基于叶氏医案探讨叶天士治疗崩漏组方用药规律  

The Medication Rules of Ye Tianshi’s Prescription for Treating Metronidae Based on the Ye Medical Case

作　　者：甄智燕 王悦 陈思琪 郭锦晨 李明珠 黄辉[2] ZHEN Zhiyan;WANG Yue;CHEN Siqi;GUO Jinchen;LI Mingzhu;HUANG Hui(The First Clinical Medical College of Anhui University of TCM,Hefei 230031,China;College of Traditional Chinese Medicine,Anhui University of TCM,Hefe 230012,China;Key Laboratory of Xin’an Medical Science,Ministry of Education,Hefei 230038,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]安徽中医药大学中医学院,安徽合肥230012 [3]新安医学教育部重点实验室,安徽合肥230038

出　　处：《湖北民族大学学报(医学版)》2025年第1期26-32,共7页Journal of Hubei Minzu University(Medical Edition)

基　　金：2022年度安徽省高校科研社科重点项目(2022AH050427);2022年度中央财政安徽中医药“北华佗、南新安”传承创新项目(2022BHTNXA02);2024年安徽中医药大学国家级大学生创新创业项目(202410369008)。

摘　　要：目的运用数据挖掘的方法探讨叶天士治疗崩漏的组方用药规律。方法检索《临证指南医案》等相关文献并收集处方73张,使用Microsoft Excel 2021、SPSS Modeler 18.0、SPSS Statistics 26.0软件开展关联分析、聚类分析;并对高频中药的特征性活性成分及作用机制,进行文献挖掘分析。结果共纳入73张处方,涉及138味中药,总使用频次580次,高频中药是人参、当归、白芍、茯神、阿胶;药物药性以温平为主,药性以甘为主,归肾、肝、脾经为主。当支持度设置为10%,置信度设置为70%,共获得37个药物对关联组合,复杂网络生成核心组方为人参、白芍、阿胶、当归、紫石英、茯神、枸杞子、生地黄,系统聚类得到熟地黄、柏子仁等4组中药聚类组合。结论叶天士认为崩漏并非皆由脏腑病所致,还可因奇经病,且崩漏有寒热虚实之分,治疗当明辨病因病机。如崩漏已久,气血虚弱者,当用温补之药:若瘀血日久所致崩漏,当用清热活血之品。Objective To explore the medication rules of Ye Tianshi’s prescription for the treatment of disintegration using the data mining.Methods The relevant literature such as Linzheng Zhinan Yian were searched and 73 prescriptions were collected,and correlation and cluster analyses were conducted using Microsoft Excel 2021,SPSS Modeler 18.0,and SPSS Statistics 26.0.Literature mining and analysis of characteristic active ingredients and mechanisms of action of the high-frequency traditional Chinese medicines were conducted.Results A total of 73 prescriptions were included,involving 138 Chinese medicines,with a total use frequency of 580 times.The high-frequency Chinese medicines were ginseng,angelica,paeony,fushen,ass hide glue.The main medicinal properties of the drug are warming and calming,while the main medicinal properties are sweet.It mainly targets the kidney,liver,and spleen meridians.When the support is set to 10%and the confidence is set to 70%,a total of 37 drug pair association combinations are obtained.The core group of complex network generation is ginseng,white peony,ass hide glue,angelica,amethyst,fushen,wolfberry fruit,and raw rehmannia glutinosa.Four groups of traditional Chinese medicine cluster combinations,such as rehmannia glutinosa and cypress seed,are obtained through systematic clustering.Conclusion Ye Tianshi believes that collapse and leakage are not all caused by internal organ diseases,but can also be caused by strange meridian diseases.Moreover,collapse and leakage can be divided into cold,heat,deficiency,and excess.Treatment should clearly distinguish the etiology and pathogenesis.If the collapse and leakage have been occurring for a long time and the qi and blood are weak,warm tonics should be used.If the collapse and leakage are caused by prolonged blood stasis,clear heat and activate blood products should be used.

关 键 词：数据挖掘 叶天士 崩漏 用药规律 新安医学 

分 类 号：R285[医药卫生—中药学]