国医大师诊治冠心病心绞痛临证医案方药分析

Medical Case Analysis of Angina Pectoris of Coronary Heart Disease Treated by TCM Master

目的明确国医大师临证医案中对冠心病心绞痛的治则治法及方药特点。方法采用文献研究方法,从已发表论著及专著中收集国医大师诊治冠心病心绞痛的临床医案,构建国医大师冠心病心绞痛临证医案数据库。联合应用描述性统计、关联规则算法及复杂系统熵聚类,对冠心病心绞痛医案中的一般资料、治则治法、遣方用药进行统计分析,获得其方药特点。结果文章累计检索60位国医大师公开发表文献5967篇,出版书籍330本,最终纳入国医大师诊治冠心病心绞痛临床病例166则。共提取出治则治法89种,活血、益气、化痰、化瘀、通阳、温阳、养阴、理气、宣痹、清热为累计频率>10%的治则治法;冠心病心绞痛的治则治法又有针对病理因素、病位、物质基础、症的不同。其药物以活血药、理气药、化痰药、补气药为主。结论冠心病心绞痛的临床论治多以活血化瘀、益气理气、化痰去浊为要。

Objective To clarify the treating principles and methods as well as the characteristics of herbal medication of TCM masters in the clinical practice of angina pectoris of coronary heart disease（ CHD）. Methods The literature research method was adopted. The clinical medical cases of angina pectoris treated by TCM masters were collected from the published papers and works. The database of clinical cases of angina pectoris treated by TCM masters was set up. In combination with descriptive statistics,association rules algorithm and complex system entropy clustering,the general data,treating principles and methods and herbal formulas were analyzed statistically. Finally,the characteristics of herbal medication were obtained. Results A total of 5967 papers and 330 works of 60 TCM masters were retrieved. Finally,166 cases of angina pectoris were collected,89 treating principles and methods were extracted. The accumulative frequency was over 10% for the treating principles and methods as activating blood circulation,benefiting qi,resolving phlegm,removing stasis,promoting yang circulation,warming yang,nourishing yin,regulating qi,removing obstruction and clearing heat. The treating principles and methods of this disease are various in terms of the pathological factors,location,material foundation and symptoms. The common herbal medicines are in the categories of activating blood circulation,regulating qi,resolving phlegm and tonifying qi. Conclusion The clinical treatment of angina pectoris of CHD focuses on activating blood circulation,removing stasis,benefiting and regulating qi and resolving phlegm.