近代中西医汇通派4位医家临证用药方剂计量学研究

Metrological Study on Clinical Prescription Characteristics of Four Famous Doctors of School of Integrative Medicine

目的:通过对比9位医家临证处方规律的异同点,分析探讨中西医汇通派张锡纯、唐容川、恽铁樵、陆渊雷4位医家临证处方用药特色。方法:选择张锡纯及其他8位医家临证医案为研究对象,运用传统文献学方法、方剂计量学方法,对各医家临证处方用药的常用药物四性五味归经补泻运用情况进行方剂计量学特有指标对比分析。结果:中西医汇通医家临证处方用药排序前5位的药物包括炙甘草、白术、白芍、茯苓、当归,具有气血并补,补中有泻之意,多以补气阳为主,恽铁樵偏补阴血。汇通各家用药偏寒凉,辛甘。张锡纯与中西医汇通医家中唐容川及陆渊雷相关性显著,相关系数分别为0.826,0.701(P<0.05),与其他医家相关性均不显著,聚类分析显示中西医汇通派医家张锡纯、唐容川、陆渊雷可聚为一类,恽铁樵单独一类,其他非汇通医家不为同类。结论:中西医汇通派4家临证处方规律有其相似之处,亦各有特色。

This article was aimed to compare similarities and differences of medication rules of clinical prescriptions from nine doctors in order to analyze and discuss the clinical medication features of four doctors of the School of Integrative Medicine, who were Zhang Xichun, Tang Rongchuan, Y un Tieqiao, and Lu Y uanlei. The clinical medical records of Dr. Zhang Xichun and eight other doctors were selected in this study. The traditional literature metrology methods and formula metrology were used in the comparative analysis of indicators on four qi, five flavours, channel tropism, supplementation and drainage of commonly used herbal medicine. The results showed that the top five herbs used by doctors of the School of Integrative Medicine were prepared licorice, bighead atractylodes rhizome, Poria, Radix Paeoniae Alba, Angelica, which had the effect of nourishing qi and blood, supplementation and drainage at the same time. Most of the herbs were used to nourishing qi and yang. Dr. Y un Tieqiao preferred to nourish yin and blood. Medications used by doctors of the School of Integrative Medicine were mostly cold and cool in nature as well as acrid and sweet in flavour. Dr. Zhang Xichun had significant correlation with Dr. Tang Rongchuan and Dr. Lu Y uanlei of the School of Integrative Medicine. The correlation coefficients were 0.826 and 0.701, respectively （P 〈0.05）. There were no significant correlation between Dr. Zhang Xichun and other doctors. The cluster analysis revealed that Dr. Zhang Xichun, Dr. Tang Rongchuan and Dr. Lu Y uanlei, who were of the School of Integrative Medicine, can be classified in one category. And Dr. Y un Tieqiao can be classified in a separate category. Doctors who were not of the School of Integrative Medicine were not in the same category. It was concluded that there were similarities in the medication rules of four doctors of the School of Integrative Medicine. However, they also had their own characteristics.