《世医得效方》头痛病因病机及处方用药规律分析  

Analysis of the etiology,mechanism and Prescription of Headache in“Shi Yi De Xiao Fang”

作　　者：杨家蕾[1] 孙晔 YANG Jialei;SUN Ye(Department of Traditional Chinese Medicine,Beijing Tiantan Hospital,Capital Medical University,Beijing 100070,China;Department of Endocrinology,Pinggu Hospital,Beijing Traditional Chinese Medicine Hospital,Beijing 101200,China)

机构地区：[1]首都医科大学附属北京天坛医院中医科,北京100070 [2]北京中医医院平谷医院内分泌科,北京101200

出　　处：《四川中医》2023年第7期38-43,共6页Journal of Sichuan of Traditional Chinese Medicine

摘　　要：目的:探究《世医得效方》头痛病因病机及用药规律。方法:归纳整理《世医得效方》中头痛的病因病机及其记载的方剂,总结头痛用药规律。结果:《世医得效方》将头痛分为风证、寒证、暑证、湿证、热证、虚证,对其病因病机的阐述主要为外邪侵袭或内伤引起的不通则痛。34首内服方剂中散剂18首,汤剂7首,丸剂9首,涉及76味中药,药性频次共354次。高频用药配伍模式共7组,其中频次排名前3组依次为川芎-细辛,防风-川芎,甘草-防风。置信度≥0.6的药物关联规则按频度大小排列依次为甘草-防风→羌活,防风→川芎,甘草-羌活→防风等。基于无监督的熵层次聚类算法共获得4个治疗头痛的潜在新方组合,分别为甘草-川芎-羌活-防风-黄芩-柴胡,麻黄-细辛-附子-甘草-川芎-石膏,细辛-羌活-荆芥-川芎-甘草-防风,白附子-天南星-石膏-白芷-甘草-当归。结论:通过对《世医得效方》头痛处方用药规律进行分析,发现头痛治疗以祛风解表为中心思想,兼行气、清热、燥湿、化痰、活血补气,对临床辨证治疗头痛有一定指导意义,对临床新方剂的研发及进一步的科学研究提供了有效参考。Objective:To investigate the etiology,pathogenesis and medication rules of headache in“S hi Yi De Xiao Fang”.Methods:To summarize the etiology,pathogenesis of headache and its prescriptions in the“Shi Yi De Xiao Fang”,and to summarize the rules of headache medicine.Results:The“Shi Yi De Xiao Fang”classifies headache into wind,cold,summerheat,dampness,heat,and deficiency syndrome,and its etiology and pathogenesis are mainly described as pain caused by external evil invasion or internal injury.Among the 34internal prescriptions,18are for powders,7are for decoctions,and 9are for pills,involving 76herbs with a total frequency of 354times.There were 7groups of high-frequency drug use patterns,among which the top 3groups were Chuan Dome-Hsiang Hsiang,Fangfeng-Chuanxiong,and Glycyrrhiza glabra-Fangfeng.The drug association rules with confidence≥0.6were,in order of frequency,Glycyrrhiza glabra-Fangfeng→Qiangwu,Fangfeng→Chuanxiong,Glycyrrhiza glabra-Qiangwu→Fangfeng,etc.The unsupervised entropy-based hierarchical clustering algorithm yielded a total of 4potential new formula combinations for the treatment of headache,namely Glycyrrhiza glabra-Chuanxiong-Qiangxiong-Fangfeng-Baicalein-Chaihu,Mahuang-Huang-Huang-Shenxin-Anemarrhena-Glycyrrhiza-Chuanxiong-Gypsophila,Huang-Huang-Qiangxiong-Chuanxiong-Glycyrrhiza-Fangfeng,and BaiHuang-TianNanXing-Gypsophila-Dahurica-Glycyrrhiza-Adang-Zi.Conclusion:By analyzing the pattern of prescriptions for headache in the prescriptions of the“Shi Yi De Xiao Fang”,we found that the treatment of headache is centered on the idea of dispelling wind and relieving symptoms,and also moving Qi,clearing heat,drying dampness,resolving phlegm,invigorating blood and replenishing Qi,which has certain guiding significance for the clinical diagnosis and treatment of headache,and provides an effective reference for the development of new clinical formulas and further scientific research.

关 键 词：《世医得效方》 头痛 病因病机 用药规律 

分 类 号：R249[医药卫生—中医临床基础]