《临证指南医案》治疗便秘用药规律

Medication Rules for Constipation in Case Records as a Guide to Clinical Practice

目的:分析《临证指南医案》治疗便秘处方的用药规律,总结叶天士治疗便秘的诊疗思路。方法:选取《临证指南医案》治疗便秘的医案,整理并建立数据库进行数据挖掘。结果:筛选并整理出37则便秘医案,共计46诊次,46个处方。频数分析得到32味高频中药,用药种类以补益药、清热药、化痰止咳平喘药、活血化瘀药为主。药物归经主要为肺经、肝经、胃经、脾经、肾经,其次为心经与大肠经。药味以甘、苦、辛为主;药性以寒、温、平为主。聚类分析得到5个聚类药组。结论:叶天士治疗便秘以润燥通塞、苦寒泄热、辛润开肺、行气活血化瘀等为治疗大法。

Objective:To analyze the medication rules of constipation formulas in Case Records as a Guide to Clinical Practice,and summarize Ye Tian-shi′s diagnosis and treatment ideas for constipation.Methods:The medical records of constipation treatment in Case Records as a Guide to Clinical Practice were selected,and the database was organized and established for data mining.Results:A total of 37 constipation cases were screened and sorted out,with 46 formulas for 46 times of diagnosis.According to the frequency analysis,32 high-frequency Chinese medicinals were obtained.The main types of medicinals used included tonic,heat-clearing ones,ones for resolving phlegm and relieving cough and calming asthma,and ones for promoting blood circulation and removing blood stasis.The medicinal channels mainly included the lung meridian,liver medicinal,stomach medicinal,spleen medicinal and kidney medicinal,followed by the heart medicinal and large intestine medicinal.The flavors of the medicinal were mainly sweet,bitter and pungent,and the properties were mainly cold,warm and mild.Five cluster medicinal groups were obtained by cluster analysis.Conclusion:In terms of constipation,Ye Tian-shi mainly adopts method of moistening dryness and unblocking obstruction,discharging heat with bitter and cold,dispersing and moistening lung with pungent,moving qi and activating blood circulation and removing blood stasis,etc.