基于验案的脱疽用药特点的研究  

Study on the Characteristics of Drug Use of Gangrene Based on Clinical Cases

作　　者：徐家祥 张玥[2] 程志新[2] 赵亚男[2] 公瑞 张军 XU Jiaxiang;ZHANG Yue;CHENG Zhixin;ZHAO Ya’nan;GONG Rui;ZHANG Jun(The First Clinical Medical College,Shandong University of Traditional Chinese Medicine,Shandong Province,Jinan 250014,China;Department of Peripheral Vascular Diseases,Affiliated Hospital of Shandong University of Traditional Chinese Medicine,Shandong Province,Jinan 250014,China)

机构地区：[1]山东中医药大学第一临床医学院,山东济南250014 [2]山东中医药大学附属医院周围血管病科,山东济南250014

出　　处：《中国中医药现代远程教育》2024年第22期111-114,共4页Chinese Medicine Modern Distance Education of China

基　　金：国家自然科学基金项目【No.82004369】;山东省中医药科技发展计划项目【No.2019-0082】;山东省青少年教育科学规划项目【No.22BSH006】。

摘　　要：目的 通过数据挖掘方法探讨验案中治疗脱疽的用药特点。方法 搜集古今医案云平台(v1.5.6)及中华医典(v5.0)的脱疽验案并进行筛选,统计方剂及药物组成并建立数据库,运用古今医案云平台数据挖掘模块及IBM SPSS Modeler 18.0软件对药物频数及组方配伍规律进行数据挖掘。结果 共纳入124首有效方剂,包括446味中药;其中频次大于150次的中药有当归、黄芪、赤芍、牛膝、金银花;统计中药性、味、归经可见,居前三的分别为温、微寒、平,甘、辛、苦,肝、脾、心经;关联分析得出置信度最高的药对为“牛膝→当归”,聚类分析分为3类,复杂网络分析得到核心组方包括当归、黄芪、赤芍、牛膝、桂枝、丹参、鸡血藤、附子、川芎、桃仁、红花、地龙、白芍。结论 脱疽验案医家组方的思路以活血化瘀为主要原则,在辨证的基础上加以温通、清热等祛邪之法,同时气血双补,补行兼施、补虚泻实。Objective To explore the drug use characteristics of the treatment of gangrene by data mining method.Methods The medi-cal records of the ancient and modern medical records cloud platform(v1.5.6)and the Chinese Medical Code(v5.0)were collected and screened,prescriptions and drug composition were counted and a database was established.The data mining module of the ancient and modern medical records cloud platform and IBM SPSS Modeler 18.0 software were used to conduct data mining on drug frequency and the compatibility rule of prescriptions.Results A total of 124 effective formulas were included,including 446 flavors of Chinese medi-cine,among which angelica,astragalus,red peony,Achyranthes bidentata and honeysuckle were more than 150 times.Statistical taste and attribution can be seen,the top three were warm,slightly cold,mild,sweet,hard,bitter,liver,spleen,heart meridian.The correla-tion analysis showed that the drug pair with the highest confidence was“achyranthes bidentata→angelica”,the cluster analysis was divided into three categories,and the core components were obtained by complex network analysis,including angelica,astragalus,red peony,achyranthes bidentata,Cassia twig,danshen,Caulis spatholobi,aconite,Chuanxiong,peach kernel,safflower,ground dragon,and white peony.Conclusion The idea of the medical team of the demobilization case is based on the main principle of activating blood and removing stasis,and on the basis of syndrome differentiation,the methods of dispelling evil spirits such as warming and clearing heat were applied,and at the same time,qi and blood were supplemented,and supplementation was applied at the same time.

关 键 词：脱疽 中医医案 数据挖掘 用药规律 

分 类 号：R249[医药卫生—中医临床基础] R261[医药卫生—中医学]