基于数据挖掘探讨《临证指南医案》便闭病用药规律  

Discussion on medication rules of constipation in Guide to Clinical Practice with Medical Records based on data mining

作　　者：李春[1] 肖宁[1] 易亮[1] 赵丹[1] 施保柱 董妍 Li Chun;Xiao Ning;Yi Liang;Zhao Dan;Shi Baozhu;Dong Yan(Department of Critical Care Medicine,Xiyuan Hospital,China Academy of Chinese Medical Sciences,Beijing 100091,China;Department of Critical Care Medicine,Hebei Provincial Hospital of Traditional Chinese Medicine,Shijiazhuang 050011,China)

机构地区：[1]中国中医科学院西苑医院重症医学科,北京100091 [2]河北省中医院重症医学科,石家庄050011

出　　处：《国际中医中药杂志》2022年第2期201-205,共5页International Journal of Traditional Chinese Medicine

基　　金：河北省中医药管理局科研计划项目(2019042、2022065)。

摘　　要：目的探讨叶天士治疗便闭病用药规律,以供临床参考和借鉴。方法收集《临证指南医案》“肠痹门”“便闭门”处方中药,运用Excel、SPSS 22.0、SPSS Modeler软件进行证型、药物频次、属性统计及关联规则分析。结果叶氏治疗便闭病主要辨证为湿热内蕴、肾阳虚、阴虚火旺、肝肾阴虚、肺失宣肃等证型。药性以温、寒、平为主,药味以甘、辛、苦为主,归经以胃、脾、肺、肝、肾、心为主,常使用苦杏仁、当归、茯苓、柏子仁、瓜蒌皮等药物,根据关联规则分析得到常用药对配伍,如苦杏仁-瓜蒌皮、苦杏仁-郁金、当归-柏子仁等。结论叶天士治疗便闭病是以调理脾胃为中心,注重湿热在致病过程中的重要地位,注重肺气宣肃、肝气疏泄、膀胱气化作用。叶天士为后世医家提供了新的治疗思路与方法,具有临床指导意义。Objective To explore the medication rules of Ye Tianshi in the treatment of constipation from his clinical records.Methods The drugs in the prescriptions of intestinal obstruction and stool closure were collected in Guide to Clinical Practice with Medical Records.Then the frequency of the prescriptions and the herbs for the treatment,as well as the herbal natures,flavors and meridian belongings were analyzed by Excel,SPSS 22.0 and SPSS Modeler software.Results The main syndrome types of Ye's treatment of fecal occlusive disease were internal accumulation of dampness and heat,deficiency of kidney Yang,hyperactivity of fire due to yin deficiency,deficiency of liver and kidney Yin,and dysfunction of lung.The medicinal properties were mainly warm,cold and flat,and the tastes were mainly sweet,pungent and bitter,and the meridians mainly belonged to spleen and stomach,lung,liver,kidney and heart.Armeniacae Semen Amarum,Angelica sinensis,Poria,Semen Platycladi,Trichosanthes kirilowii Maxim,Semen Persicae were often used.The commonly used drug pairs,included Armeniacae Amarum Semen and Trichosanthes kirilowii Maxim,Armeniacae Amarum Semen and Radix Curcumae Aromaticae,Angelica sinensis and Semen Platycladi and so on.Conclusions Ye Tianshi takes spleen and stomach as the center,pays attention to the important position of dampness pathogen in the pathogenic process,and pays attention to lung Qi purging,liver Qi drainage and bladder gasification.It provides new treatment ideas and methods,guiding future doctors.

关 键 词：数据挖掘 叶天士 《临证指南医案》 肠痹 便闭 用药规律 

分 类 号：R249[医药卫生—中医临床基础] R256.35[医药卫生—中医学]