基于医案探讨王孟英辨治温热病处方用药规律

Exploring the Prescription Drug Rules of Wang Mengying for the Treatment of Febrile Diseases Based on the Medical Cases

目的运用数据挖掘技术研究分析王孟英治疗温热病的处方用药规律。方法从《重订王孟英医案》温热案中筛选出治疗温热病的有效方药,将所得数据进行规范化处理,构建王氏治疗温热病的处方用药数据库,运用Excel 2019进行药物频次统计,通过IBM SPSS Modeler 18.0中Apriori算法、IBM SPSS Statistics 22.0进行关联规则分析、聚类分析。结果从医案中筛选出处方116个,用药总频次1444次,涉及178味中药,频率≥10%(频次≥12次)的高频药物共41味,其中排名前5的高频药物依次为:竹茹(52次,44.83%)、栀子(47次,40.52%)、黄连(45次,38.79%)、知母(43次,37.07%)、玄参(40次,34.48%);高频药物药性以寒为主,药味以苦、甘居多,归经主要涉及肺、胃、心经;关联规则分析共得到59条药物组合,其中2味、3味、4味中药关联规则分别为11、36、12条;聚类分析得到9个聚类方。结论王孟英治疗温热病尤为注重温病传变规律,擅用经方,食药相合,以清热类方药为主,结合祛痰理气、滋阴凉血生津之法,同时兼顾肺胃,豁痰理气、斡旋气机以调其愆滞,使气顺、痰消、热去而诸症自和。

Objective To analyze the prescription drug rules of Wang Mengying for the treatment of febrile diseases by using data mining technology research.Methods We screened the effective prescription drugs for the treatment of febrile diseases from the Rewiring Wang Mengying’s Medical Cases,normalized the obtained data accordingly,and constructed a prescription drug database of Wang for the treatment of febrile diseases.The Excel2019 was used for drug frequency statistics.Association rule analysis and cluster analysis were performed through the Apriori algorithm in IBM SPSS modeler 18.0,IBM SPSS Statistics 22.0.Results A total of 116 prescriptions were selected from the medical cases and 1444 prescriptions were performed with a total frequency of 1444 times,involving 178 herbs with high frequency≥10%(frequency≥12 times)in a total of 41 herbs,of which the top 5 ranked high frequency medicines were in the following order:Caulis Bambusae in Taenia(52 times,44.83%),Fructus Gardeniae(47 times,40.52%),Rhizoma Coptidis(45 times,38.79%),Rhizoma Anemarrhenae(43 times,37.07%),Radix Scrophulariae(40 times,34.48%),and the high frequency medicines were cold in nature for the most part.The medicinal flavor was dominated by bitter and sweet,and the return to meridians mainly involved the lungs,stomach,and heart meridians.Association rule analysis resulted in a total of 59 drug combinations,including 11 association rules for 2 herbs,36 association rules for 3 herbs,and 12 association rules for 4 herbs.Cluster analysis can be divided into 9 cluster squares.Conclusion Wang Mengying paid special attention to the law of transmission and transformation of febrile disease.He was good at using classical prescriptions and combining food and medicine.He mainly used heat clearing prescriptions,combined with the methods of eliminating phlegm and regulating qi,nourishing yin,cooling blood and generating body fluid.At the same time,he also took into account the lung and stomach,dispelling phlegm and regulating qi,mediating qi mechanism to regulate its evil stagnation,making qi smooth,phlegm dissipated and heat removed.