基于中医传承辅助系统治疗反胃用药规律分析

Analysis on composition principles of prescriptions for nausea by using traditional Chinese medicine inheritance support system

反胃因其症状的特殊性,食谷不化,定时反出,而与呃逆、呕吐不同。在临床上常见而又易混淆,治疗上各个医家各有不同。而西医药亦未见高效、无反复的良好治疗方法。该研究基于中医传承辅助系统(V2.5)软件,分析和总结历代中医治疗反胃处方的用药规律,以期指导临床辨证用药,总结出治疗反胃的基本规律。筛选出《中医方剂大辞典》中治疗反胃的处方,运用中医传承辅助系统,采用频次分析、关联规则apriori算法及复杂系统熵聚类等数据挖掘方法,挖掘其中的用药规律。最终确定了处方的药物频次,得出使用频次较高的药物,发现药物之间的关联规则,得到常用药物组合19个,挖掘出10组核心组合与10首新处方,发现了反胃的基本病机为脾胃虚寒,胃失和降。历代医家治疗反胃处方用药以温中健脾,降逆和胃为主,主要治以生姜、人参、白术、茯苓、甘草等,适当配以燥湿化痰、理气和胃之品,并且依据反胃所形成的不同伴随证候痰、瘀、阴虚等,对证施治。

Nausea is special in the symptoms,and is different from hiccups and vomiting. The main symptom is that the patients throw up the indigested food from the stomach regularly——if the patients have a dinner,they will throw out it in the next morning,or if the patients have a breakfast,they will throw out it at night. Nausea is common in clinic,and different physicians may use different treatment methods for it. This disease also cannot be treated efficiently and may happen repeatedly with the western medicine. In this study,the composition principles of prescriptions in past traditional Chinese medicine for nausea were analyzed and summarized by using traditional Chinese medicine inheritance support system（ V2. 5）,hoping to provide guidance for clinical drug use and summarize the basic rules for treatment of nausea. The prescriptions for nausea in ＂ the prescription of traditional Chinese medicine dictionary＂ were selected,and the information was entered into the traditional Chinese medicine inheritance support system（ TCMISS） to build a database. Data mining methods such as frequency statistics,association rules,complex system entropy clustering were used to analyze and summarize the composition principles of these prescriptions. The herb frequencies of the prescriptions were finally determined;herbs with higher use frequencies were obtained; and the association rules between herbs were found. 19 commonly used herb pairs,10 core combinations and 10 newly developed prescriptions were found. The basic pathogenesis of nausea in traditional Chinese medicine is the weakness and coldness of spleen and stomach,and the Qi adverseness of stomach. Generations of physicians＇ main therapeutic method for nausea is mainly to warm the middle and invigorate the spleen,lower Qi and regulate stomach. The commonly used herbs for nausea are ginger,ginseng,large head attractylodes,tuckahoe,licorice,and appropriately supplemented with the herbs of eliminating dampness and eliminating phlegm,and regulating Qi-flowing for harmonizing stomach. In addition,it shall be treated according to the different accompanying syndromes such as phlegm,blood stasis,and yin deficiency.