| 倪睿凡,刘果,梁錦娉.清宫感冒证治规律研究[J].浙江中医药大学学报,2025,49(2):197-206. |
| 清宫感冒证治规律研究 |
| Study on the Syndrome and Treatment Rules of Cold in the Palace of Qing Dynasty |
| DOI：10.16466/j.issn1005-5509.2025.02.012 |
| 中文关键词: 《清宫医案集成》 清代 宫廷医疗 感冒 古今医案云平台 数据挖掘 证治规律 表里同治 |
| 英文关键词: Medical Records Integration of Palace in Qing Dynasty Qing Dynasty palace medical treatment cold Ancient and Modern Medical Records Cloud Platform data mining law of syndrome differentiation and treatment treat both exterior and interior |
| 基金项目:国家中医药管理局中医药创新团队及人才支持计划项目-中医疫病学传承创新团队(ZYYCXTD-C-202006)；北京市第三批中药骨干人才项目(京中医人科字﹝2022﹞59号)；全国第五批优秀中医临床人才项目(国中医药人教函﹝2022﹞239号) |
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| 中文摘要: |
| [目的] 探讨清宫医案中感冒的证治规律。[方法] 通过搜集并整理《清宫医案集成》外感热病中的感冒医案，建立数据库，进行数据标准化处理后，导入古今医案云平台，对中药、证素、治法、处方进行频次统计、关联规则分析、复杂网络分析，同时结合个案进行分析。[结果] 共纳入196则医案、196条处方、133个症状、43个证素、159味中药。病性证素中出现频率最高的是热、风、凉、饮，脏腑病位中以胃和肺最为常见。排名前三的治法为清解、疏解、化饮。使用频率最高的中药为甘草和生姜，其次为防风、桔梗、枳壳、陈皮、黄芩等。药性方面，温性、微寒和平性中药占主导；药味以辛、苦、甘为主；归经中以肺经最多，其次为脾经、胃经和肝经。得到15组高频关联药对，置信度最高的一组中药为防风、桔梗-甘草。对12味高频药物进行聚类分析，得到3组中药:第1组:防风、荆芥、黄芩、甘草、桔梗；第2组:枳壳、生姜、紫苏叶；第3组:羌活、茯苓、陈皮、厚朴。复杂网络分析得出12味核心药物，分别为甘草、生姜、桔梗、防风、黄芩、枳壳、荆芥、紫苏叶、茯苓、陈皮、羌活、厚朴。通过个案分析得出，清宫感冒医案鲜用麻桂剂，多用羌防剂，人参等益气类药物使用较少。[结论] 清宫感冒常兼内伤脾胃，治疗上常表里同治，尤重脾胃。对于夹痰、饮、湿的病案兼用辛以散之，苦以燥之；夹滞则以健脾和胃、推陈致新为法；里热较盛，要护心护肝。处方中少用麻桂剂，多用羌防剂。对于经期感冒，注重凉润。 |
| 英文摘要: |
| [Objective] To explore the rules of cold syndrome treatment in the medical records of Qing Palace. [Methods] By collecting and sorting out the cold medical cases in Medical Records Integration of Palace in Qing Dynasty， the database and data standardization were established， and then imported into the Ancient and Modern Medical Records Cloud Platform for data mining， and combined with case analysis. [Results] A total of 196 medical records，196 prescriptions，133 symptoms，43 syndrome elements and 159 Chinese medicines were included. The most frequent syndrome elements were heat， wind， cool and fluid retention， and the most common Zang-Fu elements were stomach and lung. The top three commonly used treatment methods were expelling， dredging and resolving fluid retention. Radix glycyrrhizae and zingiberis rhizoma recens were the most commonly used， followed by saposhnikovia divaricata， platycodon grandiflorum， fructus aurantii， tangerine peel and radix scutellariae. The drug properties were warm， slightly cold and flat， and the spicy， bitter and sweet tastes were more common. The lung meridian was the most common， followed by the spleen meridian， stomach meridian and liver meridian. Fifteen groups of commonly used drug pairs were obtained， and the group with the highest confidence was saposhnikovia divaricata， platycodon grandiflorum-radix glycyrrhizae， schizonepeta-saposhnikovia divaricata， magnolia officinalis-tangerine peel， radix glycyrrhizae， and fructus aurantii- platycodon grandiflorum. Three groups of Chinese medicines were obtained by cluster analysis of 12 kinds of high frequency drugs. Through complex network analysis，12 core drugs were obtained， which were radix glycyrrhizae， zingiberis rhizoma recens， platycodon， saposhnikovia divaricata， scutellaria， fructus aurantii， schizonepeta， perilla leaf， poria， tangerine peel， radix notophylla and magnolia officinalis. [Conclusion] Cold in the Qing Dynasty often caused internal injury to the spleen and stomach. In the treatment， both the external and internal were often treated， especially the spleen and stomach. For the cases of phlegm， drink and dampness， spicy drugs were used to disperse， and bitter was used to dry. The clamping method was to invigorate the spleen and stomach， and push the old for the new. The medical records with interior heat should protect the heart and liver. The prescription of Magui was used less than the prescription of Qiangfang. For menstrual colds， cooling blood， clearing heat and moistening were very important. |
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