基于数据挖掘方法分析新安医家王仲奇治疗湿温病用药经验

An analysis of the prescription experience of Xin’an medical practitioner Wang Zhongqi in the treatment of damp-febrile diseases using data mining method

目的:运用数据挖掘技术探究新安医家王仲奇治疗湿温病的临床用药经验。方法:整理筛选出《王仲奇医案》关于治疗湿温病的24则效案共66首处方,根据《中华人民共和国药典》及《中药别名大辞典》对药物名称进行规范化统一,运用Microsoft Excel 2010构建临床方药数据库后,并对数据进行频数、性味归经、聚类等进行分析归纳总结。结果:《王仲奇医案》中治疗湿温病的66首方药中统计出使用药物175味、用药频数792次;使用频数≥ 8的24味药物使用频数前6味药物依次是:茯苓、佩兰、苦杏仁、半夏、青蒿、通草;进行药物组合进行分析,取频数≥ 20的药物组合共39组,其中药物组合频率大于60%是茯苓、佩兰,苦杏仁、茯苓,苦杏仁、佩兰,佩兰、半夏,茯苓、半夏,佩兰、青蒿;性味归经多寒、苦,归肺、脾、胃经;聚类分析结果分别是C1:竹茹、瓜蒌、橘叶,C2:连翘、栀子、寒水石、滑石,C3:藿香、旋覆花、石菖蒲,C4:金银花、荷叶,C5:薏苡仁、化橘红,C6:茯苓、佩兰、半夏、苦杏仁、通草,C7:青蒿、白薇、黄芩,C8:枳壳、白豆蔻。结论:王仲奇先生治疗湿温病用药轻灵、注重调护脾胃、治以苦寒,以达到湿去温不留,温去湿不在的治疗目的。

Objective: To explore the clinical prescription experience of Xin'an medical practitioner Wang Zhongqi in the treatment of damp-febrile diseases using data mining technology. Methods: A total of 66 effective prescriptions for treatment of damp-febrile diseases in 24 cases were compiled and screened out from Wang Zhongqi's Medical Records;the drug names were standardized and unified according to the Pharmacopoeia of the People's Republic of China and the Synonym Dictionary of Chinese Herbs;a database of clinical herbal prescriptions was built by Microsoft Excel 2010;then the data were analyzed and summarized in terms of frequency, nature, taste, meridian tropism, and cluster. Results: A total of 175 herbs (simple prescription Yuquan powder and Yiyuan powder not included) and 792 times of drug use were enumerated from 66 herbal prescriptions for treating damp-febrile diseases in Wang Zhongqi's Medical Records. The first six herbs with a frequency of ≥8 by descending order were Poria cocos, Herba Eupatorii, Semen Armeniacae Amarum, Pinellia ternata, Herba Artemisiae annuae, and rice-paper plant pith;after analysis of the drug combinations, 39 groups of drug combinations with a frequency of o20 were selected, of which the drug combinations with a frequency greater than 60% were Poria cocos and Herba Eupatorii, Semen Armeniacae Amarum and Poria cocos, Semen Armeniacae Amarum and Herba Eupatorii, Herba Eupatorii and Pinellia ternata, Poria cocos and Pinellia ternata, and Herba Eupatorii and Herba Artemisiae annuae. The nature, taste, and meridian tropism were mostly cold and bitter, and belonged to lung, spleen, and stomach meridians. The cluster analysis results were as follows: C1: bamboo shavings, Fructus Trichosanthis, and Folium Citri Reticulatae;C2: forsythia fruit, Fructus Gardeniae, calcitum, and talc;C3: Agastache rugosa, inula flower, and grassleaf sweelflag rhizome;C4: Lonicera japonica and lotus leaf;C5: coix seed and Exocarpium Citri Grandis;C6: Poria cocos cocos, Herba Eupatorii, Pinellia ternata, Semen Armeniacae Amarum, and rice-paper plant pith;C7: Herba Artemisiae annuae, Radix Cynanchi Atrati, and Scutellaria baicalensis;C8: Fructus Aurantii and Fructus Amomi Rotundus. Conclusion: Wang Zhongqi's prescription is characterized by mild and flexible use of herbs, focusing on regulating the function of spleen and stomach, and treatment with herbs of bitter and cold nature, which achieves a therapeutic purpose of eliminating both dampness and febrileness without leaving out either of the two conditions.