从历代虚劳医案中分析虚劳证候特点及药物应用规律

Analysis of Drug Application Law and Syndrome Characteristics of Consumptive Disease from Medical Cases in the Past Dynasties

目的:归纳总结虚劳的证候特点及药物应用规律。方法:通过查阅历代记载虚劳的古籍医案,采用数据挖掘的方法分析虚劳的证候特点及药物应用规律。结果:共查阅76部古籍中记载虚劳的医案640例,其中符合医案入选标准的医案262例。肝肾阴虚为出现最多的辨证类型,占总例数的17.7%,其次为肾阴虚及肾气虚,均占13.7%。食少、咳嗽、汗出为最常见症状,出现频率分别为10.8%、9.5%、6.3%,最常用的药味为补益气血类中药,如人参、茯苓、熟地黄等。根据关联规则分析,甘草与人参合用的规则支持度最高,为35.51%。结论:虚劳因致病原因不同,其证候、临床表现亦不同。其中肝肾阴虚、肾阴虚、肾气虚为主要证候类型,常用补益气血类中药治疗。

Objective: To conclude and summarize drug application laws and syndrome characteristics of consumptive disease. Methods: By consulting ancient medical cases recording consumptive disease in the past dynasties,data mining was used to analyze drug application laws and syndrome characteristics of consumptive disease. Results:There were 262 cases which met the inclusion standard after consulting 640 cases recording consumptive disease in 76 ancient books. Yin deficiency of liver and kidney was the pattern that frequently occurred in syndrome differentiation, and it held 17.7% of all the cases, the next were kidney Yin deficiency and kidney Qi deficiency, and both held 13.7%. Eating less, cough and sweating were the symptoms that are frequently to seen, and the frequencies were 10.8%, 9.5% and 6.3% respectively, and the common herbs were the ones of tonifying Qi and blood, such as ginseng, Fuling [poria cocos(Schw.) wolf], Shudi(rehmanniae radix praeparata) and others. According to the analysis of association rules, the support degree of Gancao joined with ginseng was the highest, and it was 35.51%. Conclusion: Because of different causes, consumptive disease would show the diversification of the syndromes and clinical manifestation. Yin deficiency of liver and kidney, kidney Yin deficiency, kidney Qi deficiency are the main syndromes and the disease could be treated with common herbs which could tonify Qi and blood.