含杜仲古今方剂的对比研究

Comparative Study on Ancient and Modern Prescriptions Containing Eucommia ulmoides

目的:对比含杜仲古今方剂配伍药材的性味归经及配伍规律,为杜仲的现代临床应用提供理论依据。方法:检索《中医方剂大词典》筛选含杜仲的古代方剂;在中国知网、万方数据、维普网中检索2000年1月至2020年1月发表的现代临床研究中含杜仲的方剂。采用频次统计、Apriori算法等数据挖掘方法,对含杜仲古今方剂的主治疾病和涉及药材的使用频次、种类、性味归经及配伍规律进行分析。结果:共纳入含杜仲古方84首、今方188首。古方主要用于治疗腰痛、虚病、胎动不安等疾病;今方主要用于治疗骨关节病(以腰椎间盘突出症为主)、妇产科疾病、心脑血管疾病等。古方中与杜仲配伍的高频药材为肉桂、当归、牛膝等,大多为补虚药、祛风湿药、清热药;配伍药材药性以温热性为主,归经多为肾、肝经,药味以甘、辛味为主。今方中与杜仲配伍的高频药材为当归、甘草、熟地黄等,大多为补虚药、祛风湿药、活血化瘀药;配伍药材药性以温热性为主,归经多为肝、肾经,药味以苦、辛味为主。对高频药材进行的Apriori关联规则分析结果显示,古方共获得核心药材组合10条,包含8个三阶关联规则、2个四阶关联规则;今方共获得核心药材组合11条,包含3个三阶关联规则、8个四阶关联规则。结论:含杜仲的古今方剂均主要用于治疗腰部疾病,其次为妇产科疾病,此外,今方还可用于治疗心脑血管疾病。古方主要以温补为主,而今方在补虚的基础上更多地配伍了祛风湿药和活血化瘀药;古方的配伍药材多归肾、肝经,以甘、辛味为主,今方的配伍药材多归肝经,且更多地配伍了苦味药材。

OBJECTIVE:To compare the meridian tropism of compatible herbs and compatibility rules of ancient and modern prescriptions containing Eucommia ulmoides,and to provide theoretical basis for modern clinical application of E.ulmoides.METHODS:Ancient prescriptions containing E.ulmoides were screened from Dictionary of TCM Prescription.The prescriptions containing E.ulmoides were screened from clinical trials which published in CNKI,Wanfang database and VIP during Jan.2000 to Jan.2020.Data mining methods such as frequency statistics and Apriori algorithm were used to analyze the main diseases of ancient and modern prescriptions containing E.ulmoides and the use frequency,types,meridian tropism and compatibility rules of medical materials.RESULTS:A total of 84 ancient prescriptions and 188 modern prescriptions of E.ulmoides were included.Ancient prescriptions were mainly used to treat diseases such as back pain,deficiency,threatened abortion.Modern prescriptions were mainly used to treat osteoarthropathy(mainly lumbar intervertebral disc herniation),gynecological diseases,cardiovascular diseases.Cinnamomum cassia,Angelica sinensis and Achyranthes bidentatawerethe were the high-frequency compatible herbs in ancient prescriptions with E.ulmoides,and were tonifying medicine,dispelling wind and dampness medicine and clearing heat medicine;compatible herbs were mainly of warm property,and the channel tropism was mostly kidney meridian and liver meridian;the five tastes of compatible herbs were mainly sweet and spicy.A.sinensis,Glycyrrhiza uralensis and Rehmanniae Radix Praeparata were the high-frequency compatible herbs in modern prescriptions with E.ulmoides,and were mainly tonic medicine,anti-rheumatic medicine,medicine for promoting blood circulation and removing blood stasis;compatible herbs were mainly of warm property,and the channel tropism was mostly liver meridian and kidney meridian;the five tastes of medicine were mainly bitter and spicy.By analyzing the Apriori association rules of high-frequency herbs,a total of 10 core herbs combinations were obtained in ancient prescriptions,including 8 third-order association rules and 2 fourth-order association rules;a total of 11 core herbs combinations were obtained in modern prescriptions,including 3 third-order association rules and 8 fourth-order association rules.CONCLUSIONS:Ancient and modern prescriptions containing E.ulmoidesare mainly used to treat lumbar disease,followed by obstetrics and gynecology diseases.In addition,the modern prescriptions can also be used for the treatment of cardiovascular and cerebrovascular diseases.The ancient prescriptions mainly focus on warming and tonifying,while the modern prescriptions are more compatible with medicine for dispelling wind and dampness and medicine for promoting blood circulation and removing blood stasis on the basis of tonifying deficiency;most of the medicines in ancient prescriptions contribute in kidney and liver meridians,mainly sweet and pungent,while most of the medicines in modern prescriptions contribute in liver meridian,and are more compatible with bitter medicines.