《景岳全书·痞满》用药规律及特点探析

Exploration of Medication Regularities and Characteristics in Jing Yue’s Collected Works·Piman

目的:整理并总结《景岳全书·痞满》用药规律,以期为临床治疗本病提供文献学证据。方法:收集《景岳全书·痞满》中的全部方剂,对符合纳入标准的方剂进行统计,建立方药数据库,应用SPSS Statistics 26.0软件对方药进行描述性统计分析、高频药物聚类分析,运用SPSS Modeler 18.0软件进行关联规则分析,并绘制高频药物网络可视化图。结果:共获得治疗痞满的方剂43首,其中涉及中药68味,类别14类;药性以温、平、微温居多,药味以辛、甘、苦为主,归经集中于脾(胃)、肺、心;高频药物以补虚药、理气药、温里药为主;根据高频药物关联分析,挖掘出10对常用药对和7组常用药组;通过高频药物聚类分析得到3组常用核心组方。结论:张景岳论治本病注重四维,分别为:温脾阳,散阴滞;益脾气,护中焦;燥脾土,化痰湿;理气机,消宿食;核心用药为甘草、陈皮、白术、人参、茯苓、干姜、半夏;核心证型为痰湿蕴脾证,气滞食积证,中虚脏寒证;核心方剂为四君子汤、二陈汤、温胃饮。本研究结果可为临床治疗痞满提供借鉴。

Objective:To sort out and summarize the medication rule of Jing Yue’s Collected Works·Piman,aiming to provide documentary evidence for clinical treatment of Piman.Methods:All the prescriptions in Jing Yue’s Collected Works·Piman were collected,the prescriptions in accordance with the inclusion criteria were counted,the prescription database was established,the descriptive statistical analysis and high frequency herb cluster analysis were carried out by using SPSS 26.0 software,the association rules were analyzed by SPSS Modeler 18.0 software,and the visualization map of high frequency herb network was drawn.Results:A total of 43 prescriptions were obtained,including 68 herbs and 14 categories of Chinese medicinal;the properties of the medicinal were mainly warm,mild or slight warm,the flavors were mainly pungent,sweet or bitter,the medicinal channels mainly included Spleen meridian,Stomach meridian,Lung meridian and Heart meridian;high-frequency herbs were mainly those with the actions of deficiency-tonifying,Qi-regulating and interior-warming;according to the association analysis of high-frequency herbs,10 pairs of commonly used herbal pairs and 7 groups of commonly used herbal groups were obtained;3 groups of common core prescriptions were obtained by high frequency cluster analysis.Conclusion:ZHANG Jingyue paid attention to the four dimensions in the treatment of Piman,which were warming Spleen-Yang and dispersing Yin stagnation;tonifying Spleen and protecting middle energizer;drying Spleen soil and resolving phlegm-dampness;regulating Qi and digesting retained food;the core herbs were Licorice,Tangerine peel,Atractylodes macrocephala,Ginseng,Poria cocos,Dried ginger and Pinellia ternata;the core syndrome types were phlegm-dampness accumulation syndrome,Qi stagnation and food accumulation syndrome,Spleen deficiency and visceral cold syndrome;the core prescriptions were Sijunzi Decoction,Erchen Decoction and Wenwei Yin.The results of this study can provide reference for clinical treatment of Piman.