基于隐结构模型的《幼科发挥》“药-证-方”规律  

“Medicine-Syndrome-Prescription”Law in Elaboration on Pediatrics Based on the Hidden Structure Model

作　　者：李宇迪 丁樱[1,2,4] 徐炎 孟浩基 刘文博 杜昊雨 LI Yudi;DING Ying;XU Yan;MENG Haoji;LIU Wenbo;DU Haoyu(The First Affiliated Hospital of Henan University of Chinese Medicine,Zhengzhou 450003,China;Department of Pediatrics,The First Affiliated Hospital of Henan University of Chinese Medicine,Zhengzhou 450003,China;School of Pediatrics,Henan University of Chinese Medicine,Zhengzhou 450046,China;Henan Children′s Purpura Nephropathy Diagnosis and Treatment Center,Zhengzhou 450003,China;Henan Children′s Encephalopathy Diagnosis and Rehabilitation Center,Zhengzhou 450003,China;Henan Provincial Children′s Fever of Unknown Origin Traditional Chinese and Western Medicine Diagnosis and Treatment Center,Zhengzhou 450003,China)

机构地区：[1]河南中医药大学第一附属医院,郑州450003 [2]河南中医药大学第一附属医院儿科医院,郑州450003 [3]河南中医药大学儿科医学院,郑州450046 [4]河南省儿童紫癜肾病诊疗中心,郑州450003 [5]河南省儿童脑病诊疗康复中心,郑州450003 [6]河南省儿童不明原因发热中西医诊疗中心,郑州450003

出　　处：《世界中医药》2025年第4期606-612,共7页World Chinese Medicine

基　　金：国家自然科学基金面上项目(81873343);国家自然科学基金青年科学基金项目(82205190);中国博士后科学基金面上项目(2023M731027);国医大师工作室建设项目(丁樱国医大师传承工作室);河南省博士后项目(HN2022096);河南省中医学“双一流”创建科学研究专项(HSRP-DFCTCM-2023-8-21)。

摘　　要：目的:分析《幼科发挥》治疗儿科疾病的用药规律,为临床“药-证-方”诊治儿科疾病提供参考。方法:统计《幼科发挥》卷之四附汤方中的内服方剂,使用Excel2021进行频数统计,SPSS Modeler18.0、Cytoscape 3.8.0统计软件进行关联规则和复杂网络分析,Lantern 5.0进行隐结构模型分析,总结《幼科发挥》治疗儿科疾病的“药-证-方”规律。结果:共纳入73首方剂,137味中药,累积用药频次605次。高频药物共31味(频次>5次),使用频次前5位的中药依次为甘草、茯苓、陈皮、人参、白术;药性以温、寒为主(频次>50),药味以辛、苦、甘为主(频次>50);主归肺、脾、胃、肝经;关联规则分析得出20组常见药对,其中高频药对(实例≥20)为甘草-茯苓、甘草-人参、甘草-陈皮、茯苓-白术、甘草-白术,甘草、茯苓、陈皮、白术、半夏、当归、人参等药物间关联度最强;隐结构模型分析得出脾虚痰聚、肺脾气虚、痰阻气滞、风热犯肺证,以及心惊肝风肾虚诸证。结论:《幼科发挥》以治儿童肺脾诸疾为主,脾虚类证以补脾、运气、化痰、渗湿,肺虚外感风热以疏散风热、降气化痰;用药以寒温并用、辛开苦降,强调调理气机,运脾行气之重,同时兼顾心惊肝风肾虚诸证。Objective:To analyze the medication patterns in the treatment of pediatric diseases as outlined in Elaboration on Pediatrics(You Ke Fa Hui)and provide references for clinical“medicine-syndrome-prescription”diagnosis and treatment of pediatric diseases.Methods:Internal medicinal prescriptions from Elaboration on Pediatrics(Volume 4)were statistically analyzed.Frequency statistics were conducted using Excel 2021,and association rules and complex network analysis were performed using SPSS Modeler 18.0 and Cytoscape 3.8.0.Hidden structure model analysis was conducted using Lantern 5.0 to summarize the“medicine-syndrome-prescription”law in the treatment of pediatric diseases as described in Elaboration on Pediatrics.Results:A total of 73 prescriptions and 137 Chinese medicines were included,with a cumulative frequency of 605 uses.A total of 31 Chinese medicines were used with a frequency of over 5 times.The top 5 Chinese medicines in terms of frequency were Glycyrrhizae Radix et Rhizoma,Poria,Citri Reticulatae Pericarpium,Ginseng Radix et Rhizoma,and Atractylodis Macrocephalae Rhizoma.The properties of the Chinese medicines were predominantly warm and cold(with frequencies>50),and the flavors were mostly pungent,bitter,and sweet(with frequencies>50).The Chinese medicines mainly acted on the lungs,spleen,stomach,and liver meridians.Association rule analysis identified 20 common drug pairs,with high-frequency pairs(instances≥20)being Glycyrrhizae Radix et Rhizoma-Poria,Glycyrrhizae Radix et Rhizoma-Ginseng Radix et Rhizoma,Glycyrrhizae Radix et Rhizoma-Citri Reticulatae Pericarpium,Poria-Atractylodis Macrocephalae Rhizoma,and Glycyrrhizae Radix et Rhizoma-Atractylodis Macrocephalae Rhizoma.The strongest associations were found between Glycyrrhizae Radix et Rhizoma,Poria,Citri Reticulatae Pericarpium,Atractylodis Macrocephalae Rhizoma,Pinelliae Rhizoma,Angelicae Sinensis Radix,and Ginseng Radix et Rhizoma.Hidden structure model analysis revealed syndromes related to spleen deficiency with phlegm accumulation,lu

关 键 词：关联规则 隐结构模型 药-证-方 幼科发挥 用药规律 儿科 肺脾 心肝肾 

分 类 号：R272[医药卫生—中医儿科学]