《医案类聚》明清医家治疗臌胀用药规律数据挖掘研究  

Study on data mining of the medication law of treating abdominal tympanites in the Yi An Lei Ju in the Ming and Qing Dynasties

作　　者：周纪军 姚子昂 吕文良[3] Zhou Jijun;Yao Zi'ang;Lyu Wenliang(the First Clinical College of Medicine,Shaanxi University of Chinese Medicine,Xianyang 712046,China;Department of Traditional Chinese Medicine,Peking University People's Hospital,Beijing 100044,China;Department of Infectious Diseases,Guang'anmen Hospital,China Academy of Chinese Medical Sciences,Beijing 100053,China)

机构地区：[1]陕西中医药大学第一临床医学院,咸阳712046 [2]北京大学人民医院中医科,北京100044 [3]中国中医科学院广安门医院感染疾病科,北京100053

出　　处：《国际中医中药杂志》2024年第8期1060-1064,共5页International Journal of Traditional Chinese Medicine

基　　金：北京市自然科学基金(7222295)。

摘　　要：目的基于《医案类聚》探讨明清时期医家治疗臌胀的用药、组方规律及其学术思想。方法检索《医案类聚》所载明清时期医家治疗臌胀的医案,提取其中处方信息,基于R 4.2.1和中医传承计算平台V3.0统计药物频次、性味归经、功效类别,并进行关联规则分析及聚类分析。结果共纳入处方214首,涉及中药239味,总频次2080次,高频中药(频次≥30)有茯苓、陈皮、泽泻、白术、附子等,用药药性以温、平、寒为主,药味以辛、甘、苦为主,归经以脾、肝、肾经为主,功效类别以补虚药、利水渗湿药、理气药为主。关联规则分析发现,使用频次最高的药对为茯苓-陈皮。聚类分析发现,频次≥20的中药可分为4个聚类。结论明清医家治疗臌胀以健脾利水、疏肝理气、温肾化饮为基本治法,用药兼顾升降气机、攻补兼施、寒热并调、燮和气血。Objective:To discuss the medication,prescription law and academic thoughts of doctors in the Ming and Qing Dynasties for the treatment of abdominal tympanites based on the Yi An Lei Ju.Methods:The medical records of doctors in the Ming and Qing Dynasties for the treatment of tympanites contained in Yi An Lei Ju were retrieved,and the prescription information was extracted.Based on R4.2.1 and the TCM inheritance calculation platform V3.0,the frequency,property and taste,and meridian tropism,and efficacy categories of drugs were counted,and association rules analysis and clustering analysis were performed.Results:A total of 214 prescriptions were included,involving 239 kinds of Chinese materia medica,with a total frequency of 2080 times.The high-frequency drugs(frequency≥30)were Poria,Citri Reticulatae Pericarpium,Alismatis Rhizoma,Atractylodis Macrocephalae Rhizoma,Aconiti Lateralis Radix Praeparata,etc.The medicinal properties of the drugs were mainly warm,neutral and cold.The flavors were mainly pungent,sweet and bitter.The meridians were mainly spleen,liver and kidney meridians.The efficacy categories were mainly tonic drugs,diuresis and dampness drugs,and qi-regulating drugs.Association rule analysis found that the most frequently used drug pair was Poria-Citri Reticulatae Pericarpium.Clustering analysis showed that drugs(frequency≥20)could be divided into 4 clusters.Conclusions:Doctors in the Ming and Qing Dynasties treated abdominal tympanites with the basic treatment methods of invigorating the spleen and promoting diuresis,soothing the liver and regulating qi,warming the kidney and resolving fluid retention.The medication took into account the ascending and descending of qi,the combination of attack and supplement,the combination of cold and heat,and the harmony of qi and blood.

关 键 词：臌胀 《医案类聚》 中医传承计算平台 R语言 处方挖掘 用药规律 

分 类 号：R256.42[医药卫生—中医内科学] TP311.13[医药卫生—中医学]