基于数据挖掘探讨《临证指南医案》痹证病案用药规律  

Analysis of Bi Diseases in Clinic Guideline of Medical Records with Text Mining

作　　者：李雨彦[1] 戈娜[1] 李顺民[1] Li Yuyan;Ge Na;Li Shunmin(Department of Nephrology,Guangdong Shenzhen Traditional Chinese Medicine Hospital,Shenzhen 518033,China)

机构地区：[1]广东省深圳市中医院肾病科,深圳518033

出　　处：《世界中医药》2018年第10期2629-2632,共4页World Chinese Medicine

基　　金：深圳市卫生三名工程张大宁国医大师中医药防护肾脏疾病团队(SZSM201512040);深圳市科技计划项目(JCYJ20160428182213078)

摘　　要：目的:探讨《临证指南医案》痹证医案的核心用药情况,认识叶天士辨治痹证的用药规律,为临床痹证辨治开拓思路。方法:通过分层切片算法的应用,进行《临证指南医案》痹证病案数据的目标关键词频率统计的计算。利用Cytoscape可视化,提取医案的中药及药物性味归经规律。结果:卷七痹所载55例医案,共有处方79条,共使用中药122种。叶天士常用茯苓、桂枝、白术、当归等药物辨治痹证。叶天士治痹喜用温药、寒药、平药维多,甘味药、苦味药、辛味药次之。用药归经方面,叶天士治痹注重调肝、肺,其次为调脾、肾、胃、心。对《临证指南医案》中提及的4种痹证进行总结发现:4种痹证在补气、养血、健脾、祛湿方面存在共同之处,且各有特色及不同侧重。结论:叶氏在辨治痹证时,学宗《内经》,尊经不泥,重视脾胃,培补中焦,认为痹证多病久入络,善用虫药以通为用。Objective To explore the core medication situation of Bi diseases in Clinical Guideline of Medical Records through text mining to deeply understand Ye Tianshi′s medication law of differentiation and treatment of phlegm syndrome,and to open up ideas for differentiation and treatment of clinical phlegm syndrome. Methods： Through the application of the hierarchical slicing algorithm based on sensitive keywords frequency statistics method,we calculated the case data of the Clinical Guideline Medical Case.Using Cytoscape visualization,we extracted the regularity of traditional Chinese medicine and property,flavor and channel tropism in medical records. Results： There were 55 medical records in volume seven,79 prescription,and 122 kinds of traditional Chinese medicines about treating Bi diseases in Clinical Guideline Medical Case written by doctor Ye Tainshi.Results of mining these medical records showed us that doctor Ye Tianshi liked to use Poria,Ramulus Cinnamomi,Rhizoma Atractylodis Macrocephalae,Radix Angelicae Sinensis to treat Bi diseases.In terms of medicinal property,Ye Tianshi treated Bi diseases with warm,cold and flat medicine,followed by sweet,bitter and pungent medicine.In terms of medication,Ye Tianshi′s treatment of Bi diseases focused on regulating the liver and lungs,followed by regulating the spleen,kidney,stomach,and heart.According to the comparison of four different Bi diseases in Clinical Guideline Medical Case,we found that four kinds of Bi diseases were all treated with benefiting qi,nourishing blood,invigorating spleen and removing dampness,and each had its own characteristics and different emphasis. Conclusion： In our study,we found that the theories of TCM Masters in treating Bi diseases are mostly from Huangdi′s Internal Classic.The treatment mainly focused on spleen stomach,as well as harmony with Qi,water and blood were excavated.“Persistent illness entering collaterals” and “treatment with insect drugs” are also the features of doctor Ye in treating Bi diseases.

关 键 词：数据挖掘 叶天士 临证指南医案 痹证 用药规律 

分 类 号：R229[医药卫生—中医基础理论]