基于“病-药-量”探索黄芪古代用药规律  

Medication rules of Astragali Radix in ancient Chinese medical books based on"disease-medicine-dose"pattern

作　　者：曹佳蕾 梁绿圆 刘宜杭 徐梓铭 王选 魏文希 万和伽 吕星航 李维笑 张煜欣 魏炳琦 任献青[1,2] CAO Jia-lei;LIANG Lü-yuan;LIU Yi-hang;XU Zi-ming;WANG Xuan;WEI Wen-xi;WAN He-jia;LYU Xing-hang;LI Wei-xiao;ZHANG Yu-xin;WEI Bing-qi;REN Xian-qing(Pediatric Hospital of the First Affiliated Hospital of Henan University of Chinese Medicine,Zhengzhou 450099,China;School of Pediatrics,Henan University of Chinese Medicine,Zhengzhou 450046,China;School of Traditional Chinese Medicine,Henan University of Chinese Medicine,Zhengzhou 450046,China)

机构地区：[1]河南中医药大学第一附属医院儿科医院,河南郑州450099 [2]河南中医药大学儿科医学院,河南郑州450046 [3]河南中医药大学中医学院,河南郑州450046

出　　处：《中国中药杂志》2025年第3期798-811,共14页China Journal of Chinese Materia Medica

基　　金：国家自然科学基金项目(82374519);河南省省级科技研发计划联合基金项目(222301420022);河南省卫生健康委国家中医临床研究基地科研专项(2021JDZY013);2021年度河南省中原英才计划(育才系列)项目(豫组通[2021]44号)。

摘　　要：该研究利用“病-药-量”体系分析古代典籍中含有黄芪中药方剂的用药规律,为黄芪的临床应用及药品开发提供科学依据。从《中华医典》等古籍数据库中收集含有黄芪的中药方剂,采用Excel 2020建立古代黄芪临证方药数据库,对其病症、证型、药物使用频次、功效类别、性味归经、剂型、用量等进行统计分析,运用SPSS statistics 26.0、IBM SPSS Modeler 18.0软件进行关联规则、聚类分析、公因子分析等数据挖掘。经筛选共纳入含黄芪方剂2297首,主治病症233种,其中高频病症7种(频次>25次),主要为疮疡、虚劳、汗病、中风等。治疗疮疡证型以气血两虚为主,虚劳证型以气血亏虚为主,汗病证型以阴阳两虚为主,中风证型以气虚络瘀为主。组方中使用频次>25次的药物有98味,药物功效种类以补气药、补血药较多,使用频次较高的有甘草、当归、人参、白术、陈皮等。配伍中药药性以温、寒为主,药味以甘、辛、苦为主,主要归脾、肺、心、肾、肝经。高频病症剂型及药物用量分析显示,治疗疮疡时,黄芪常用剂量3.73 g,核心药物配伍甘草以生肌敛疮;治疗虚劳时,黄芪常用剂量37.30 g,核心药物配伍人参以补虚益气;治疗汗病时,黄芪常用剂量3.73 g,核心药物配伍甘草以固表止汗;治疗中风时,黄芪常用剂量7.46 g,核心药物配伍甘草以祛风止痉。黄芪在治疗多种系统疾病时,发挥补气升阳、固表止汗、托毒生肌等作用。根据不同疾病表现,与其他药物相配伍时,黄芪又被赋予“生肌敛疮”“补虚益气”“固表止汗”“祛风益气”等特点,为黄芪的现代诊疗提供理论依据,以开发更多的药用价值。This study employed the"disease-medicine-dose"pattern to mine the medication rules of traditional Chinese medicine(TCM)prescriptions containing Astragali Radix in ancient Chinese medical books,aiming to provide a scientific basis for the clinical application of Astragali Radix and the development of new medicines.The TCM prescriptions containing Astragali Radix were retrieved from databases such as Chinese Medical Dictionary and imported into Excel 2020 to construct the prescription library.Statical analysis were performed for the prescriptions regarding the indications,syndromes,medicine use frequency,herb effects,nature and taste,meridian tropism,dosage forms,and dose.SPSS statistics 26.0 and IBM SPSS Modeler 18.0 were used for association rules analysis and cluster analysis.A total of 2297 prescriptions containing Astragali Radix were collected,involving 233 indications,among which sore and ulcer,consumptive disease,sweating disorder,and apoplexy had high frequency(>25),and their syndromes were mainly Qi and blood deficiency,Qi and blood deficiency,Yin and Yang deficiency,and Qi deficiency and collateral obstruction,respectively.In the prescriptions,98 medicines were used with the frequency>25 and they mainly included Qi-tonifying medicines and blood-tonifying medicines.Glycyrrhizae Radix et Rhizoma,Angelicae Sinensis Radix,Ginseng Radix et Rhizoma,Atractylodis Macrocephalae Rhizoma,and Citri Reticulatae Pericarpium were frequently used.The medicines with high frequency mainly have warm or cold nature,and sweet,pungent,or bitter taste,with tropism to spleen,lung,heart,liver,and kidney meridians.In the treatment of sore and ulcer,Astragali Radix was mainly used with the dose of 3.73 g and combined with Glycyrrhizae Radix et Rhizoma to promote granulation and heal up sores.In the treatment of consumptive disease,Astragali Radix was mainly used with the dose of 37.30 g and combined with Ginseng Radix et Rhizoma to tonify deficiency and replenish Qi.In the treatment of sweating disorder,Astragali Radix was mainly

关 键 词：黄芪 古代 病-药-量 数据挖掘 用药规律 疮疡 虚劳 汗病 中风 

分 类 号：R282.71[医药卫生—中药学]