基于数据挖掘的赵绍琴治疗温病用药规律研究

Analysis of ZHAO Shaoqin’s Prescription Principle in the Treatment of Febrile Diseases based on Data Mining

目的:基于数据挖掘分析并总结赵绍琴教授治疗温病的组方用药规律。方法:收集《赵绍琴临证验案精选》《跟名师学临床系列丛书-赵绍琴》《赵绍琴临证400法》《赵绍琴临床经验辑要》中所记载的治疗温病的医案和处方,筛选后建立方剂数据库,使用中医传承计算平台中的频次分析、关联规则、Kmeans算法聚类分析模块等分析方法进行数据挖掘,对方剂中核心药物的性味归经、核心用药及类方等进行总结分析。结果:对最终筛选出的256首方剂、涉及的211味中药进行分析,发现在治疗温热病的处方中,使用频次前10位的药物分别是芦根、前胡、杏仁、连翘、黄芩、甘草、白茅根、生地、麦冬、姜黄;而治疗湿热病的处方中,使用频次前10位的药物分别是杏仁、制半夏、厚朴、藿香、佩兰、栀子、淡豆豉、陈皮、白豆蔻、大豆卷。以上药物药味以苦味为主,药性以寒性居多,归经主入肺经,其次为胃经、脾经和心经。关联规则分析,将药物组合频次由高到低排序,前三位分别是"杏仁-前胡""芦根-前胡""芦根-白茅根"。处方规律分析得出,赵绍琴教授在治疗温热病时,常用白虎汤、增液汤、升降散、银翘散、栀子豉汤等方剂;在治疗湿热病时常用藿朴夏苓汤、三仁汤等方剂。K-means聚类分析,演化出治疗温热病的6个类方,如"僵蚕,连翘,姜黄,生石膏,芦根,蝉衣"、"栀子,淡豆豉,前胡,芦根,玉竹,白茅根"等;以及治疗湿热病的4个类方,如"佩兰,藿香,厚朴,大豆卷"、"厚朴,茯苓皮,制半夏,杏仁"等。结论:赵绍琴教授一般将温热病按卫气营血传变进行辨证,而湿热病多从三焦传变进行分析。温热病治疗重点包括:调畅气机、宣透郁热;透热转气;顾护阴液;消食导滞。湿热病治则以化湿、祛湿、渗湿为主。分析结果挖掘了赵绍琴教授治疗温病的用药经验,为赵绍琴教授临床经验的深入挖掘和学术思想传承提供依据,以期对急性突发呼吸道传染病的中医药治疗提供思路。

Objective:Based on the method of data mining,this paper analyzed and summarized the prescription principle of professor ZHAO Shaoqin,a wendiatrist,in the treatment of febrile diseases.Methods:Medical cases and prescriptions for the treatment of febrile diseases recorded in<Selected Clinical Cases of ZHAO Shaoqin>,<Clinical Series books on Famous Teachers-ZHAO Shaoqin>,<Clinical 400 Method of ZHAO Shaoqin>,And<Clinical Experience Collection of ZHAO Shaoqin>were collected.After screening,the prescription database was established.Data mining was conducted by using frequency analysis,association rules,Kmeans algorithm cluster analysis module and other analysis methods in the TCM inheritance computing platform,and summarizing and analyzing the characteristics and characteristics of core drugs in the prescription.Results:(1)The 256 formulations and 211 Chinese medicines were analyzed,and found that the prescription in the treatment of wendiatosis disease,the use frequency of the top10 before the drugs were Lugen(PhragmitesCommunis),Qianhu(PeucedanumRoot),Xingren(Almond),Lianqiao(FructusForsythia),Huangqin(Radix Scutellariae),Gancao(Radix Glycyrrhizae),Bai Maogen(CogongrassRhizome),Shengdi(RadixRehmanniae),Maidong(RadixOphiopogonis),Jianghuang(Turmeric).Among the prescriptions for the treatment of dampness-heat disease,the top 10 most frequently used drugs were Xingren(Almond),Banxia(Pinellia Ternata),Houpo(Magnolia Officinalis),Huoxiang(Agastache rugosus),Peilan(Herba Eupatorii),Zhizi(Gardenia Jasminoides),Douchi(Fermented Blank Bean),Chenpi(Dried Tangerine Peel),Bai Doukou(White Cardamom)and Doujuan(Soybean).The above drug ingredients is given priority to with the bitter taste,medicinal properties in the majority with cold property,belong to the lung meridian,followed by the stomach,spleen and heart meridians.(2)Association rule analysis,the drug combination frequency was ranked from high to low,and the top three were"Xingren(Almond)-Qianhu(Peucedanum Root)","Lugen(Phragmites Communis)-Qianhu(PeucedanumRoot)"and"Lugen(PhragmitesCommunis)-BaiMaogen(Cogongrass Rhizome)".(3)The prescription law analysis showed that Professor ZHAO Shaoqin used Baihu decoction,Zengye decoction,Shengjiang powder,Yinqiao powder,Zhi Zichi decoction and other prescriptions in the treatment of febrile disease.In the treatment of dampness-heat disease often with HuoPu Xialing decoction,Sanren decoction and other prescriptions.(4)K-means cluster analysis,evolved six types of prescriptions for the treatment of febrile diseases,such as"Jiangcan(Silkworm),Lianqiao(FructusForsythia),Jianghuang(Turmeric),Shigao(Gypsum),Lugen(Phragmites Communis),Chanyi(Cicadas)","Zhizi(Gardenia Jasminoides),Douchi(Lobster sauce),Qianhu(Peucedanum Root),Lugen(Phragmites Communis),Yuzhu(Radix Polygonati Officinalis),Bai Maogen(Cogongrass Rhizome)";And 4 prescriptions for the treatment of dampness-heat disease,such as"Peilan(Orchid),Huoxiang(Agastache Rugosus),Houpu(Magnoliaofficinalis),Doujuan(Soybean)""Houpu(MagnoliaOfficinalis),Fuling(PoriaCocos),Banxia(Pinellia Ternata),Xingren(Almond)"Conclusion:Professor ZHAO Shaoqin generally differentiates the febrile disease according to the"Syndrome differentiation of Wei Qi Ying Blood",while the dampness-heat disease is mainly analyzed from the transmission of the Sanjiao(Triple Energizer).The key points for the treatment of febrile disease include:regulating Qi circulation and penetrating depression-heat;Diathermy into Qi;Care Yin fluid;Improve digestion.The treatment of dampness-heat disease was mainly resolving dampness,clearing damp and excreting dampness.The results of the analysis excavated Professor ZHAO Shaoqin’s experience in the treatment of febrile diseases,and provided the basis for professor ZHAO Shaoqin’s indepth exploration of clinical experience and academic thought inheritance,so as to provide ideas for the treatment of acute respiratory tract infectious diseases with traditional Chinese medicine.