基于证-症-药-方研究模式探讨保元养心方加减治疗室性期前收缩的证治规律  

Exploration of Syndrome and Treatment Rule of Modified Baoyuan Yangxin Formula for the Treatment of Ventricular Precontraction Based on the Study Model of Syndrome-symptom-medication-prescription

作　　者：李亨达 包宇 韩梦阳 陈亚南 韩朋朋 朱明军[3] 袁智宇[3] 李西云[3] LI Hengda;BAO Yu;HAN Mengyang;CHEN Yanan;HAN Pengpeng;ZHU Mingjun;YUAN Zhiyu;LI Xiyun(The First Clinical Medical College of Henan University of Chinese Medicine,Zhengzhou 450000,Henan,China;Tianjin University of Chinese Medicine;The First Affiliated Hospital of Henan University of Chinese Medicine,Zhengzhou 450000,Henan,China)

机构地区：[1]河南中医药大学第一临床医学院,郑州450000 [2]天津中医药大学 [3]河南中医药大学第一附属医院,郑州450000

出　　处：《中西医结合心脑血管病杂志》2025年第7期961-975,共15页Chinese Journal of Integrative Medicine on Cardio-Cerebrovascular Disease

基　　金：国家自然科学基金重点项目(No.82030120)。

摘　　要：目的:采用回顾性病例研究方式,应用数据挖掘技术,探究全国名老中医袁海波教授保元养心方加减治疗室性期前收缩(PVCs)的证治规律。方法:收集整理2020年12月—2022年12月河南中医药大学第一附属医院病历系统中以保元养心方加减治疗室性期前收缩的门诊病例,录入中医传承计算平台V3.0软件,运用软件进行证治规律研究。结果:共收集病例203例,常见中医证型4种,分别为气阴两虚血瘀证、气阴两虚血瘀证兼气滞、气阴两虚血瘀证兼痰湿、气阴两虚血瘀证兼阳虚;整体研究显示,心悸、失眠、乏力、胸闷、气短、心烦、口干、胸痛是保元养心方加减治疗室性期前收缩的高频症状;舌质暗淡、络脉青紫、苔薄白、脉细是高频舌脉;以太子参、茯苓、炙甘草、丹参、酸枣仁、白术、徐长卿、紫石英等高频药物组合的保元养心方加减是治疗室性期前收缩的常用方;药物聚类分析获得4类新方。分证型研究显示,心悸易惊、失眠、口干、心烦、乏力、头晕等是室性期前收缩气阴两虚血瘀证的高频症状及关联组合;舌质红、络脉青紫、苔薄白、脉细是高频舌脉及关联组合;保元养心方加减是常用方。心悸怔忡、胸闷、情志不遂诱发、失眠、心烦、乏力、胁胀等是室性期前收缩气阴两虚血瘀兼气滞的高频症状及关联组合;舌质暗淡、络脉青紫、苔薄白、脉细是高频舌脉及关联组合;保元养心方加减柴胡舒肝散是常用方。心悸怔忡、乏力、胸脘胀满、口黏、泛酸、纳呆、大便黏腻等是室性期前收缩气阴两虚血瘀证兼痰湿的高频症状及关联组合;舌质暗红、苔薄白腻、络脉青紫、脉弦是高频舌脉及关联组合;保元养心方加减六君子汤是常用方。心悸眩晕、倦怠乏力、形寒肢冷、下肢浮肿、胸闷、气短等是室性期前收缩气阴两虚血瘀证兼阳虚的高频症状及关联组合;胖大舌、�ObjectiveObjective:Using the method of retrospective case study and data mining technology,this study explored the treatment rule of Baoyuan Yangxin Formula by professor Yuan Haibo for the treatment of ventricular precontraction(PVCs).MethodsMethods:Outpatient cases treated with modified Baoyuan Yangxin Formula for ventricular precontraction in the medical record system of the First Affiliated Hospital of Henan University of Chinese Medicine from December 2020 to December 2022 were collected and recorded into the V3.0 software of TCM inheritance computing platform,and the rule of syndrome and treatment was studied with the software.ResultsResults:A total of 203 cases were collected,and there were 4 common traditional Chinese medicine(TCM)syndrome types,including Qi Yin deficiency and blood stasis syndrome,Qi Yin deficiency and blood stasis syndrome with Qi stagnation,Qi Yin deficiency and blood stasis syndrome with phlegm dampness,and Qi Yin deficiency and blood stasis syndrome with Yang deficiency.Overall research showed that palpitations,insomnia,fatigue,chest tightness,shortness of breath,restlessness,dry mouth,and chest pain were the high-frequency symptoms of Baoyuan Yangxin Formula for the treatment of PVCs.The tongue was dull,the veins were blue and purple,the coating was thin and white,and the veins were thin,which were high-frequency tongue veins.The commonly used formula for treating PVCs was the Baoyuan Yangxin Formula,which was a combination of high-frequency drugs such as Radix Pseudostellariae,Poria cocos,roasted licorice,Salvia miltiorrhiza,sour jujube kernel,Atractylodes macrocephala,Xu Changqing,and amethyst.Four types of new prescriptions were identified through drug cluster analysis.Research on syndrome differentiation showed that,palpitations,insomnia,dry mouth,restlessness,fatigue,dizziness,etc.were the high-frequency symptoms and combinations of Qi Yin deficiency and blood stasis syndrome in PVCs.Red tongue texture,blue and purple veins,thin and white fur,and thin veins were high-frequency t

关 键 词：室性期前收缩 保元养心方加减 数据挖掘 证治规律 

分 类 号：R259[医药卫生—中西医结合]