《圣济总录》中胸痹心痛方剂的用药及证治规律研究

Study on Drug Use and Syndrome and Treatment of Thoracic Obstruction in Shengji Zonglu

目的分析《圣济总录》中胸痹心痛方剂的用药规律,探讨与之相应的病机学说和证治规律。方法搜集整理《圣济总录》中胸痹心痛相关方剂,对搜集到的方剂和中药进行频数分析和关联规则分析,得到核心药物、核心药对、高频药别和高频药别组合。结果共收录方剂242首。《圣济总录》胸痹心痛方剂中使用频次较高的中药有肉桂、当归、干姜、甘草、木香、陈皮等;最常用的药对有肉桂-干姜、肉桂-当归、肉桂-人参、甘草-干姜、肉桂-甘草等;药别里出现频率前5位的有温阳药、理气药、补气药、补血药和活血化瘀药;主要的3组药别组合是温阳药-理气药、温阳药-补气药、温阳药-补血药。结论《圣济总录》中"阳微阴弦"是胸痹心痛的病机关键,其属本虚标实之证,治法强调标本兼治,以温阳通脉、疏通气机和补益气血为主。

Objective:To analyze the medication rule for treating thoracic obstruction in Shengji Zonglu and discuss the pathogenesis and syndrome rule.Methods:The prescriptions applied to treating thoracic obstruction in Shengji Zonglu were collected.Frequency analysis and association rule analysis of the collected prescriptions and traditional Chinese medicines were carried out to obtain core drugs,core drug pairs,high-frequency drugs and high-frequency drug combinations.Results:242 prescriptions were included.The herbs like cinnamon,angelica,rhizoma zingiberis,liquorice,radices saussureae,dried tangerine peel were commonly used.Cinnamon and rhizoma zingiberis,cinnamon and angelica,cinnamon and ginseng,liquorice and rhizoma zingiberis,cinnamon and liquorice were the most commonly used herbal pairs.The top 5 herbal classes were herbs for dispelling internal cold,regulating Qi flow,tonifying Qi,supplementing blood,or invigorating blood circulation and eliminating stasis.The main 3 groups were herbs for dispelling internal cold and regulating Qi flow,dispelling internal cold and tonifying Qi,dispelling internal cold and supplementing blood.Conclusion:The key pathogenesis of thoracic obstruction in Shengji Zonglu is Yang-insufficiency-Yin-excessive.And the standard is asthenia in origin and asthenia in superficiality.The main treatment for thoracic obstruction is warming Yang and dredging the pulse,regulating Qi flow,tonifying Qi and supplementing blood.