明清时期疫病核心症状的处方用药规律分析  

Analysis of Prescription Drug Use Patterns for Core Symptoms of Epidemic Diseases in the Ming and Qing Dynasties

作　　者：张泽涵 李峰 于清茜 李儒婷 毛萌 Zhang Zehan;Li Feng;Yu Qingqian;Li Ruting;Mao Meng(College of Traditional Chinese Medicine,Beijing University of Chinese Medicine,Beijing 102488,China)

机构地区：[1]北京中医药大学中医学院,北京102488

出　　处：《中国药事》2025年第1期105-117,共13页Chinese Pharmaceutical Affairs

摘　　要：目的:基于数据挖掘分析明清时期疫病核心症状及相应的处方用药规律,为现代中医药治疗疫病提供思路。方法:以成书于明清时期与疫病相关的中医古籍记载为文献来源,以Excel 2019软件进行文献整理与筛选,应用4.1.1版本的R软件、古今医案云平台v2.3、IBM SPSS Statistics 26.0等软件及平台,对核心症状进行频次统计、关联规则分析,对处方用药进行频次与属性统计、关联规则分析、系统聚类分析和因子分析,并应用Cytoscape 3.7.1软件构建“疫病-核心症状-高频用药”复杂网络。结果:纳入研究的224条医案记载中出现最多的症状为脉数、发热等,关联规则分析发现16种核心症状组合。从医案中获得的336个临床处方中,除甘草外,频次较高的用药为连翘,药性大多属寒性,药味以苦、辛味为主,主归肺、胃二经,多有清热解毒、疏散风热之功效,关联规则分析发现15种潜在配伍组合,因子分析中提取得到11个公因子,系统聚类分析中将高频用药归为8大类。结论:明清时期疫病以发热烦渴等临床表现为多,总体病性以热性为主。临床治疗以清热解毒、疏散风热为核心,临证选用具有利咽、开窍、泻下等功效的药物,常用的基础方有银翘散、清营汤等。通过对明清时期疫病的核心症状及其处方用药规律进行系统挖掘,为现代医家治疗疫病的临床用药思路提供借鉴。Objective:To analyze the core symptoms of epidemic diseases and corresponding drug use patterns in the Ming and Qing Dynasties based on data mining,so as to provide ideas for the treatment of epidemic diseases by modern traditional Chinese medicine.Methods:Taking the ancient records of traditional Chinese medicine related to epidemic diseases in the Ming and Qing dynasties as the literature source,the literature was sorted and screened with Excel 2019.With R Version 4.1.1,ancient and modern medical record cloud platform v2.3,IBM SPSS Statistics 26.0 and so on,the core symptoms were analyzed by frequency statistics and association rule analysis,and prescription medication were analyzed by frequency and attribute statistics,association rule analysis,systematic cluster analysis and factor analysis.The complex network of“epidemic disease-core symptoms-high-frequency drug use”was constructed by using Cytoscape 3.7.1 software.Results:Among the 224 medical records included in the study,the most common symptoms were pulse number,fever and so on.16 kinds of core symptom combinations were found by association rule analysis.Among the 336 clinical prescriptions obtained from the medical records,except Glycyrrhizae Radix et Rhizoma,the more frequent drug was Forsythiae Fructus,most of which were cold,with bitter and pungent taste,mainly belonging to the two meridians of the lung and stomach,and most of them had the effect of clearing away heat and detoxification and dispersing wind and heat.15 potential compatibility groups were found by association rule analysis,11 common factors were extracted from factor analysis,and high frequency drugs were classified into 8 categories in systematic cluster analysis.Conclusion:The epidemic disease in Ming and Qing Dynasties was characterized by fever,irritation,thirst and other clinical manifestations,and the overall disease was mainly febrile.Clinical treatment takes heat-clearing and detoxification and wind-heat evacuation as the core,and drugs with the effects of pharynx,opening o

关 键 词：疫病 数据挖掘 用药规律 症状 中医药 

分 类 号：R95[医药卫生—药学]