基于症状-证候-药物的新安医家治疗肺胀医案数据挖掘研究  

Xin’an doctors’ records of treating lung distention based on the “symptoms-patterns-medicines” model: A data mining study

作　　者：杨勤军 何振豪 史友 朱洁[1] 高雅婷 童佳兵[1,2,5] 石孟瑶 丁焕章 吴迪 孙登第[3] 李泽庚[1,2,4,5] 韩明向[2,4] YANG Qinjun;HE Zhenhao;SHI You;ZHU Jie;GAO Yating;TONG Jiabing;SHI Mengyao;DING Huanzhang;WU Di;SUN Dengdi;LI Zegeng;HAN Mingxiang(Anhui University of Chinese Medicine,Hefei 230038,China;Institute of Respiratory Disease Prevention and Treatment of Chinese Medicine,Anhui Academy of Chinese Medicine,Hefei 230038,China;Anhui University,Hefei 230039,China;The First Affiliated Hospital of Anhui University of Chinese Medicine,Hefei 230031,China;Key Laboratory of Education Department of Anhui Province-Key Laboratory of TCM Prevention and Treatment of Major Lung Diseases,Hefei 230038,China)

机构地区：[1]安徽中医药大学,合肥230038 [2]安徽省中医药科学院中医呼吸病防治研究所 [3]安徽大学 [4]安徽中医药大学第一附属医院 [5]安徽省教育厅重点实验室中医药防治肺系重大疾病重点实验室

出　　处：《北京中医药大学学报》2022年第6期594-602,共9页Journal of Beijing University of Traditional Chinese Medicine

基　　金：国家自然科学基金联合基金重点项目(No.U20A20398);安徽省科技重大专项(No.201903a07020015);国家中医药管理局内科气虚病证重点研究室(国中药函[2009]95号)。

摘　　要：目的 使用数据挖掘方法对新安医家治疗肺胀的医案从症状、证候、药物进行多维度研究,探讨其辨治肺胀的特色。方法 收集整理新安医籍中有关肺胀治疗的医案,将各项信息规范化处理后,利用频数分析、拓扑学分析、Louvain聚类算法、因子分析等数学模型对症状、证候、方药进行分析、关联。结果 共纳入361则医案,涉及272味药物,其中核心药物35味,包括茯苓、甘草、苦杏仁、薏苡仁、半夏、人参、白术、五味子等;补虚药(30.14%)使用最多,其次为化痰止咳平喘药(22.81%)。实证中痰湿蕴肺证(30.19%)最多,虚证中以肺气虚证(22.44%)、脾气虚证(21.05%)、肾气虚证(17.45%)为主。苦杏仁、茯苓、薏苡仁、半夏、化橘红等是痰湿蕴肺证的核心处方药物;茯苓、甘草、人参、白术、苦杏仁、陈皮等是肺气虚证的核心处方药物;茯苓、人参、甘草、白术、陈皮、半夏等是脾气虚证的核心处方药物;茯苓、山药、熟地黄、山萸肉、五味子等是肾气虚证的核心处方药物。共提取10个公因子;主要病位证素为肺、脾、肾,水湿、痰饮、瘀血是主要病理要素。结论 肺胀属本虚标实之证,以肺、脾、肾亏虚为本,痰、瘀、热等病理因素为标。新安医家辨治肺胀喜用茯苓、薏苡仁、人参、白术;重视标本兼治,在祛痰、清肺、止咳、平喘治标的同时,常配伍补肺、健脾、益肾之品以治其本。Objective To study the rules of symptoms, patterns, and medicines of medical records of lung distention treated by Xin’an doctors through data mining methods, and to explore the characteristics of Xin’an doctors in the treatment of lung distention.Methods Medical records related to the treatment of lung distention by Xin’an doctors were collected and sorted from the medical books of Xin’an. After the standardized processing of various information, mathematical models such as frequency analysis, topology analysis, Louvain clustering, and factor analysis were used to conduct data mining research on symptoms, patterns, and prescriptions.Results We included 361 medical records and counted 272 traditional Chinese medicines in total. Among them, 35 were core medicines, including Poria, Radix Glycyrrhizae, Semen Armeniacae Amarum, Semen Coicis, Rhizoma Pinelliae, Radix Ginseng, Rhizoma Atractylodis Macrocephalae, and Fructus Schisandrae Chinensis. In the lung distention, clinical practice of Xin’an doctors, tonic medicines(30.14%) were used most, followed by expectorant cough suppressants and anti-asthmatic medicines(22.81%). The pattern of phlegm and dampness accumulating in the lung(30.19%) was the most commonly observed, and the patterns of deficiency were mainly lung qi deficiency(22.44%), spleen qi deficiency(21.05%), and kidney qi deficiency(17.45%). Semen Armeniacae Amarum, Poria, Semen Coicis, Rhizoma Pinelliae, and Exocarpium Citri Grandis were the core prescription medicines for the pattern of phlegm and dampness accumulating in the lung. Poria, Radix Glycyrrhizae, Radix Ginseng, Rhizoma Atractylodis Macrocephalae, Semen Armeniacae Amarum, and Pericarpium Citri Reticulatae were the core prescription medicines of the lung qi deficiency pattern. Poria, Radix Ginseng, Radix Glycyrrhizae, Rhizoma Atractylodis Macrocephalae, Pericarpium Citri Reticulatae, and Rhizoma Pinelliae were the core prescription medicines of the spleen qi deficiency pattern. Poria, Rhizoma Dioscoreae, Radix Rehmanniae Preparata, F

关 键 词：肺胀 新安医家 症状 证候 方药 数据挖掘 茯苓 痰湿蕴肺证 

分 类 号：R256.14[医药卫生—中医内科学]