基于数据挖掘法探讨《世医得效方》中治伤方剂的用药规律  

A data mining-based analysis of clinical medication rules of prescriptions for treatment of orthopedic and traumatic diseases in Shiyi Dexiao Fang

作　　者：祁建华 明洪 张会择 胡友鹏 戴泽林 杨斐[1] 陈日高[1] QI Jianhua;MING Hong;ZHANG Huize;HU Youpeng;DAI Zelin;YANG Fei;CHEN Rigao(Hospital of Chengdu University of TCM,Chengdu 610072,Sichuan,China)

机构地区：[1]成都中医药大学附属医院,四川成都610072

出　　处：《中医正骨》2022年第3期20-25,31,共7页The Journal of Traditional Chinese Orthopedics and Traumatology

摘　　要：目的:探讨《世医得效方》中治伤方剂的用药规律。方法:收集《世医得效方》中第18卷“正骨兼金镞科”中的治伤方剂,建立标准化方药数据库。采用中医传承计算平台(V3.0)统计纳入方剂中药物的使用频次、功效、药性、药味及归经,采用SPSS Modeler 18.0软件对其中的高频药物进行关联规则分析,采用SPSSS tatistics 26.0软件对其中的高频药物进行聚类分析。结果:共收集79首方剂,其中内服方剂40首、外用方剂39首,共涉及154味中药。内服中药115味,累计使用频次278次,使用频次≥4的中药共21味,居于前5位的中药依次为当归、川芎、乳香、大黄、甘草;外用中药81味,累计使用频次135次,使用频次≥3的中药共15味,居于前5位的中药依次为铅丹、白芷、枫香脂、地黄、生姜。《世医得效方》治伤方剂中内服中药多采用活血化瘀、补虚、解表类药物,外用中药主要以解表、清热、活血化瘀类药物为主;药物多归肝、脾、心经,药味多辛、苦;内服药的药性偏温、平,外用药的药性偏温、寒。对使用频次≥4的21味内服中药进行关联规则分析,得到10条关联规则,涉及10个核心药物组合,分别为川芎→当归、没药→乳香、苏木→当归、白芍→当归、自然铜→没药、肉桂→当归、白芷→木香、白芷→川芎、白芷→当归、白芍+川芎→当归;对使用频次≥3的15味外用中药进行关联规则分析,得到10条关联规则,涉及10个核心药物组合,分别为川芎→白芷、半夏+生姜→黄柏、半夏+黄柏→生姜、生姜+黄柏→半夏、枫香脂+铅丹→石膏、枫香脂+石膏→铅丹、枫香脂+铅丹→白芷、铅丹+白芷→枫香脂、枫香脂+石膏→白芷、石膏+白芷→枫香脂。聚类分析结果显示,使用频次≥4的21味内服中药可聚为5类,第1类包括白芷、紫金皮、木香、白芍、地黄、川芎,合用能补血活血、行气止痛;第2类包括草乌、川Objective:To explore the clinical medication rules of prescriptions for treatment of orthopedic and traumatic diseases in Shiyi Dexiao Fang.Methods:The prescriptions aimed at treating orthopedic and traumatic diseases were extracted from Volume XVIII of Bonesetting&Battlefield Surgery in Shiyi Dexiao Fang and a standard database for the prescriptions was established.The normalized Chinese herbs(CHs)in the extracted prescriptions were input into the Microsoft Office Excel 2016 software for building a standard database, based on which their usage frequency, efficacy, medicinal property, medicinal flavor and meridian tropism were statistically analyzed by using traditional Chinese medicine inheritance support system(TCMISS)software(V3.0).The high-frequency CHs were then subjected to association rule analysis by using SPSS Modeler 18.0 software and cluster analysis by using SPSS Statistics 26.0 software.Results:Seventy-nine prescriptions(154 CHs)were included in the final analysis, including 40 oral prescriptions(115 CHs)and 39 external-applied prescriptions(81 CHs).Among the 115 oral CHs(appeared 278 times),21 ones displayed a usage frequency of ≥4,and the top 5 ones with high usage frequency included Angelica sinensis, Chuanxiong Rhizoma, Frankincense, Rhei Radix et Rhizoma and Glycyrrhiza Uralensis.Among the 81 external-applied CHs(appeared 135 times),15 ones displayed a usage frequency of ≥3,and the top 5 ones with high usage frequency included Plumbum Rubrum,Angelicae Dahuricae Radix,Liquidambaris Resina,Rehmannia Glutinosa and Zingiberis Rhizoma Recens. The CHs are often the ones presented with pungent flavor and bitter flavor and mainly act on liver meridians,spleen meridians and heart meridians in the prescriptions aimed at treating orthopedic and traumatic diseases inShiyi Dexiao Fang,among which,the oral CHs are mainly the ones for promoting blood circulation to remove blood stasis,tonifying deficiency as well as relieving superficies with properties mainly as warm and neutral;while the external-applied

关 键 词：《世医得效方》 中医骨伤科疾病 方剂分析 计算机辅助 数据挖掘 

分 类 号：R269[医药卫生—中西医结合]