基于数据挖掘技术探讨清代名医陈士铎《辨证奇闻》治疗痰证的经验  

Discussion on the experience of Bianzheng Qiwen written by famous doctor CHEN Shiduo in treating phlegm syndrome based on data mining

作　　者：陆婷儿 韩庆龙 LU Ting’er

机构地区：[1]湖北中医药大学,湖北武汉430065 [2]宜昌市中医医院,湖北宜昌443001

出　　处：《中医临床研究》2024年第34期35-40,共6页Clinical Journal Of Chinese Medicine

基　　金：2023年宜昌市医疗卫生研究项目(A23-1-063):基于数据挖掘技术探寻清名医陈士铎《辨证奇闻》组方用药规律。

摘　　要：目的:基于数据挖掘技术探讨陈士铎治疗痰证的临证治验。方法:总结归纳清代名医陈士铎《辨证奇闻》中的痰证处方,运用中医传承计算平台V3.0软件进行数据分析。结果:归纳整理方剂21首,包含中药60味。药物四气多温性、平性、寒性,五味以甘味、苦味、辛味为主,归经分布主要集中在脾经、肺经、胃经和肾经,功效分布以补虚类、利水渗湿类、理气类药物为主。使用频次在5次以上的中药有11味,主要为茯苓、陈皮、半夏等;有14组使用7次以上的药物组合,核心药物组合为茯苓-半夏、茯苓-陈皮、陈皮-人参等。根据聚类分析所有方剂可分为3类,由茯苓、人参、半夏、白术、陈皮组成的第1类核心处方具有代表性。结论:对陈士铎《辨证奇闻》痰证处方的用药配伍规律分析揭示了其治疗痰证以茯苓为核心药物,并以由人参、陈皮、白术、半夏、甘草组成的六君子汤为核心处方。其治法体现了“补虚健脾、燥湿化痰”的核心,兼以“温化痰湿、行气消痰、疏肝解郁”等,注重虚实兼顾、标本同治。其临证思想及独特的辨证用药对临床诊治痰证及院内协定处方和新药开发具有重要指导意义。Objective:Based on data mining technology,this paper discusses the clinical experience and medication rules of OCHEN Shiduo in the treatment of phlegm syndrome.Methods:The prescription of phlegm syndrome in the famous doctor CHEN Shiduo’s Bianzheng Qiwen(《辨证奇闻》)was summarized,and the data analysis was carried out by the Traditional Chinese Medicine Inheritance Computer System V3.0 software.Results:A total of 21 prescriptions were summarized,including 60 traditional Chinese medicines,and the four Qi of the drugs were warm,moderate and cold.The five flavors were sweet,bitter and spicy.The meridian tropism of drugs was mainly the spleen,lung,stomach and kidney meridians.The efficacy distribution was dominated by tonifying drugs,diuresis and dampness promoting drugs,and Qi regulating drugs.There were 11 traditional Chinese medicines used more than 5 times,mainly including Fuling(Poria),Chenpi(Pericarpium Citri Reticulatae),Banxia(Rhizoma Pinelliae),etc..Fourteen groups of drugs were used in combination for more than 7 times.The core drug combinations were mainly Fuling-Banxia,Fuling-Chenpi,Chenpi-Renshen(Radix Ginseng),etc..All prescriptions could be divided into three categories according to cluster analysis.Among them,the first type of core prescription composed of Fuling,Renshen,Banxia,Baizhu(Rhizoma Atractylodis Macrocephalae)and Chenpi was more representative.Conclusion:The medication rules of phlegm syndrome prescription in CHEN Shiduo’s Bianzheng Qiwen reveal that Fuling is the core drug in the treatment of phlegm syndrome,and the core prescription is the Liujunzi decoction(六君子汤)composed of Renshen,Chenpi,Baizhu,Banxia and Gancao(Radix Glycyrrhizae).Its treatment method embodies the core of“tonifying and strengthening spleen,drying dampness and resolving phlegm”,and also takes the methods of“warming phlegm dampness,promoting Qi and eliminating phlegm,soothing liver and resolving depression”,paying attention to both deficiency and excess,and treating both symptoms and root causes

关 键 词：《辨证奇闻》 痰证 用药规律 

分 类 号：R255.8[医药卫生—中医内科学]