《古今名医临证金鉴·胸痹心痛卷》治疗胸痹心痛用药规律研究

Study on Medication Rules of Treatment of Stroke In Gu Jing Ming Yi Lin Zheng Jin Jian

目的:总结古今名医治疗胸痹心痛方药规律,为胸痹心痛的临床用药提供参考。方法:通过查找《古今名医临证金鉴·胸痹心痛卷》相关医家治疗胸痹心痛有效的经验方,纳入33位医家治疗胸痹心痛处方155首,将处方的单味中药导入EXCEL 2013中建立用药数据库,再将数据库导入古今医案云平台(V2.2.3),从单味药物频次分析、中药属性分析、关联规则分析、聚类分析、复杂网络分析等多角度研究治疗胸痹心痛用药规律与特征。结果:155首处方涉及中药261味,用药频次高达40次以上的有丹参、茯苓、瓜蒌、桂枝、薤白、当归、半夏、炙甘草、陈皮、白术、党参、郁金,主要归属于肺、脾、心经,功效以润肠通便、燥湿化痰、活血祛瘀、清心除烦、通经止痛为主,关联规则分析提示"瓜蒌,桂枝-薤白""半夏,薤白-瓜蒌""半夏,瓜蒌-薤白""薤白-瓜蒌""桂枝,薤白-瓜蒌"为常用药对;复杂网络分析提示核心药物以瓜蒌薤白半夏汤加减而来。结论:该研究通过多角度分析《古今名医临证金鉴·胸痹心痛卷》中历代名医治疗胸痹心痛的用药规律,为临床用药提供参考依据。

Objective:To summarize the prescription law o Gu Jing Ming Yi Lin Zheng Jin Jian and to provide reference for clinical medication of chest pain.Methods:155 Chinese herbal compound prescriptions were selected and imported into Excel 2013 by searching for the effective experience prescriptions of Gu Jing Ming Yi Lin Zheng Jin Jianthe medication database was established,and then the database was imported into the ancient and modern medical record cloud platform(V2.2.3).From the frequency analysis of single drug,attribute analysis of traditional Chinese medicine,association rule analysis,cluster analysis,complex network analysis and other aspects,the medication rules and characteristics of chest pain were studied and analyzed.Results:A total of 155 prescriptions of 33 doctors were included,involving 261 kinds of traditional Chinese medicine.The frequency of medication was more than 40 times,including Salvia miltiorrhiza,Poria cocos,Trichosanthes Trichosanthes,Ramulus Cinnamomi,Allium macrostemon,Angelica sinensis,Pinellia ternata,Fried licorice,Tangerine peel,Atractylodes macrocephala,dangshen and Yujin.Drugs mainly belong to lung,spleen and heart meridian.Association rules analysis showed that“Gualou,Guizhi-Xiebai”,“Banxia,Xiebai-Gualou”,“Banxia,Gualou-Xiebai”,“Xiebai-Gualou”,“Guizhi,Xiebai-Gualou”were commonly used;complex network analysis suggested that the core drug could be considered as Gualou Xiebai Banxia decoction It comes from addition and subtraction.Conclusion:Through multi angle research and analysis of Gu Jing Ming Yi Lin Zheng Jin Jian,the medication law of famous doctors in the past dynasties in the treatment of chest pain,to provide reference for clinical treatment of chest pain.