从《当代名老中医典型医案集》探讨肺系疾病的用药规律及思想  

Explore the Medicinal Patterns and Ideological Insights for Pulmonary Diseases from“A Collection of Typical Medical Cases by Contemporary Renowned Chinese Medicine Practitioners”

作　　者：黄万秋 宇明慧[2] 杨勤军 李泽庚[2,4] HUANG Wanqiu;YU Minghui;YANG Qinjun;LI Zegeng(Anhui University of Chinese Medicine,School of First Clinical Medical Sciences,Anhui Hefei 230031,China;The First Affiliated Hospital of Anhui University of Chinese Medicine,Anhui Hefei 230031,China;Anhui University of Chinese Medicine,Ahui Hefei 230031,China;Anhui Province Key Laboratory of the Application and Transformation of Traditional Chinese Medicine in the Prevention and Treatment of Major Pulmonary Diseases,AhuiHefei 230031,China)

机构地区：[1]安徽中医药大学第一临床医学院,安徽合肥230031 [2]安徽中医药大学第一附属医院,安徽合肥230031 [3]安徽中医药大学,安徽合肥230031 [4]安徽省教育厅重点实验室,安徽合肥230031

出　　处：《中医药临床杂志》2025年第3期506-513,共8页Clinical Journal of Traditional Chinese Medicine

基　　金：国家自然科学基金联合重点项目(U20A20398);国家自然科学基金(82374399);合肥综合性国家科学中心大健康研究院新安医学与中医药现代化研究所“揭榜挂帅”重大突破项目(2023CXMMTCM005);安徽省中医药传承创新科研项目(2024CCCX077);全国名中医肺系疾病学术思想传承及特色方药的临床开发研究(202204295107020045)。

摘　　要：目的:基于数据挖掘技术探讨当代名老中医治疗肺系疾病的用药规律,为临床治疗肺系疾病提供参考。方法:整理《当代名老中医典型医案集》中肺系疾病的方剂,使用Microsoft Excel 2021建立数据库,并进行中药出现频次、功效、四气五味和归经分析。采用SPSS Modeler18.0的Apriori算法进行关联规则分析,并联合Cytoscape3.10.2进行中药网络分析。采用SPSS Statistics 26.0的Jaccard距离法进行聚类分析发掘聚类方,并对核心药物进行因子分析,最大方差法正交旋转后提取公因子。结果:共纳入158个处方,涉及257种中药,总次数为2383次,使用频次排前20(>27次)的药物为苦杏仁、甘草、半夏、紫菀、茯苓、黄芩、麻黄、麦冬、陈皮、五味子、黄芪、白术、紫苏子、前胡、薏苡仁、桔梗、浙贝母、枇杷叶、款冬花和太子参。药性寒性和温性为主,药味以辛、甘和苦为主。归经则以肺经和肝经为主。关联分析得到核心药对11条,网络分析发掘出核心处方,聚类分析得到5项聚类,因子分析得出7个公因子。结论:肺系疾病以“肺失宣肃”为主要病机,治疗应肝肺同治、肺脾同补和化痰止咳平喘。Objective:To explore the medication patterns in the treatment of pulmonary diseases by contemporary renowned Chinese medicine practitioners using data mining techniques,providing guidance for clinical diagnosis and medication.Methods:We organized prescriptions for pulmonary diseases from“A Collection of Typical Medical Cases by Contemporary Renowned Chinese Medicine Practitioners”and established a database using Microsoft Excel 2021.The frequency,efficacy,four qi and five flavors,and meridian tropism of the Chinese herbs were analyzed.The Apriori algorithm in SPSS Modeler 18.0 was used for association rule analysis,and Cytoscape 3.10.2 was employed for network analysis of Chinese herbs.Cluster analysis was conducted using the Jaccard distance method in SPSS Statistics 26.0 to identify clustered prescriptions,and factor analysis was performed on core herbs,with varimax rotation after principal component analysis to extract common factors.Results:A total of 158 prescriptions involving 257 Chinese herbs were included,with a total of 2383 occurrences.The top 20 most frequently used herbs(>27 times)were bit-ter apricot kernel,licorice,pinellia,aster,poria,scutellaria,ephedra,ophiopogon,tangerine peel,schisandra,astragalus,atractylodes,perilla seed,peucedanum,coix seed,platycodon,forsythia,fritillaria,loquat leaf,and adenophora.The properties were mainly cold and warm,the tastes were predominantly pungent,sweet,and bitter.The meridians primarily involved were the lung and liver meridians.Association analysis yielded 11 core herb pairs,net-work analysis identified core prescriptions,cluster analysis resulted in 5 clusters,and factor analysis extracted 7 com-mon factors.Conclusion:The treatment of pulmonary diseases focuses on the core concept of“lung failure to disperse and descend”,with an emphasis on treating the liver and lung simultaneously,supplementing the lung and spleen,and resolving phlegm,cough,and asthma,which can be referred to in clinical practice.

关 键 词：《当代名老中医典型医案集》 数据挖掘 肺系疾病 

分 类 号：R223.1[医药卫生—中医基础理论]