明清时期情志病伴胃肠症状医案的整理研究  

Medical records of emotional disease with gastrointestinal symptoms from the Ming and Qing Dynasties

作　　者：杜晓娜 赖添武 谢蕾卉 DU Xiaona;LAI Tianwu;XIE Leihui(Fangchenggang Hospital of Traditional Chinese Medicine,Fangchenggang 538021,Guangxi,China)

机构地区：[1]防城港市中医医院,广西防城港538021

出　　处：《湖南中医杂志》2024年第8期29-34,共6页Hunan Journal of Traditional Chinese Medicine

基　　金：广西壮族自治区科技计划重点研发计划项目(桂科AB23026064)。

摘　　要：目的:探究明清时期情志病伴胃肠症状医案的病证名、病性、病位及用药规律。方法:通过《中华医典》检索明清时期情志病伴胃肠症状的医案,建立数据库。采用Excel软件对病证名、病性、病位、用药频次进行描述性统计。采用RStudio软件对药物进行关联规则分析。结果:共纳入119个医案,包含病证名29个。寒热病性以无寒热为首,占62.18%;其次是热证,占36.97%;寒证仅1次。虚实病性中,实证占51.26%;虚实错杂证占42.02%。涉及病位10个,频次排前4位的依次是胃(119次)、肝(97次)、脾(96次)、肺(16次)。使用频率>20%的药物有9味:茯苓、半夏、白芍、陈皮、郁金、黄连、当归、人参、香附。关联规则得出治疗情志病伴胃肠症状的4个药物组合:枳实-半夏,人参-茯苓,半夏-茯苓,半夏-陈皮-茯苓。结论:情志病与胃肠症状密切相关,脾胃在各类情志病证中有特殊地位,提示医师在治疗情志病时要注意调护脾胃。与其他病因导致的胃肠病相比,肝、肺的功能失调在情志相关胃肠病的病机因素中尤为突出,为该病从肝肺论治提供了理论依据。根据该病的虚实寒热偏性,临床应谨慎使用助热化火的药物,治法上应补虚与泻实相结合。To investigate the disease names,disease nature,disease location,and medication rule of emotional disease with gastrointestinal symptoms in the Ming and Qing Dynasties.Methods:Chinese Medical Classics was used to obtain the medical records of emotional disease with gastrointestinal symptoms from the Ming and Qing Dynasties,and a database was established.Excel software was used to perform descriptive statistics of disease names,disease nature,disease location,and medication frequency,and RStudio software was used to perform the association rule analysis of drugs.Results:A total of 119 medical records were included,involving 29 disease names.As for the tendency of cold and heat,absence of cold and heat accounted for the highest proportion of 62.18%,followed by heat syndrome accounting for 36.97%,with only 1 case of cold syndrome.As for the disease nature of deficiency and excess,excess syndrome accounted for 51.26%,and the syndrome of intermingled deficiency and excess accounted for 42.02%.A total of 10 disease locations were involved,among which the top 4 disease locations in terms of frequency were the stomach(119 times),the liver(97 times),the spleen(96 times),and the lungs(16 times).There were 9 drugs with a frequency of use of>20%,i.e.,Poria cocos,Pinellia ternata,Radix Paeoniae Alba,tangerine peel,Curcuma aromatica,Coptis chinensis,Angelica sinensis,Panax ginseng,and Rhizoma Cyperi.The association rule analysis obtained 4 drug combinations for the treatment of emotional disease with gastrointestinal symptoms,i.e.,Fructus Aurantii Immaturus-Pinellia ternata,Panax ginseng-Poria cocos,Pinellia ternata-Poria cocos,and Pinellia ternata-tangerine peel-Poria cocos.Conclusion:Emotional disease is closely associated with gastrointestinal symptoms,and the spleen and the stomach play a special role in various syndromes of emotional disease,suggesting that physicians should pay attention to the regulation and protection of the spleen and the stomach during the treatment of emotional disease.Compared with gastrointestinal

关 键 词：情志病 胃肠症状 明清时期 医案 数据挖掘 

分 类 号：R277.7[医药卫生—中医学] R256.3