基于数据挖掘探讨明清新安医家治疗噎膈的用药规律及学术思想  

Medication Rules and Academic Thoughts of Xin’an Doctors in the Treatment of Choking and Diaphragm in the Ming and Qing Dynasties Based on Data Mining

作　　者：赵婉竹 任涵 魏科东 吴婉婉 徐少华 黄金玲[2] ZHAO Wanzhu;REN Han;WEI Kedong;WU Wanwan;XU Shaohua;HUANG Jinling(School of Chinese Medicine,Anhui University of Chinese Medicine,Hefei 230012,China;School of Integrated Chinese Medicine and Western Medicine,Anhui University of Chinese Medicine,Hefei 230012,China)

机构地区：[1]安徽中医药大学中医学院,合肥230012 [2]安徽中医药大学中西医结合学院,合肥230012

出　　处：《中国医院用药评价与分析》2025年第2期137-142,共6页Evaluation and Analysis of Drug-use in Hospitals of China

基　　金：国家自然科学基金面上项目(No.81573864)。

摘　　要：目的:探讨明清新安医家治疗噎膈的用药规律及学术思想,为临床提供借鉴。方法:遴选明清新安医家代表著作《石山医案》《医读》《名医类案》和《古今医统大全》等中治疗噎膈的方药,借助Microsofe Excel 2021软件建立数据库,使用SPSS Statistics 26.0软件、R软件(4.3.3版)进行数据分析。结果:纳入处方153首、中药195味,用药频次数合计1165次,高频药物(频率>10%)共20味,药物类别以补虚药、理气药和化湿药为主;药性以温性为主;药味以甘、辛、苦味为主;归经以胃、脾、肝经居多。关联规则中,支持度最高的二项、三项和四项关联规则分别为“茯苓-白术”“陈皮-半夏-茯苓”和“人参-白术-茯苓-陈皮”。聚类分析得出2个类聚方,为二陈汤、小半夏汤。因子分析得出6个公因子,新处方3首,为四君子汤、人参利膈丸和香砂宽中丸。结论:噎膈多属本虚标实,气郁、痰浊错杂为患,新安医家将“燥湿化痰”“行气开郁”“益气健脾”和“温中止痛”贯穿于治疗,体现出标本兼治、固本培元的学术思想。OBJECTIVE:To explore the medicine rules and academic thoughts of Xin’an doctors in the treatment of choking and diaphragm in the Ming and Qing dynasties,so as to provide reference for modern clinical practice.METHODS:The prescriptions for the treatment of choking and diaphragm in Shishan Medical Records,Medical Reading,Famous Medical Cases,and the Complete Collection of Ancient and Modern Medical Systems written by Xin’an doctors in the Ming and Qing dynasties were selected,and the database was established with the help of Microsoft Excel 2021.SPSS Statistics 26.0 software and R software(4.3.3 version)were used for data analysis.RESULTS:A total of 153 prescriptions and 195 flavors of traditional Chinese medicine were included,with a total frequency of 1165,and 20 flavors of high-frequency drugs(frequency>10%).The main categories of drugs were deficiency tonifying drugs,Qi regulating drugs and dampness-clearing drugs.The drug properties were mainly warm.The taste of medicine was mainly sweet,spicy and bitter.The main channels were stomach,spleen and liver.Among the association rules,the two,three and four association rules with the highest degree of support were“Poria cocos-Atractylodes macrocephala koidz”“Citrus reticulata-Arum ternatum thunb-Poria cocos”and“Panax Ginseng-Atractylodes macrocephala koidz-Poria cocos-Citrus reticulata”.The cluster analysis showed that there were two kinds of decoction,namely Erchen decoction and Xiaobanxia decoction.Factor analysis obtained 6 common factors,3 new prescriptions,namely Sijunzi decoction,Renshen Lige pills,and Xiangsha Kuanzhong pills.CONCLUSIONS:Choking and diaphragm are more of the deficiency standard,with Qi stagnation and phlegm turbidity.Xinan doctors put“Zaoshi Huatan”“Xingqi Kaiyu”“Yiqi Jianpi”and“Wenzhong Zhitong”principles throughout the treatment,reflecting the academic thoughts of treating both symptoms and root causes.

关 键 词：噎膈 明清新安医家 数据挖掘 用药规律 学术思想 

分 类 号：R932[医药卫生—生药学]