《二续名医类案》成人与小儿泄泻治疗处方用药特点比较分析

Comparison of the characteristics of medication fordiarrhea between adult and child in Erxu Mingyi Lei’an

目的比较分析《二续名医类案》收录医案治疗成人和小儿泄泻的用药规律。方法收集《二续名医类案》中药内服治疗成人与小儿泄泻的处方,采用古今医案云平台(V 2.1)进行药物使用频次统计、关联规则分析、药对分析、功效统计、药物性味归经统计、聚类分析等,并比较分析成人与小儿处方用药特点的异同。结果纳入中医治疗成人泄泻处方456首,涉及药物360种,频次排名前5位为茯苓、白术、陈皮、白芍、木香,常用药对有白术-茯苓、陈皮-茯苓、陈皮-白术、白芍-白术,核心药物为陈皮、白术、茯苓。中医治疗小儿泄泻处方111首,涉及药物180种,频次排名前5位为白术、茯苓、白芍、生甘草、荷叶,常用药对有茯苓-白术、白术-炙甘草、附子-白术,核心药物为白术、茯苓、附子。中医治疗成人与小儿泄泻用药均以温性为主,药味均以甘为多,归经均以脾经为主,其次为胃经、肺经。成人使用炭类药多于小儿。结论《二续名医类案》中,中医治疗成人与小儿泄泻用药均以补气药为主,其次为利水渗湿药;在健脾化湿基础上,成人常配燥湿健脾、芳香化湿、淡渗利湿之药,小儿常配升阳温阳、消导利湿之药。治疗成人泄泻可活用多种炭类药,而治疗小儿时则需慎用。

ed,involving 360 drugs,and the top 5 drugs were Poria,Atractylodis Macrocephalae Rhizoma,Citri Reticulatae Pericarpium,Paeoniae Radix Alba and Aucklandiae Radix.The Atractylodis Macrocephalae Rhizoma paired with Poria,Citri Reticulatae Pericarpium with Poria,Citri Reticulatae Pericarpium with Atractylodis Macrocephalae Rhizoma,and Paeoniae Radix Alba with Atractylodis Macrocephalae Rhizoma were commonly used in the treatment of adult diarrhea.Citri Reticulatae Pericarpium,Atractylodis Macrocephalae Rhizoma and Poria were the core drugs for adult diarrhea.There were 111 prescriptions for pediatric diarrhea,involving 180 drugs,and the top 5 were Atractylodis Macrocephalae Rhizoma,Poria,Paeoniae Radix Alba,Glycyrrhizae Radix et Rhizoma,and Nelumbinis Folium.The Poria paired with Atractylodis Macrocephalae Rhizoma,Atractylodis Macrocephalae Rhizoma with Glycyrrhizae Radix et Rhizoma Praeparata Cum Melle,and Aconiti Lateralis Radix Praeparata with Atractylodis Macrocephalae Rhizoma were commonly used in the treatment of diarrhea in children.The Atractylodis Macrocephalae Rhizoma,Poria and Aconiti Lateralis Radix Praeparata were the core drugs for children diarrhea.The main charateristics of drugswas warm type,sweet taste,and the main meridian belongs to spleen,followed by stomach and lung meridians.The use of carbided drugs in adults were significantly higher than children.Conclusions The Erxu Mingyi Lei’an forcused the treatment of invigorating the spleen qi,where the adult formular often matches the drugs of drying dampness and invigorating the spleen,aromatizing dampness,slight infiltration and eliminating dampness,while the children formular often matches the drugs of warming the Yang and warming the Yang.Many kinds of carbonaceous drugs can be used in the treatment of adult diarrhea,but they should be used with caution in the treatment of children.