国医大师及全国名中医治疗心力衰竭用药规律分析

Research on Medication Regularity of Heart Failure by Masters of Traditional Chinese Medicine and National Famous Chinese Physicians

目的:探讨和总结国医大师及全国名中医对心力衰竭的证治用药规律。方法:收集各中医大家治疗心力衰竭的医案,建立相应的经验文献数据库,运用频数统计、聚类分析和关联规则分析等数据挖掘方法分析中药用药规律。结果:筛选出的107首处方中,共涉及中药210味,用药频数1468次,其中使用频数≥18的中药有22味,茯苓、附子、白术、黄芪、桂枝、丹参、泽泻、桃仁、麦冬和川芎居前10位。以补益类、活血化瘀类和利水渗湿类药物出现频数最高,累计频率为51.36%。同时挖掘出5类聚类组合、8组常用药对及10种有效关联规则。结论:中医大家应用中药治疗心衰,遣方用药重视益气活血利水功能,进一步佐证心力衰竭主要的病因病机为虚实夹杂,本虚标实。本虚主要为气虚、阳虚,标实主要为瘀血、水饮、痰浊。

Objective:To explore and summarize the medication regularity of heart failure by TCM masters and national famous Chinese physicians.Methods:Medical cases of heart failure by TCM physicians were collected,and the empirical literature database was established,then applied to analyze the law of TCM drugs use by using data mining methods such as frequency statistics,cluster analysis and association rule analysis.Results:Totally 107 prescriptions were screened out and 210 kinds of Traditional Chinese Medicines were involved.The frequency of medication was 1468 times and 22 Chinese Medicines were used more than 18 times.The top ten ones are Fuling(poria cocos),Fuzi(aconite),Baizhu(atractylodes macrocephala),Huangqi(radix astragali),Guizhi(cassia twig),Danshen(salvia miltiorrhiza),Zexie(rhizoma alismatis),Taoren(peach kernel),Maidong(liriope graminifolia)and Chuanxiong(rhizoma chuanxiong).The medicine on replenishing,activating blood to eliminate stasis and promoting diuresis are taken at most,with a cumulative frequency of 51.36%.At the same time,five types of cluster combinations,eight groups of common drug pairs and 10 kinds of effective association rules are excavated.Conclusion:TCM physicians treat heart failure by using drugs of benefiting Qi and activating blood circulation and promoting diuresis.It is confirmed that the main etiology and pathogenesis of heart failure is deficiency-excess complex and deficiency in origin with excess in superficislity.The deficiency is mainly Qi deficiency and yang deficiency,and the excess is mainly blood stasis,retained fluid and phlegm turbidity.