基于数据挖掘的《医宗必读》内科疾病用药规律分析

Analysis on Composition Principles of “Yizong Bidu ” Based on Data Mining

[目的]基于数据挖掘分析李中梓《医宗必读》的内科疾病用药规律,指导临床用药。[方法]收集并整理《医宗必读》中治疗内科疾病的方剂,采用中医传承辅助平台软件(V2.5),对药物频次、性味归经频次、方剂频次、常用药对频次进行描述性分析,并对常用药对、核心药物组合进行关联规则Apriori算法分析和复杂网络化分析。[结果]共纳入方剂450首,关联药物350味。使用频次≥40的药物共19味,排序前10的药物分别为茯苓、人参、炙甘草、甘草、白术、陈皮、当归、肉桂、半夏、黄芪,其中温里药类药物使用频次最高的为肉桂。药物四气以温为主,五味以辛、苦、甘为主,药物归经主要是归脾经。使用频次≥5的方剂共16首;使用频次≥20的药对共50个,其中使用频次最高的为人参-茯苓。复杂网络化分析显示,核心药物组合为人参、甘草、白术、茯苓、陈皮。[结论]李中梓辨治内科疾病,重视温补、慎用攻伐,注重脾肾、尤重脾胃,以异功散为核心基本方。这些用药特点,不仅反映了其"阴阳宜协调,尤以阳为重""肾为先天本,脾为后天本"和"先天后天并重"的学术思想,也为今后内科疾病的临床治疗提供了诊疗思路。

[Objective] To analyze the composition principles of "Yizong Bidu"based on data mining,in order to instruct clinical administration.[Methods]Prescriptions recorded in "Yizong Bidu"were collected,based on the Traditional Chinese Medicine Inheritance System(TCMISS) Version 2.5,the descriptive analysis of the frequency of herb used,the frequency of the herb nature and taste,the frequency of herb meridian tropism,the frequency of prescriptions,and the frequency of medicine pairs were carried out,and the Apriori algorithm analysis and complex network analysis of the association rules of commonly used medicine pairs and core medicine combinations were carried out.[Results] In total,450 prescriptions were enrolled,involved 350 herbs. There were 19 herbs with frequency more than 40,and the top 10 were Poria cocos,Radix ginseng,Radix glycyrrhizae preparata,Radix glycyrrhizae,Rhizoma atractylodis macrocephalae,Pericarpium citri reticulatae,Radix angelicae sinensis,Cortex cinnamomi,Rhizoma pinelliae,Radix astragali,the most frequently used single herb was Cortex cinnamomi in interior-warming herbs. The herb natures were mainly warm;flavors were mainly pungent, bitter and sweet;the highest frequency of meridian tropism was splee. There were 16 prescriptions with frequency larger than 5,50 herb pairs with frequency larger than 20,and the most common herb pair was Radix ginseng-Poria cocos. Complex network analysis showed Radix ginseng,Radix glycyrrhizae,Rhizoma atractylodis macrocephalae,Poria cocos,Pericarpium citri reticulatae,were the core combinations of herbs. [Conclusion] LI Zhongzi paid attention to warming and tonifying and cautiously using attacking herbs;he focused on the spleen and kidney,especially the spleen and stomach;and took Yigong powder as the core basic prescription. These treatment views not only reflect his academic ideas of "Yin and Yang should be coordinated,especially Yang""kidney is the foundation of congenital,spleen is the root of acquired constitution",and "both congenital and acquired are important",but also provide diagnosis and treatment ideas for future clinical treatment.