基于聚类分析探讨黄元御“土枢四象”用药规律  

To Study Medication Principles of “Earth Pivot Four Images” by HUANG Yuanyu Based on Cluster Analysis

作　　者：张毅[1] 李海[2] 林嬿钊[2] 原嘉民[2] ZHANG Yi;LI Hai;LIN Yanzhao;YUAN Jiamin(The Second Clinical College,Guangzhou University of Chinese Medicine,Guangzhou 510405,China;Department of Preventive Treatment of Disease,Guangdong Provincial Hospital of Traditional Chinese Medicine,Guangzhou 510120,China)

机构地区：[1]广州中医药大学第二临床医学院,广东广州510405 [2]广东省中医院治未病中心,广东广州510120

出　　处：《山东中医杂志》2020年第9期926-930,共5页Shandong Journal of Traditional Chinese Medicine

基　　金：广东省中医药局面上科研项目(编号:20171116)。

摘　　要：目的:探索黄元御"土枢四象"思想指导下的用药规律。方法:提取《黄元御医集(五)》中的方药信息,建立数据库,进行药物频数分析和聚类分析。结果:①医集共载方219首,载药116味。医方中甘草使用频数最高,所用药物的气味以气温平、味甘辛为主,归经以脾、胃经为主,功效类别以补虚类最高。②聚类分析可得7个药组,分别为黄芩、柴胡、半夏(升阳清热、燥湿降逆);石膏、浮萍、玄参(清热泻火、宣散透表);生姜、大枣(温中散寒、益气补脾);生地黄、当归、牡丹皮(凉血养血、滋肝清木);甘草、白芍(补脾益气、敛阴平肝);干姜、附子、人参(温里助阳、益气补脾);桂枝、茯苓(温通渗湿、健脾培土)。结论:黄元御用药重中土崇脾阳,立足于中土枢转四旁理论,通过温里、益气、化湿以扶土建中为主,兼有达木清肝或泻热降逆以拨动中土恢复枢转。Objective:To study the medication principles of "earth pivot four images" theory by HUANG Yuanyu. Methods:The prescriptions in Huang Yuanyu’s Medical Collection(5) were collected to set up a database and to perform frequency analysis and cluster analysis. Results:①In Huang Yuanyu’s Medical Collection,there are 219 prescriptions with 116 medicinals. Gancao(Glycyrrhizae Rhizoma et Radix) is of the highest frequency. Medicinals used were warm and neutral in nature,sweet and pungent in flavor,usually enters spleen and stomach meridians,and medicinals of reinforcing deficiency are of the highest frequency.②There are seven medicinal clusters after cluster analysis:Huangqin(Scutellariae Radix),Chaihu(Bupleuri Radix) and Banxia(Pinelliae Rhizoma)(lifting yang and clearing heat,drying dampness and directing counterflow downward);Shigao(Gypsum Fibrosum),Fuping(Spirodelae Herba),Xuanshen(Scrophulariae Radix)(cleaning heat and purging fire;dispersing and relieving the exterior);Shengjiang(Zingiberis Rhizoma Recens),Dazao(Jujubae Fructus)(warming the center and dissipating cold,boosting qi and tonifying spleen);Shengdihuang(Rehmanniae Radix),Danggui(Angelicae Sinensis Radix) and Mudanpi(Moutan Cortex)(cooling blood and nourishing blood,nourishing liver and clearing liver);Gancao and Baishao(Paeoniae Radix Alba)(tonifying spleen and boosting qi,consolidating yin and calming liver);Ganjiang(Zingiberis Rhizoma),Fuzi(Aconiti Lateralis Radix Praeparata)and Renshen(Ginseng Radix et Rhizoma)(warming the interior and assist yang,boosting qi and tonifying spleen;Guizhi( Cinnamomi Ramulus) and Fuling( Poria)( warming and unblocking to drain dampness,invigorating spleen and cultivating earth. Conclusions:HUANG Yuanyu emphasized the importance of central earth and spleen yang,and proposed the theory that the central earth is the pivot for the four directions.Through warming the interior,boosting qi,resolving dampness to assist the earth and construct the center,and accompanied with straightening wood and clearing liver or purging

关 键 词：黄元御 土枢四象 脾阳 温里 益气 化湿 用药规律 聚类分析 

分 类 号：R223.1[医药卫生—中医基础理论]