基于医案数据挖掘探讨《金匮要略》乌头汤的应用规律

Application Rule Analysis of Synopsis of Golden Chamber Wutou Decoction Based on Data Mining of Medical Cases

目的:探讨现代医家运用乌头汤治疗杂病的思路。方法:检索中国知网、万方数据知识服务平台、维普数据库和中国生物医学文献数据库,获取应用乌头汤的医案并建立数据库,并用SPSS Statistics软件对医案数据进行挖掘。结果:共检索到乌头汤医案165个,疾病诊断涉及诸多慢性病种,其中绝大部分为经络肢体病证。证候诊断中寒湿阻滞证占比最多,四诊统计结果显示多数患者的主诉与疼痛相关,淡白舌、薄白苔和弦脉是出现频次最多的舌脉记录。乌头汤原方中最常被删减的药物是蜂蜜,高频辅助用药共有20种,聚类分析发现高频辅助药物中的6个潜在药对组合,相关分析发现川乌和白芍的剂量可能会影响川乌先煎时长。结论:本研究应用数据挖掘分析的乌头汤应用规律,为临床医师合理应用乌头汤提供方证对应和加减用药的参考。

Objective:To analyze and explore the thinking way of modern physicians in the treatment of miscellaneous diseases with Wutou decoction.Methods:China National Knowledge Internet,Wanfang Data Knowledge Service Platform,VIP Information Chinese Periodical Service Platform,and Chinese Biomedicine Literature Database were retrieved to obtain the medical cases of Wutou Decoction and establish the database.SPSS statistics software was used to mine the medical cases data.Results:A total of 165 qualified medical cases of Wutou Decoction were included,and the disease diagnosis involved many kinds of chronic diseases,most of which were meridian and limb diseases.Cold-dampness blocking accounts for the largest proportion in the syndrome diagnoses.The statistical results of four diagnostic parameters show that the chief complaints of most patients were related to pain.Pale tongue,thin and white coating,taut pulse were the most frequent tongue-pulse records.Fengmi is the most frequently deleted herb in the original prescription of Wutou Decoction,and there are 20 high-frequency adjuvant herbs.Six potential couplet medicines were identified by cluster analysis of high-frequency adjuvant herbs.The results of multiple linear regression analysis suggested that the dosage of Chuanwu and Baishao might be the factors affecting the decoction time of Chuanwu.Conclusion:This study explored the application rules of Wutou Decoction in relevant medical cases by data mining method,and provided a reference for clinical physicians to apply Wutou Decoction rationally.