基于数据挖掘探讨徐经世膏方调治不寐病的用药规律

Discussion on XU Jing-shi's Medication Rule of Herbal Paste in Treatment of Insomnia Based on Data Mining

目的:探讨国医大师徐经世运用膏方治疗不寐病的处方用药规律。方法:通过本院临床病历数据处理系统搜集徐经世2013年12月至2021年1月膏方处方121首,应用复杂网络分析等数据挖掘方法,对不寐病患者年龄、性别、中医证型、药物类别、性味归经、使用频次及核心处方进行分析。结果:患者年龄以41~60岁最为多见,中医证型以肝郁脾虚、肝肾阴虚为主,药物类别以补阴药最多,归经以入肝经最多,其次为心经,性味以平甘为主。使用频次超过50%的药物有酸枣仁、甘草、远志、白芍、石斛、竹茹、女贞子、龟甲胶、黄连、杜仲,复杂网络图显示酸枣仁、远志、石斛、白芍、甘草、竹茹、天麻、女贞子等22味为核心处方,核心药物为酸枣仁和远志,根据聚类图并结合临床实际形成4个聚类方。结论:本研究显示徐经世认为不寐病致因在郁,病位在肝,治从肝论,从肝养心,膏方调补以甘淡平补、双向调节、以平为期为组方原则。

Objective:To discuss the prescription pattern of TCM herbal paste prescriptions for the treatment of Insomnia by Xu Jingshi,a national medical master,through data mining techniques.Methods:121prescriptions of XU Jing-shi's herbal paste prescriptions from December 2013 to January 2021 were collected,data mining was applied with complex network analysis.We analyzed the age,gender,TCM syndromes,types of herbal medicines and their properties,frequency of each herb,and the core prescriptions for treatingInsomnia.Results:Majority of the patients were aged between 41 to 60 years,and the frequency analysis of TCM syndrome showed that liver-depression spleen-deficiency and liver-kidney Yindeficiency were predominant.We found that the primary drug category was nourishing-Yin drugs.The meridian tropism of drugs mainly lied in liver and heart.Most of the drugs’nature is plain and the flavor is sweet.Ziziphi Spinosae Semen,Glycyrrhizae Radix et Rhizoma,Polygalae Radix,Paeoniae Radix Alba,Dendrobii Caulis,Bambusae caulis in Taenias,Ligustri Lucidi Fructus,Testudinis Carapacis et Plastri Colla,Coptidis Rhizoma,and Eucommiae Cortex were used in more than 50%prescriptions.The complex network analysis showed that Ziziphi Spinosae Semen,Polygalae Radix,Dendrobii Caulis,Paeoniae Radix Alba,Glycyrrhizae Radix et Rhizoma,Bambusae caulis in Taenias,Gastrodiae Rhizoma,Ligustri Lucidi Fructusand other 14 durgs,22 in total,were the core composition.The core drugs were Ziziphi Spinosae Semen and Polygalae Radix,and four clusters wereestablished.Conclusions:This study showed that the cause of Insomnia is liver depression,XU Jing-shi's herbal paste formula for treating Insomnia is based on relieving liver depression and nourishing heart.The principle of the formula were mild nourishing and two-way regulation with the goal of keeping balance.