古医籍疫病舌象临床用药规律探析  

Exploration into the Rules of Clinical Medication Based on the Tongue Manifestations of Epidemic Disease in Ancient Medical Books

作　　者：张平[1] 刘雪峰 吕文亮[1] 陈炜[2] 潘广涛 ZHANG Ping;LIU Xuefeng;LYU Wenliang;CHEN Wei;PAN Guangtao(Hubei University of Chinese Medicine,Wuhan 430061,China;Guangxi University of Chinese Medicine,Nanning 530299,China;Yancheng Hospital of TCM Affiliated to Nanjing University of Chinese Medicine,Yancheng 224000,China)

机构地区：[1]湖北中医药大学,湖北武汉430061 [2]广西中医药大学,广西南宁530299 [3]南京中医药大学附属盐城市中医院,江苏盐城224000

出　　处：《西部中医药》2023年第11期42-47,共6页Western Journal of Traditional Chinese Medicine

基　　金：广西中医基础研究重点实验室开放课题(20-065-53-08);湖北中医药大学新冠肺炎应急科技攻关资助项目(16)。

摘　　要：目的:系统整理和挖掘疫病的舌象表现、治疗思路及用药规律,旨在让疫病舌象理论在指导新型冠状病毒感染以及疫病的中医辨证论治中发挥更大作用。方法:采用文本挖掘和语义网络构建方法,分析总结历代涉及“疫病”的古医籍中疫病“舌象”的临床表现、病因病机、方药中的舌与方药等信息的直接关系。挖掘疫病舌-方药的临床用药经验及其规律。结果:涉及疫病“舌象”的古医籍有39部,其中晋代1部、唐代2部、宋代2部、元代1部、明代10部、清代25部。涉及方药12部,频度从高到低依次是承气汤(81次)、达原饮(37次),再为白虎汤、至宝丹、生脉散、六味地黄汤。药物依次为大黄(51次)、石膏(48次)、犀角(41次),再为连翘、生地黄、黄连、黄芩、甘草、柴胡、知母、银花、玄参、花粉、麦冬、葛根、桔梗、薄荷。与舌象关联的方药节点频度最高,达10次以上的是石膏、连翘,其次为玄参、知母、黄芩、黄连、大黄、生地黄、犀角、甘草,再为牡丹皮,节点度7次有花粉、银花、赤芍、麦冬、柴胡、牛蒡子和凉膈散、达原饮;节点度6次有贝母、石菖蒲、桔梗、天花粉和白虎汤。舌黄、或伴见芒刺、或舌苔黑、或舌燥关联度最高方剂为承气汤;舌苔白或舌粉腻苔关联度最高方剂为达原饮。结论:疫病舌象理论可为新型冠状病毒感染的迅速辨证提供指导,为选方用药加减提供参考。Objective:To systematically arrange and excavate the tongue manifestations,therapeutic idea and medication laws of epidemic disease by taking the tongue manifestations as the main line,in order to make the theory of tongue manifestations of epidemic disease play a greater role in guiding syndrome differentiation and treatment of the COVID-19 and modern epidemics.Methods:Using text mining and semantic network construction methods,this paper analyzes and summarizes the complex relationship between the clinical manifestations of tongue manifestations of epidemic disease in ancient medical books about the epidemics in the past dynasties,etiology and pathogenesis,the tongue and prescription and herbs in the formulation,to dig out the rules of clinical medication experience and model about tongue-prescription and herbs for epidemic disease.Results:The study revealed that there were 39 ancient medical records involving the"tongue manifestations"of epidemic diseases.Among them,one belonging to Jin dynasty,two to Tang dynasty,two to Song dynasty,one to Yuan dynasty,ten to Ming dynasty and 25 to Qing dynasty.12 books on the prescription and herbs were involved,the prescriptions ranked in the descending order of frequency:Chengqi decoction(81 times),Dayuan drink(37 times),Baihu decoction,Zhibao pills,Shengmai powder and Liuwei Dihuang decoction.The herbs were Dahuang(rhei radix et rhizoma,51 times),Shigao(cypsum fibrosum,48 times),Xijiao(Rhinoceros unicornis L,41 times),and then Lianqiao(Forsythiae fructus),Shengdi(Rehmanniae radix),Huanglian(coptidis rhizoma),Huangqin(scutellariae radix),Gancao(glycyrrhizae radix et rhizoma),Chaihu(Bupleuri radix),Zhimu(Anemarrhenae rhizoma),Yinhua(Lonicerae japonicae flos),Xuanshen(Scrophulariae radix),Huafen(Trichosanthis radix),Maidong(Ophiopogonis radix),Gegen(puerariae lobatae radix),Jiegeng(Platycodonis radix)and Bohe(mint).The frequency of prescription nodes associated with tongue images was the highest,the herbs with the nodes greater than 10 were Shigao and Lianqiao,the next Xuans

关 键 词：疫病 新型冠状病毒感染 舌象 数据挖掘 用药经验 

分 类 号：R241.25[医药卫生—中医诊断学]