基于隐结构模型结合关联规则探讨遗精“症-证-药”规律  

Exploring the Laws of"Symptom-Syndrome-Medication"in Nocturnal Emission Based on Latent Structure Model Combined with Association Rules

作　　者：陈晓宇 周星宇 CHEN Xiaoyu;ZHOU Xingyu(Nanyang Medical College,Nanyang,Henan,China,473000)

机构地区：[1]南阳医学高等专科学校,河南南阳473000

出　　处：《河南中医》2025年第5期737-743,共7页Henan Traditional Chinese Medicine

基　　金：河南省5G+智慧教育创新应用试点项目{豫通局〔2023〕3号};南阳医学高等专科学校校级科学研究基金项目(2022ZRKX003);南阳医学高等专科学校校级教育教学改革研究项目(FYJGXM08,XLJGXN08)。

摘　　要：目的:基于隐结构模型结合关联规则探讨遗精的主要症状、证候要素及临床用药规律。方法:检索中国知网、万方知识服务平台、维普数据库自建库以来收录的有效治疗遗精的医案,对文献进行筛选后,运用Excel进行规范化处理。利用Lantern 5.0进行隐结构构建,采用Python对治疗中药进行关联规则分析。结果:检索三大数据库后筛选得到139例医案。对症状分布分析发现,出现频次较高的是脉细、眠差、神疲乏力等;用药以牡蛎、龙骨、芡实为主;功效主要是补虚、清热及收涩。构建隐结构模型后分析发现,遗精的证候要素包括热、阴虚、阳虚、气虚、血虚、湿等,证型包含肾阳虚证、气血两虚证、寒湿困脾证、肝肾阴虚证;治法分为温补阳气、益气补血、清热燥湿利水、滋阴、活血化瘀5种。中药关联规则分析得出支持度较高的药物组合是龙骨-牡蛎。结论:遗精病位主要在肝脾肾,属本虚标实之证,临证应辨证选取温补阳气、益气补血、滋阴、清热燥湿等方法治疗。Objective:To explore the main symptoms,syndrome elements,and clinical medication laws of nocturnal emission based on the latent structure model.Methods:Medical cases effectively treating nocturnal emission were retrieved from CNKI,Wanfang,and VIP databases.After screening the literature,Excel was used for standardized processing.Lantern 5.0 was employed to construct the latent structure model,and Python was utilized for association rule analysis of Chinese medicinal medications.Results:A total of 139 medical cases were screened from the three databases.Symptom distribution analysis revealed high-frequency symptoms such as thready pulse,poor sleep,and fatigue,etc.Commonly used Chinese medicinals included Muli(Concha Ostreae),Longgu(Os Draconis)and Qianshi(Semen Euryales),with primary effects of tonifying deficiency,clearing heat,and astringing.After constructing the latent structure model and conducting analysis,it was found that the syndrome elements of nocturnal emission included heat,yin deficiency,yang deficiency,qi deficiency,blood deficiency,and dampness,etc.The syndrome types included kidney yang deficiency syndrome,qi and blood deficiency syndrome,cold-dampness encumbering the spleen syndrome,and liver-kidney yin deficiency syndrome.The treatment methods were divided into five types:warming and tonifying yang qi,tonifying qi and nourishing blood,clearing heat,drying dampness and inducing diuresis,nourishing yin,promoting blood circulation and removing blood stasis.The analysis of the association rules of Chinese medicinals revealed that the drug combination with a relatively high support degree was Longgu-Muli.Conclusion:Nocturnal emission primarily involves the liver,spleen,and kidney,characterized by root deficiency and branch excess.Clinical treatment should focus on syndrome differentiation,selecting methods such as warming and tonifying yang qi,supplementing qi and nourishing blood,nourishing yin,clearing heat and drying dampness,etc.

关 键 词：遗精 关联规则 隐结构模型 证治规律 

分 类 号：R287[医药卫生—中药学]