi’s Experience in Treating Cervical and Lumbar Syndrome and Inheritance of Academic Thought

作　　者：赵翅 许辉[1] 冉磊 韩海慧 马迎辉 肖涟波 施杞[5,6] Zhao Chi;Xu Hui;Ran Lei;Han Haihui;Ma Yinghui;Xiao Lianbo;Shi Qi(Henan University of Chinese Medicine,School of Acupuncture-moxibustion and Tuina,Zhengzhou 450003,China;Shanghai University of Traditional Chinese Medicine,Guanghua Clinical Medical College,Shanghai 201203,China;Guanghua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 200050,China;Arthritis Research Institute of Integrated Traditional Chinese and Western Medicine,Shanghai Academy of Traditional Chinese Medicine,Shanghai 200050,China;Longhua Hospital Affiliated to Shanghai University of Chinese Medicine,Shanghai 200003,China;Institute of Spinal Diseases,Shanghai University of Chinese Medicine,Shanghai 200003,China)

机构地区：[1]河南中医药大学针灸推拿学院,郑州450003 [2]上海中医药大学光华临床医学院,上海201203 [3]上海中医药大学附属光华医院,上海200050 [4]上海市中医药研究院中西医结合关节炎研究所,上海200050 [5]上海中医药大学附属龙华医院,上海200003 [6]上海中医药大学脊柱病研究所,上海200003

出　　处：《世界科学技术-中医药现代化》2022年第9期3556-3562,共7页Modernization of Traditional Chinese Medicine and Materia Medica-World Science and Technology

基　　金：上海市卫生健康委员会上海市临床重点专科建设项目(shslczdzk04801):上海市临床重点专科建设-中西医结合骨关节病科,负责人:肖涟波;上海市长宁区科学技术委员会一般项目(CNKW2020Y23):基于多模态MRI研究推拿治疗膝关节骨关节炎镇痛作用的脑中枢机制,负责人:解骏;上海中医药大学研究生创新培养专项(Y2021009):基于静息态BOLD-fMRI研究巨刺法对全膝关节置换术后镇痛作用的脑中枢机制,负责人:赵翅

摘　　要：目的借助中医传承平台(V3.0)软件,分析探讨施杞教授治疗颈腰综合征的用药经验及组方规律,传承施杞教授临床诊治颈腰综合征学术思想。方法收集归纳施杞教授2018-2020年门诊治疗颈腰综合征的治验处方,将方药信息录入中医传承计算平台,采用改进的互信息法、关联规则、聚类分析(复杂系统熵聚类及无监督熵层次聚类)等数据挖掘方法分析处方用药性味、归经、使用频次、药对组合及方剂配伍规律并发现新方。结果共整理施杞教授治疗颈腰综合征验方150则,中药183味,多为甘、苦、辛药物,归经以肝、脾为主,兼有心、肾、肺、胃、胆、膀胱、三焦、大肠、小肠、心包经。单味药物使用频次最高的为柴胡,高频药对组合为柴胡-黄芪147次(占98.00%),柴胡-川芎142次(占94.67%);常用角药组合为柴胡-黄芪-川芎140次(占93.33%),柴胡-甘草-黄芪130次(占86.67%),柴胡-秦艽-黄芪130次(占86.67%)。常用药对为柴胡-川芎、黄芪-川芎等。核心处方为柴胡、黄芪、川芎、当归、秦艽、甘草。结论施杞教授治疗颈腰综合征以圣愈汤为主方,药物以柴胡、黄芪、川芎、甘草、秦艽、当归、川牛膝、大枣等为主,临床诊治时随病、证、症以用药加减,体现了“气血为先,少阳为枢,八纲统领,本于五脏”的学术思想。Objective With the help of traditional Chinese medicine inheritance platform(V3.0)software,we analyze and discuss Professor Shi Qi’s medication experience and prescription rules in the treatment of cervical and lumbar syndrome,and inherit Professor Shi Qi’s academic thought of clinical diagnosis and treatment of cervical-lumbar syndrome.Methods Professor Shi Qi’s outpatient prescriptions for cervical-lumbar syndrome from 2018 to 2020 were collected and summarized.The prescription information was input into the traditional Chinese medicine inheritance calculation platform.The improved mutual information method,association rules,cluster analysis(complex system entropy clustering and unsupervised entropy hierarchical clustering)and other data mining methods were used to analyze the nature and flavor of prescription,meridian tropism,frequency of use,drug pair combination and prescription compatibility,and find new prescriptions.Results We sorted out Professor Shi Qi’s 150 prescriptions for cervical and lumbar syndrome.There were 183 traditional Chinese medicines,mostly sweet,bitter and pungent drugs.The meridians were mainly liver and spleen,with heart,kidney,lung,stomach,gallbladder,bladder,triple energizer,large intestine,small intestine and pericardium.The highest frequency of single drug use was Chaihu,and the high frequency drug pair combination was Chaihu-Huangqi 147 times(98.00%),Chaihu-Chuanxiong 142 times(94.67%).Commonly used triple medicinal combinations is Chaihu-Huangqi-Chuanxiong 140 times(93.33%),Chaihu-Gancao-Huangqi 130 times(86.67%),Chaihu-Qinjiao-Huangqi 130 times(86.67%).Common drug pairs were Chaihu-Chuanxiong,HuangqiChuangxiong etc.The core prescription were Chaihu,Huangqi,Chuanxiong,Danggui,Qinjiao,Gancao.Conclusion Professor Shi Qi mainly uses Shengyu Decoction in the treatment of cervical-lumbar syndrome,and the drugs dominate by Chaihu,Huangqi,Chuanxiong,Gancao,Qinjiao,Danggui,Chuanniuxi and Dazao.The clinical diagnosis and treatment are modified with the disease,syndrome and symptom

关 键 词：颈腰综合征 用药规律 组方分析 名老中医 中医传承辅助系统 

分 类 号：R249[医药卫生—中医临床基础] R274.9[医药卫生—中医学]