《永类钤方》中骨伤内服药方的用药规律分析  

Clinical medication rules of the oral prescriptions for treatment of orthopedic traumatologic diseases(TCM)in Yonglei Qianfang

作　　者：李琰 尹煜辉 刘宁 魏戌[1] LI Yan;YIN Yuhui;LIU Ning;WEI Xu(Wangjing Hospital of CACMS,Beijing 100102,China)

机构地区：[1]中国中医科学院望京医院,北京100102

出　　处：《中医正骨》2024年第4期47-54,共8页The Journal of Traditional Chinese Orthopedics and Traumatology

基　　金：中国中医科学院科技创新工程重大攻关项目(CI2021A02013)。

摘　　要：目的:分析《永类钤方》中骨伤内服药方的用药规律。方法:收集《永类钤方》中的骨伤内服药方,建立标准化方药数据库。采用Microsoft Office Excel 2019软件统计纳入方剂中组方药物的出现频次、药性、药味、归经和功效,采用SPSS Modeler 18.0软件分析纳入方剂中组方药物的关联规则,采用SPSS Statistics 26.0软件对高频药物进行系统聚类分析。结果:共收集到47首内服药方,涉及162味中药。出现频次≥5的中药共34味,出现频次排前6位的中药依次为当归、川芎、白芷、生川乌、乳香、肉桂。药性出现频次最高的为温,药味出现频次较高的依次为辛、苦、甘,归经主要归肝经、脾经、心经,药物功效出现频次较高的依次为活血化瘀、补虚和解表。对47首骨伤内服药方中的组方药物进行关联规则分析,共得到17条关联规则,增益均>1,支持度最高的关联规则为当归→川芎,置信度为100%的关联规则为当归→肉桂+川芎、当归→肉桂+白芷、当归→没药+川芎;关联度较强的药对为川芎-当归、当归-肉桂、当归-乳香、白芷-当归、没药-乳香。聚类分析得到新处方3首,分别为川椒-泽兰-甘草-当归-川芎-肉桂、白芷-桔梗-陈皮-赤芍-茴香-生姜-生地黄、独活-生草乌-干姜-羌活-苍术-牛膝-细辛-续断-何首乌-生川乌-白芍-骨碎补-木鳖子仁-乳香-没药-自然铜。结论:《永类钤方》中骨伤内服药方多采用辛温、苦温和甘温之药,常从肝经、脾经、心经论治,以活血化瘀、补虚并兼顾解表为主要治法,以“发散寒邪,通气通血”为主要用药思想。Objective:To analyze the clinical medication rules of the oral prescriptions for treatment of orthopedic traumatologic diseases(TCM)in Yonglei Qianfang.Methods:The oral prescriptions aimed at treating orthopedic traumatologic diseases(TCM)were extracted from Yonglei Qianfang and a standard database for the prescriptions was established.The occurrence frequency,medicinal property,medicinal flavor,meridian tropism and efficacy of the normalized Chinese herbs(CHs)in the included prescriptions were statistically analyzed by using the Microsoft Office Excel 2019 software;the association rules of the CHs involved in the included prescriptions were analyzed by employing SPSS Modeler 18.0 software;and the high-frequency CHs were then subjected to systematic cluster analysis by using SPSS Statistics 26 software.Results:Forty-seven oral prescriptions were included in the final analysis,involving 162 CHs,among which 34 ones displayed a occurrence frequency of≥5,and the top 6 ones with a high occurrence frequency included Angelicae Sinensis Radix(TCD),Chuanxiong Rhizoma,Angelicae Dahuricae Radix,Radix Aconiti Kusenzoffii,Olibanum(TCD)and Cinnamomi Cortex.The CHs in the 47 oral prescriptions are often the ones presented with warm property,pungent,bitter and sweet flavors,and mainly act on liver meridians,spleen meridians and heart meridians with the efficacies mainly as promoting blood circulation to remove blood stasis,tonifying deficiency as well as releasing exterior.The association rule analysis on the 47 oral prescriptions aimed at treating orthopedic traumatologic diseases(TCM)yielded 17 association rules,with the gains of>1.The association rule with the highest support was Angelicae Sinensis Radix(TCD)→Chuanxiong Rhizoma,the ones with a confidence of 100%included Angelicae Sinensis Radix(TCD)→Cinnamomi Cortex+Chuanxiong Rhizoma,Angelicae Sinensis Radix(TCD)→Cinnamomi Cortex+Angelicae Dahuricae Radix and Angelicae Sinensis Radix(TCD)→Myrrha+Chuanxiong Rhizoma.The paired-herbs with strong correlation were Chuan

关 键 词：中医药学文献 《永类钤方》 中医骨伤科疾病 方剂构成 方剂分析 计算机辅助 数据挖掘 聚类分析 

分 类 号：R274[医药卫生—中医骨伤科学]