基于偏序结构和药性理论的“方-药-量-性”共性关联分析

Generic Association Analysis on "Prescription-Formula-Dosage-Property" of Tibetan Medicine Based on Partial Order Structure and Property Theory

目的:探索藏族医(简称藏医)"方-药-量-性"关系复杂而共性关联突出,难以揭示隐形特异性藏医药临床用药规律等科学问题的解决方法。方法:该研究基于属性偏序结构、"味性化味"矢量结构模型、聚类分析等方法,分析《中华人民共和国卫生部药品标准藏药(第一册)》收载184首藏医临床常用方剂的"方-药-量-性"关系。结果:方-药关系分析发现诃子、红花等11个最大共有属性组方,是分类配伍的关键组方,可以有效分类治疗隆病、赤巴病、血热病等8类方剂,在方剂中三果汤散、六味良药散等调节三因和辅助脏腑功能类组方药物的共有性最强。药-量关系分析发现,诃子、红花、石榴子、余甘子等用量最高,表明这些组方药物一般以君药形式入药,而豆蔻、草果等六味良药散组方药物虽频次较高,但剂量较低,主要起着调节方剂整体药性和保护脏腑的作用,而麝香、牛黄、渣驯等藏医特效药物,频次虽高但剂量很低,具有增强药性,引药患处的作用。量-性关系分析发现属于凉性方剂较多,占75.6%,发现有67首方剂因其组方剂量不同而产生药性与功效不相符的现象。结论:藏医方剂中存在很多共性组方和共性用法,如不对这些共性关联加以处理,会出现任何疾病均以这些共性关联为核心的结果,却无法解开隐性的关键因素。因此,在"方-药-量-性"等多维层面同时注重敏感性和特异性规律,才能更有效地揭示藏医临床用药思想。

Objective: In view of the complexity of the "Prescription-Formula-Dosage-Property" relationship of Tibetan medicine and the outstanding common relationship,it is difficult to reveal the hidden and specific rules of clinical medication of Tibetan medicine. Method: Based on the attribute partial order structure and the vector structure model of "Ro-Nus-Zhu-Rjes"(Taste,Post-Digestive Tastes and Potency),clustering analysis and other methods and software,this study analyzed the "Prescription-Formula-Dosage-Property" relationship of 184 commonly used prescriptions in the 1995 edition of the standards issued by the Ministry of Tibetan medicine(SIMTM). Result: Among them,the analysis of the relationship between prescription and formula found that 11 prescriptions with the largest common attribute,such as Chebulae Fructus and Carthami Flos,were the key components of classification and compatibility,which could effectively classify the 8 kinds of prescriptions for the treatment of lung disease,tripa disease and blood fever. Among them,the san Yin and auxiliary viscera function prescriptions,such as Sanguotang powder and Liuwei Liangyao powder,had the strongest commonality. According to the analysis of relationship between formula and dosage,the dosage of Chebulae Fructus,Carthami Flos,pomegranate seed,Phyllanthi Fructus was the highest,which suggested that these drugs were often used as primary drugs,while the Liuwei Liangyao powder,such as Amomi Fructus Rotundus and Tsaoko Fructus,had a higher frequency but a lower dose,which mainly played a role in regulating the overall drug property of the prescription and protecting the viscera. The Tibetan medicine-specific drugs including Moschus,Bovis Calculus,and Zhaxun,which were used in a high frequency but very low dose,had the effect of enhancing the drug property and guiding the affected part. According to the analysis of the relationship between dosage and property,there were many prescriptions belonging to cool nature,accounting for 75.6%. It was found that 67 prescriptions did not conform to the efficacy due to their different dosage. Conclusion:There are many common components and common usages in Tibetan medicine prescriptions. If these common associations are not treated,it will lead to the result that all diseases take these common associations as the core,but the hidden key factors cannot be solved. Therefore,it is necessary to pay attention to sensitivity and specificity at the multi-dimensional level of "prescription-formula-dosage-property",so as to reveal the clinical medication thought of Tibetan medicine more effectively.