文章摘要
沈云博,刘枫,兰向宇,等.温病医家辨治虚劳用药规律探析[J].浙江中医药大学学报,2022,(6):669-676.
温病医家辨治虚劳用药规律探析
On the Medication Rule in the Treatment of Consumptive Disease by the School of Epidemic Febrile Diseases
DOI:10.16466/j.issn1005-5509.2022.06.018
中文关键词: 虚劳  数据挖掘  用药规律  叶天士  薛生白  吴鞠通  王孟英
英文关键词: consumptive disease  data mining  medication rule  YE Tianshi  XUE Shengbai  WU Jutong  WANG Mengying
基金项目:国家自然科学基金项目(81603447);第二批天津市中医药专家学术经验继承项目(津卫中[2018]176号);天津市十二五特色学科中医肺病学科(20200402)
作者单位
沈云博 天津中医药大学研究生院 天津 301617 
刘枫 天津中医药大学研究生院 天津 301617 
兰向宇 天津中医药大学研究生院 天津 301617 
严博煜 天津中医药大学研究生院 天津 301617 
张笑雪 天津中医药大学研究生院 天津 301617 
刘伟 天津中医药大学第二附属医院 
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中文摘要:
      [目的] 基于数据挖掘探讨温病代表医家叶天士、薛生白、吴鞠通及王孟英四人对虚劳病的辨治及用药规律,以期为此病的治疗提供更多参考。[方法] 通过收集并整理四位温病医家医案中“虚劳”篇或“劳伤”篇所载的首诊及复诊处方,建立数据库,运用SPSS Modeler 18.0、SPSS Statistics 25.0及中医传承计算平台软件(V3.0),分析药物频次、性味归经、功效、高频药物组合,并进行关联规则及聚类分析。[结果] 筛选处方共计295首,涉及中药166味,高频药物28味(频次>20次);四气以温、平为主;五味以甘味为主;归经以入肾、脾经为主;药物以补虚药最多,其中补气药>补血药>补阴药>补阳药,其次为利水渗湿药、收涩药;得出高频药物组合28组(频次≥30次);药物关联规则8条;5个聚类方。[结论] 温病医家以甘温之品从脾肾入手辨治虚劳,重在补益中焦气血,对于后期阴阳亏虚明显者,填补肾之阴阳。善以血肉有情之品从补益奇经论治,补益同时注重收涩药的运用,补涩兼顾。尤其对于真阴耗竭之证,创“甘寒育阴”法以填补真阴,为温病医家辨治虚劳的特色所在。
英文摘要:
      [Objective] To discuss the treatment and medication rule of consumptive disease by YE Tianshi, XUE Shengbai, WU Jutong and WANG Mengying of the febrile disease school based on data mining, in order to provide more references for the treatment of this disease. [Methods] By collecting and sorting out the prescriptions of initial and follow-up visits contained in “Consumptive Disease Chapter” in Clinical Guideline of Medical Records, Saoyezhuang Medical Cases, WU Jutong‘s Collection of Case Histories and WANG Mengying‘s Collection of Case Histories, a prescription database was established and SPSS Modeler 18.0, SPSS Statistics 25.0 software and traditional Chinese medicine(TCM) Inheritance Computing Platform Software(V3.0) was used to analyze drug properties, efficacy, frequency, combination and association rules, cluster analysis. [Results] A total of 295 prescriptions were screened, involving 166 Chinese herbs and 28 high-frequency herbs(frequency>20 times). Four properties in the prescriptions were mainly warm and flat, and the five tastes were mainly sweet. Meridian tropism mainly entered kidney, spleen meridians. The most used herbs were tonifying herbs, and Qi-invigorating herbs>blood-tonifying herbs>Yin-tonifying herbs>Yang-tonifying herbs, followed by diuretic and eliminating dampness herbs, astringent herbs. And 28 groups of high-frequency drug combinations(frequency≥30 times), 8 drug association rules and 5 cluster prescriptions were obtained. [Conclusion] Febrile disease doctors treated consumptive disease mostly from the spleen and kidney meridians with sweet and warm herbs, and they focused on supplementing middle-Jiao Qi and blood. For those with obvious deficiency of Yin and Yang in the later stage of disease, they filled in Yin and Yang of the kidney. They were good at using herbs with affinity to flesh and blood to treat consumptive disease from eight extra-channel, at the same time they paid attention to the use of astringent herbs. Especially for the true Yin exhaustion, the febrile disease doctors created “sweet cold breeding Yin” method to fill the true Yin, which was the characteristic for the school of epidemic febrile diseases to treat consumptive disease.
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