国医大师刘柏龄治疗脊髓型颈椎病用药规律探析

Analysis of the Medication Law of Traditional Chinese Medicine Master Liu Bailing in Treating Cervical Spondylotic Myelopathy

目的挖掘、分析国医大师刘柏龄治疗脊髓型颈椎病的用药特点及组方规律。方法收集120份符合纳入标准的刘柏龄教授治疗脊髓型颈椎病的验案,利用Epidata 3.0软件建立方药数据库,使用IBM SPSS Modeler 18.2软件中基于关联规则的Apriori算法,对处方中的中药及其分类的使用频次、中药之间的应用关系进行分析。结果纳入处方共涉及中药104味,其中使用频次较高的中药依次为黄芪、当归、附子、丹参、赤芍等,用药以补虚药、活血化瘀药、祛风湿药、平肝息风药为主,辅以解表、温里、化湿等药。在关联规则集中,在支持度20%和置信度90%的情况下分析得到二阶、三阶和四阶关联规则,核心药物群包括黄芪、当归、赤芍、附子、红花、桃仁、鸡血藤、地龙、川芎等。结论刘柏龄治疗脊髓型颈椎病用药具有补虚祛邪并重的鲜明特点,主要采取益气温里助阳、活血化瘀通络、补肾强骨、祛除风湿之邪的治疗原则。

Objective To explore and analyze the medicine characteristics and prescription law of the treatment of cervical spondylotic myelopathy by traditional Chinese medicine master Liu Bailing.Methods Totally 120 cases of professor Liu Bailing′s treatment of cervical spondylotic myelopathy that met the inclusion criteria were collected.Epidata 3.0 software was used to establish the prescription database,and Apriori algorithm based on association rules in IBM SPSS Modeler 18.2 software was used to analyze the usage frequency of traditional Chinese medicine and its classification in prescriptions and the application relationship between traditional Chinese medicine.Results A total of104 traditional Chinese medicines were included in the prescription,among which,Radix Astragali seu Hedysari,Angelicae Sinensis Radix,Aconiti Lateralis Radix Praeparata,Radix Salviae,Radix Paeoniae Rubra,etc.,were used in order of high frequency.The medicines were mainly tonic,blood-activating and stasis-resolving medicinal,wind-dampdispelling medicinal,liver-pacifying wind-extinguishing medicinal,supplemented by medicines such as exteriorreleasing medicinal,interior-warming medicinal,damp-resolving medicinal,etc.In the association rule set,the secondorder,third-order and fourth-order association rules were obtained under the condition of 20%support and 90%confidence,and the core herb group included Radix Astragali seu Hedysari,Radix Angelicae Sinensis,Radix Paeoniae Rubra,Aconiti Lateralis Radix Praeparata,Flos Carthami,Semen Persicae,Caulis Spatholobi,Lumbricus,Rhizoma Ligustici,etc.Conclusion The treatment of cervical spondylotic myelopathy by Liu Bailing has the distinct characteristics of paying equal attention to the tonic and eliminating pathogen,it mainly adopts the treatment principle of warming yang and replenishing qi,warming interior method,activating blood and resolving stasis and dredging collaterals,sinew-bonestrengthening kidney-yang tonic,and dispelling the evil of wind-damp.