基于数据挖掘探析龙砂医学流派顾植山治疗慢性胃炎学术特色

Discussion and Analysis on Characteristics of Academic Thoughts of Famous Physician GU Zhishan of Longsha Medical School Treating Chronic Gastritis Based on Data Mining

目的:基于数据挖掘方法和运气理论探讨龙砂医学流派顾植山教授治疗慢性胃炎的用药规律和学术特色。方法:收集整理顾植山临床治疗慢性胃炎的有效医案,采用关联规则分析、改进的互信息法、复杂系统熵聚类等数据挖掘方法,分析医案处方的用药规律。结果:筛选得到295个处方,挖掘153条症状。用药的主要药性是温、寒、平,主要药味是甘、辛、苦,主要药物归脾、肺、胃、心、肝经。最核心药物为炙甘草、黄芪、白芍、茯苓、干姜。挖掘出30个核心药物组合,聚类分析得15个新处方。结论:慢性胃炎的临床症状特征与癸巳年"岁火不及,寒乃盛行"的运气格局相一致,"寒湿阻滞气机"是主因,基本治则是调肝、升脾、降肺、和胃。药物四气五味结果提示顾植山用药主以温升,辅以苦降的规律及重视运气格局,善用经方、三因司天运气方的学术特色。

Objective:To discuss administration rules and characteristics of academic thoughts of famous physician GU Zhishan in Longsha medical school treating chronic gastritis based on data mining and theory of circuit qi. Methods: The effective medical cases of GU Zhishan in clinical treatment of chronic gastritis were collected and sorted out. With the help of association rules analysis,modified mutual information method,complex system entropy clustering technique,and other data mining methods,the administration rules of prescriptions in those medical cases were analyzed. Results:A total of295 prescriptions were screened out,and 153 symptoms were found. The nature of most medicines was warm,cold,and neutral;the flavor of most medicines was sweet,acrid,and bitter;the meridian entry of most medicines was dominated by the spleen,lung,stomach,heart,and live meridians;the core medicines were Radix et Rhizoma Glycyrrhizae,Radix Astragali, Radix Paeoniae Alba, Poria, and Rhizoma Zingiberis. There were 30 core medicine combinations. A total of15 new prescriptions were obtained through cluster analysis. Conclusion:The characteristics of clinical symptoms of chronic gastritis is consistent with the pattern of circuit qi in Guisi year:“pathogenic cold is prevalent due to yang qi insufficiency”.The main cause of the disease is “cold-dampness obstructing qi movement”,and the basic therapeutic principles include regulating the liver,ascending of the spleen qi,descending of the lung qi,and harmonizing the stomach. According to the results of four qi and five flavors,the administration rules of GU Zhishan are summarized as following:the treatment mainly involve medicines with the warm nature and upward direction of medicinal action,assisted by medicines with bitter flavor and downward direction of medicinal action. Besides, the results indicate the characteristics of GU’s academic thoughts: he attaches great importance to the pattern of circuit qi,and makes good use of classical prescriptions,Sanyin Sitian circuit qi prescription.