名医群体辨治血精（精囊炎）方药规律探析

Exploration of Medication Rules in the Treatment of Hemospermia(Seminal Vesiculitis)Based on Syndrome Differentiation by Famous Doctors

目的通过分析国家级名医群体辨治血精的方药规律,探讨血精病机关键,提供选方用药和治疗思路借鉴。方法检索中国知网建库至2017年9月主治病证为“血精”或“精囊炎”文献,遴选主治医家为第一至第五批国家级老中医药专家学术经验继承工作指导老师文献,统计处方与用药。采用中医传承辅助系统(V2.5)软件,通过关联规则、改进的互信息法、复杂系统熵聚类等数据挖掘方法,分析常用的方药、组合规则、核心组合。结果检索得到19位名医血精文献共计31篇,涉及33首古代方剂,159味中药。单味中药使用频次由高到低依次为:生地黄、牡丹皮、甘草、黄柏、熟地黄。方剂类别涉及15类,使用频次由高到低依次为:补阴、清热祛湿、活血祛瘀、清脏腑热。药物归经由多到少依次为:肝、肾、心、肺、脾胃、膀胱等。药物在“五味”中所占比重由多到少依次为:甘、苦、辛、涩、酸、咸。药物在“四气”中所占比重由高到低依次为:寒、温、平、凉、热。总结显性常用药物47个,分析处方规则19个,药物间核心组合模式多见女贞子、牡丹皮等药物与生地黄、黄柏等关联。结论数据挖掘法对于明确国家级名医群体辨治血精(精囊炎)的方药规律有重要的实用价值,血精用药的规律多以理血、澄源、固本为治疗大法,论治多扶正祛邪、标本兼顾。

Objective To provide the thoughts for medication and treatment by analyzing the medication rules of national famous doctors in the treatment of hemospermia and exploring the key pathogenesis of hemospermia.Methods Papers with"hemospermia"or"seminal vesiculitis"as main disease from Chinese National Knowledge Infrastructure(CNKI)before September 2017 were searched.Papers with the attending physicians who are instructors of the inheritance work of the first to five batches of national senior Chinese medicine experts'academic experience were selected.All prescriptions and herbs used in those papers were analyzed.The software named Traditional Chinese Medicine Inheritance Support System(TCMISS)(V2.5)was used to analyze the commonly used prescriptions and drugs,the combination rules,the core combinations by applying data mining methods such as the association rules,the improved mutual information method and the complex system entropy clustering.Results A total of 31 papers about hemospermia by 19 famous doctors were selected,including 33 ancient formulas and 159 Chinese herbs.The herbs listed in usage frequency from high to low were Radix Rehmanniae Recens,Cortex Moutan Radicis,Radix Glycyrrhizae,Cortex Phellodendri,Radix Rehmanniae Preparata.The prescription was divided into 15 categories,and according to usage frequency from high to low were invigorating Yin,clearing heat and eliminating dampness,promoting blood circulation and removing blood stasis,clearing heat in viscerae.Channel tropism of herbs listed from most to least was liver,kidney,heart,lung,spleen and stomach,bladder and so on.Herbs used by proportion in five flavours from high to low were sweet,bitter,pungent,astringent,sour,salty.Herbs used by proportion in four natures from high to low were cold,warm,neutral,cool,hot.In conclusion,there were 47 obvious frequently used herbs and 19 analyzed prescription rules.The core combination model between herbs was mostly herbs like Fructus Ligustri Lucidi and Cortex Moutan Radicis combined with herbs like Radix Rehmanniae Recens and Cortex Phellodendri.Conclusion Data mining method shows its great practical value for the identification of the medication rules of national famous medical groups in the treatment of hemospermia(seminal vesiculitis)based on syndrome differentiation.The rules of treating hemospermia are mainly regulating blood,clearing root cause and consolidating body resistance.The treatment principles are strengthening vital Qi to eliminate pathogenic factor and treating manifestation and root cause meanwhile.