瘰疬外用方药的用药规律分析  

A Study on the Regularity of Ancient TCM Prescriptions of External Drugs for Tuberculous Lymphadenitis

作　　者：王芷乔[1] 靳汝辉[1] 高金辉 WANG Zhi-qiao;JIN Ru-hui;GAO Jin-hui(Nanjing Integrated Traditional Chinese and Western Medicine Hospital Affiliated to Nanjing University of Chinese Medicine,Nanjing Jiangsu 210014,China)

机构地区：[1]南京中医药大学附属南京市中西医结合医院,江苏南京210014

出　　处：《中医药导报》2020年第11期164-168,共5页Guiding Journal of Traditional Chinese Medicine and Pharmacy

基　　金：江苏省“十二五”中医重点学科(中医疮疡病学)建设项目(苏中医政[2013]30号)。

摘　　要：目的:基于数据挖掘技术,探讨古代瘰疬用药与组方规律。方法:对古籍文献中治疗瘰疬的方药进行搜集、整理,从瘰疬专病的角度探讨用药规律,对其组方规律进行分析、研究,总结疾病层面用药的共性特征,挖掘其诊治规律。结果:纳入中药方剂数据库涉及瘰疬方药共计308首,其中外用107首,涉及中药252味,散见于88本相关古籍。其中高频药物为乳香、麝香、没药、朱砂、黄丹、麻油等,所用药物四气以温、寒、平药为主,五味以辛、苦、甘为主,药物归经以归肝经、脾经、心经、胃经为主,置信度较高的常用药物组合如没药-麝香-乳香、血竭-乳香、轻粉-麝香等。获得核心药物组合5组,并生成外用新处方备选组合5个,如杏仁-松香-木鳖子-穿山甲、雄黄-麝香-白矾-硇砂-砒霜等。结论:历代医家外治瘰疬医案的组方法则以活血化瘀、拔毒生肌为主。应用数据挖掘技术研究历代医家治疗瘰疬用药特点、组方规律有助于指导中医药防治瘰疬的临床实践。Objective: To study on the regularity of ancient TCM prescriptions of external drugs for tuberculous lymphadenitis. Methods: By collecting and sorting out the prescriptions and drugs for the treatment of tuberculous lymphadenitis in the ancient books, the author discussed the rules of drug use from the angle of scrofula specific disease, analyzed and studied the rules of its composition, summarized the common characteristics of drug use at the disease level, and digged out the rules of diagnosis and treatment. Results: A total number of308 prescriptions(included 107 external prescriptions), including 252 herbs, have been selected from 88 ancient TCM books. The high-frequency drugs used are Ruxiang(olibanum), Shexiang(moschus), Moyao(myrrha), Zhusha(cinnabaris), Huangdan(yellow lead), and Mayou(sesame oil). The medicines applied have characteristics of warm,cold and calm, which share the tastes of pungent, bitter and sweet. These drugs commonly share the meridian tropi sm of liver, spleen, heart and stomach meridian. The commonly used drug combinations with higher confidence include Moyao(myrrha)-Shexiang(moschus)-Ruxiang(olibanum), Xuejie(draconis sanguis)-Ruxiang(olibanum),Qingfen(calomelas)-Shexiang(moschus), etc. Five core drug combinations were obtained, and five new prescriptions for external use were generated, such as Xingren(almond)-Songxiang(rosin)-Mubiezi(momordicae semen)-Chuanshanjia(manis squama), Xionghuang(realgar)-Shexiang(moschus)-Baifan(alumen)-Xingsha(sal-ammoniae)-Pishuang(arsenic), and so on. Conclusion: The principle of external treatment of scrofula in ancient Chinese medicine was to activate blood circulation and remove blood stasis, and extract toxin to generate muscle. The application of data mining technology to study the characteristics of medication and the rule of prescription composition of doctors in the past dynasties is helpful to guide the clinical practice of traditional Chinese medicine in the prevention and treatment of scrofula.

关 键 词：淋巴结结核 瘰疬 古方 外用 中国方剂数据库 用药规律 数据挖掘 

分 类 号：R263[医药卫生—中医外科学]