近现代医家治疗瘿病组方用药规律分析

Cluster Analysis of Chinese Medicine in the Treatment of Thyroid Disease in Modern Times

目的探讨近现代医家治疗瘿病的临床用药规律,通过聚类分析方法对该时期中医治疗瘿病选方用药特点加以分析。方法查阅近现代医家医案并从中摘录治疗瘿病的方药,将所涉及到的单味药建立Excel2017用药数据库,运用频数分析法与聚类分析法对用药规律进行统计学分析。结果共搜集得到38位医家50例病案,筛选摘录复方61首,共涉及药物179味,用药频次达871次,其中用药频次20次以上的分别为夏枯草、牡蛎、浙贝母、玄参、当归、白芍。按照中药类别分析,用药总频次最多的是补虚药,其次为清热药、化痰药。聚类分析结果显示滋阴补气、清热解毒燥湿、理气化痰、活血化瘀,是临床治疗瘿病的常用配伍。结论近现代医家治疗瘿病的中药以补虚、清热、化痰、散瘀为主,海藻玉壶汤、栀子清肝汤、当归六黄汤、天王补心丹、四物汤等为治疗瘿病的主要方药。

Objective To study the period of modern times Chinese medicine treatment of thyroid disease by use cluster analysis.Methods Consult medical works of the modern times, then extract Chinese medicine treatment of thyroid disease from those works, and put the involved herbs into a database by Excel software. Frequency analysis and cluster analysis were applied to analyze the prescription law. Results There were 38 doctors, 50 medical records, 61 formulas selected involving 179 herbs, with medication frequency of 871, in which the medication frequency of Xiakucao, Muli, Zhebeimu, Xuanshen, Danggui, Baishao was more than 20 times. According to the herbal category, herbs for tonifying with the highest frequency followed by heat-clearing and phlegm-resolving were made. Cluster analysis results showed that yin tonifying qi, clear heat, detoxify dryness and dampness, regulating qi-flowing for eliminating phlegm, promoting circulation and removing stasis were the commonest combination. Conclusion The treatment for thyroid disease in modern times mainly involves tonifying deficiency, clearing heat, resolving phlegm, and removing blood stasis. The type of Haizao Yuhu decoction, Zhizi Qinggan decoction, Danggui Liuhuang decoction, Tianwang Buxin mini-pill, Siwu decoction were the mainly formulas of thyroid disease.