《辅行诀》所载“汤液经法图”体系中五脏虚实辨证的四诊信息库构建和判别模型研究  

Construction of Four-Diagnosis Information Database and Discrimination Model of Syndrome Differentiation on Deficiency and Excess ZHENG of Five Zang Based on Tangye Jingfa map in Fuxingjue

作　　者：金锐 郭红叶[1] 田佳鑫[1] JIN Rui;GUO Hongye;TIAN Jiaxing(Department.of Pharmacy,Xiyuan Hospital,Chinese Academy of Chinese Medical Science,Beijing 100091,China)

机构地区：[1]中国中医科学院西苑医院药学部,北京100091

出　　处：《医药导报》2023年第4期464-471,共8页Herald of Medicine

基　　金：中国中医科学院科技创新工程重大攻关项目(CI2021A03805)。

摘　　要：《辅行诀五脏用药法要》(简称《辅行诀》)所载“汤液经法图”包含了一个完整的辨证论治体系,包括疾病诊断和药物治疗。在疾病诊断方面,“汤液经法图”独尊五脏虚实辨证,以肝心脾肺肾的虚实定病性,而《辅行诀》中收录的20首五脏大小补泻诸方,则明确记载了五脏虚实病证的临床表现。该文汇总分析《辅行诀》中五脏大小补泻诸方的主治症记载,对证候描述进行标准化和等价转换,统一“痛引少腹迫急”与“少腹迫满而痛”以及“烦躁”与“心中虚烦”等不同证候描述。同时,构建五脏虚实病证的四诊信息库,发现同一脏腑同一补泻的小汤证与大汤证(例如小补肝汤证与大补肝汤证)之间,相邻脏腑的大补汤证或大泻汤证(例如大补脾汤与大补肺汤)之间,均存在适应证重叠的情况。采用决策树判别模型的C4.5算法和随机树算法,均可以得到五脏虚实病证的诊断判别模型,识别出关键的症状节点。通过上述研究,为“汤液经法图”所示辨证论治理论的临床应用提供学术支持。The“Tangye Jingfa map”of Fuxingjue contains a complete syndrome differentiation and treatment system,including disease diagnosis and herbal treatment.In terms of disease diagnosis,“Tangye Jingfa map”respects the syndrome differentiation on deficiency and excess syndrome of Five Zang only,and determines the disease nature based on the deficiency and excess syndrome of liver,heart,spleen,lungs,and kidneys.The 20 prescriptions for tonifying or reducing Five Zang included in Fuxingjue,which clearly records the clinical manifestations of deficiency and excess syndrome of Five Zang.This paper summarizes and analyzes the records of the main symptoms of the prescriptions for tonifying and reducing Five Zang in Fuxingjue,standardizes and equivalently converts the description of syndromes,and unifies the description of different syndromes,such as“pain leads to less abdominal urgency”and“less abdominal fullness and pain”,“irritability”and“heart deficiency”.At the same time,the diagnosis information database of deficiency and excess syndromes of Five Zang was constructed.It was found that there were overlaps of indications between the syndrome of small Decoction and large Decoction in the same Zang(such as the small Decoction of tonifying liver and the large Decoction of tonifying liver),and between the syndrome of large tonifying Decoctions in the adjacent Zang(such as the large Decoction of tonifying spleen and the large Decoction of tonifying lung).Using C4.5 algorithm and random tree algorithm of the decision tree discrimination model,we can also get the diagnosis discrimination model of the deficiency and excess syndrome of Five Zang,and identify the key symptom nodes.Through the above research,it provides academic support for the clinical application of syndrome differentiation and treatment theory shown in“Tangye Jingfa map”.

关 键 词：汤液经法图 辅行诀五脏用药法要 五脏虚实证候 辨证论治 决策树 

分 类 号：R944[医药卫生—药剂学] R24[医药卫生—药学]