基于数据挖掘分析小青龙汤的方证关系

Relationship between Formula and Syndrome of Xiaoqinglong Decoction(小青龙汤)Based on Data Mining

目的:基于500例医案分析小青龙汤的证治规律,探讨小青龙汤的方证关系,为现代临床运用提供参考。方法:检索选取符合纳入标准的500例小青龙汤医案,将医案中的症状及体征进行术语规范化处理,抽取医案信息建立Excel表,应用数据分析软件包R3.6.3对数据进行关联规则分析。结果:①500例小青龙汤医案中,男289例,女211例,性别之比约是1.3∶1;性别与发病无相关性;②发病季节以冬春为主,秋季次之,夏季最少;③主治疾病方面以喘证、咳嗽、肺胀、感冒、哮病、痹病等为主;④主要症状体征为咳嗽、白苔、痰质稀、喘、舌质淡、弦脉、脉滑、纳呆、腻苔等;⑤关联项集方面,支持度≥0.1,置信度≥0.5,提升度≥1.5的关联项集共有11项,主要为“白苔,恶寒,咳嗽→发热”“白苔,发热→恶寒”“恶寒,咳嗽→发热”“咳嗽,哮鸣→喘”等。结合频数和关联规则分析,可以认为小青龙汤的主要适应证候是:①舌象方面舌质以舌质淡、舌暗为主,苔象以白苔、腻苔为主;②脉象以弦脉、脉滑、脉浮、脉细为主;③主要症状体征以咳嗽、痰质稀、喘、纳呆、胸满、恶寒、发热、痰鸣音、浮肿、头痛、畏寒、哮鸣音、小便不利为主。结论:现代运用小青龙汤证的指征与《伤寒杂病论》原文基本一致,主治疾病广泛,在遵守病机的基础上可灵活使用。

Objective:To analyze the syndrome and treatment regularity of Xiaoqinglong Decoction(小青龙汤)based on 500 medical cases,and to explore the relationship between formula and syndrome of Xiaoqinglong Decoction,so as to provide reference for modern clinical application.Methods:Total 500 cases of Xiaoqinglong Decoction meeting inclusion criteria were searched,the symptoms and signs in the medical records were standardized,the medical record information was extracted to establish the Excel table,and the association rule analysis of data was analyzed by using software package R3.6.3.Results:①Among 500 cases of Xiaoqinglong Decoction,there were 289 males and 211 females,and the ratio of male to female was about 1.3∶1,gender has no effect on its incidence.②The onset season was mainly winter and spring,followed by autumn and the least in summer.③The main indicated diseases are dyspnea syndrome,cough,pulmonary distention,cold,wheezing,impediment disease,etc..④The main symptoms and signs were cough,white tongue coating,thin phlegm,dyspnea,light tongue,wiry pulse,slippery pulse,poor appetite,greasy tongue coating,etc..⑤In terms of related item set,there are 11 related item sets with support≥0.1,confidence≥0.5 and improvement≥1.5,mainly including“white tongue coating,aversion to cold,cough→fever”,“white tongue coating,fever→aversion to cold”,“aversion to cold,cough→fever”,“cough,wheezing→dyspnea”,etc.Combined with the analysis of frequency and association rules,it can be considered that the main indications of Xiaoqinglong Decoction are:①In terms of tongue manifestation,the tongue is mainly light and dark,and the tongue coating is mainly white and greasy;②Pulse conditions are mainly wiry pulse,slippery pulse,floating pulse and fine pulse;③The main symptoms and signs are cough,thin phlegm,dyspnea,poor appetite,chest fullness,aversion to cold,fever,wheezing with phlegm,edema,headache,chills,wheezing and dysuria.Conclusions:The indications of Xiaoqinglong Decoction in modern application are basically consistent with the original text in Treatise on Cold Pathogenic and Miscellaneous Diseases.It is flexibly used to treat a wide range of diseases based on the pathogenesis.