基于数据挖掘探析永嘉医派陈无择治疗腰痛的用药规律  

Exploring the Medication Pattern of Yongjia Medical School CHEN Wuze in Treating Low Back Pain Based on Data Mining

作　　者：张亚辉 陈佳君 陈怡瑞 朱一波 王庆来[1] ZHANG Yahui;CHEN Jiajun;CHEN Yirui(Wenzhou Hospital of Traditional Chinese Medicine,Zhejiang Chinese Medical University,Wenzhou(325000),China)

机构地区：[1]浙江中医药大学附属温州市中医院浙江,温州325000

出　　处：《浙江中医药大学学报》2025年第3期309-315,共7页Journal of Zhejiang Chinese Medical University

基　　金：浙江省中医药科技计划项目(2024ZF140);王庆来名老中医专家传承工作室建设计划项目(GZS2021034)。

摘　　要：[目的]运用数据挖掘技术分析《三因极一病证方论》中关于腰痛的辨治用方,探讨陈无择对腰痛的认识及遣方用药规律。[方法]筛选符合纳入标准的处方建立数据库,运用SPSS Modeler 18.0软件进行关联规则分析,采用SPSS statistics 26.0软件进行药物频次统计和聚类分析,结合古文记载,探析陈无择对腰痛的认识、治疗思路及用药规律。[结果]共纳入处方63首,涉及143味中药,总用药频次581次,高频药物共17味,主要有炙甘草、茯苓、生姜、附子、白芍、肉桂等,常见的药对包括“白术-茯苓”、“茯苓-肉桂”、“肉桂-当归”等。药效以补虚药为最多;药性以温、平、寒为主;药味以甘、辛、苦多见;归脾、肾、肺经最多。聚类分析将高频药物分为3组,涉及祛风除湿、补益肝肾、柔筋活血、温阳化湿等功用。[结论]陈无择治疗腰痛,重视三因分治,强调从脾胃着手,用药上偏以温补,主要以健脾除湿、温阳化湿、温通血脉等法治疗腰痛。总结提炼永嘉医派陈无择治疗腰痛的用药规律及学术思想,对临床上腰痛的治疗具有参考价值。[ObjectiveObjective]To analyze the prescriptions for the differentiation,treatment and application in the Treatise on Three Categories of Pathogenic Factors regarding low back pain by using data mining technology,and to explore CHEN Wuze’s understanding of low back pain as well as the rules for prescribing medications.[MethodsMethods]Prescriptions that met the inclusion criteria were screened to establish a database.The IBM SPSS Modeler 18.0 software was used for association rule analysis,and the SPSS statistics 26.0 software was adopted for drug frequency statistics and cluster analysis.Combined with ancient literature records,CHEN’s understanding of low back pain,treatment ideas and medication rules were analyzed.[ResultsResults]A total of 63 prescriptions were included,involving 143 types of Chinese medicinal herbs with a total frequency of 581 applications.Seventeen high-frequency herbs were identified,primarily including roasted licorice(Glycyrrhiza uralensis),poria(Poria cocos),ginger(Zingiber officinale),aconite(Aconitum carmichaelii),white peony root(Paeonia lactiflora),and cinnamon bark(Cinnamomum cassia).Common herb pairs included“Atractylodes macrocephala-Poria cocos”,“Poria cocos-Cinnamomum cassia”and“Cinnamomum cassia-Angelica sinensis”.The predominant therapeutic effects involved tonifying and deficiency-replenishing medicinals.Medicinal properties were mainly warm,neutral and cold,with sweet,pungent and bitter flavors predominating.Herbs primarily entered the spleen,kidney and lung meridians.Cluster analysis categorized high-frequency herbs into three groups associated with functions such as dispelling wind and eliminating dampness,tonifying the liver and kidney,relaxing tendons and nourishing blood and warming Yang to resolve dampness.[ConclusionConclusion]CHEN’s approach to treating low back pain emphasizes differentiation and treatment based on the three etiological factors(internal,external and non-internal/external causes),and a spleen-stomach-focused treatment strategy.Core

关 键 词：腰痛 陈无择 数据挖掘 永嘉医派 三因方 用药规律 隐结构 四气五味 

分 类 号：R274[医药卫生—中医骨伤科学]