《石室秘录》从肾论治方药规律分析

Analysis on the Law of Treating Prescriptions and Drugs from Kidney in Secret Records of Stone Chamber

目的:研究医家陈士铎《石室秘录》中从肾论治组方的用药规律,为从肾论治疾病的临床运用与药物研发提供参考。方法:利用软件IBM SPSS Statistics(ISS)23、R Language(RL)等对《石室秘录》中的涉及从肾论治相关的方剂药物信息进行描述性分析、因子分析与聚类分析。结果:《石室秘录》从肾论治方中使用频数频率较高的药物共有31味,其中使用频率居前的有熟地黄、麦冬、人参、山茱萸、白术、五味子、茯苓与肉桂等;用药主要涉及11个药类,以补虚药、收涩药、利水渗湿药、温里药、清热药与化痰止咳平喘药等排名居前,累计频率可达72.97%;药味以甘、苦、辛味使用最频繁,药性中以温、寒、平三者为多;药物归经中,以肾经居首位,肺经与脾经居第二与第三位;药物来源基本都是植物,以根及根茎类为排名第一,频率为48.83%,果实及种子类居其次,频率为18.99%;因子分析共得出10个公因子,聚类分析出5个从肾论治新方。结论:《石室秘录》从肾论治组方注重以五行论治,金水互用,水火既济。金水互用使肺肾通调以利水渗湿;水火既济以交通心肾,安神益精。且重视从阴阳论理组方,专治肾阴,补敛固精,甘温补阳,兼治脾肾。

Objective:To study the medication law of prescriptions based on kidney in the Secret Records of Stone Chamber by physician Chen Shiduo,so as to provide necessary reference for clinical application and drug research and development of diseases based on kidney.Methods:IBM SPSS statistics(ISS)23software and R language(RL)software were used to carry out descriptive analysis,factor analysis and cluster analysis on the information of prescriptions and drugs related to treatment from kidney in Secret Records of Stone Chamber.Results:There were 31frequently used drugs in the prescription of kidney treatment in the secret record of stone chamber,among which the most frequently used drugs were Rehmannia glutinosa,Ophiopogon japonicus,ginseng,Cornus officinalis,Atractylodes macrocephala,Schisandra chinensis,Poria cocos and cinnamon.Drug use mainly involves 11categories of drugs,with the cumulative frequency of 72.97%.Sweet,bitter and pungent taste are the most frequently used drugs,and most of the drugs are warm,cold and flat.Among the drug meridians,the kidney meridians ranked first,the lung meridians and the spleen meridians ranked second and third.The drug sources are basically plants,with roots and rhizomes ranking first,with a frequency of 48.83%,followed by fruits and seeds,with a frequency of 18.99%.Ten common factors were obtained by factor analysis,and five new prescriptions were obtained by cluster analysis.Conclusion:The Secret Records of Stone Chamber is based on the treatment of kidney,focusing on the treatment of five elements,the mutual use of gold and water,and the combination of water and fire.The mutual use of gold and water makes the lung and kidney regulate to facilitate water infiltration and dampness;Water and fire not only help to communicate with the heart and kidney,but also calm the mind and benefit the essence.And pay attention to the formulation based on the theory of yin and Yang,specializing in the treatment of kidney yin,tonifying and consolidating essence,warming and tonifying yang,as well as the treatment of spleen and kidney.