基于中医传承辅助系统分析舒兰治疗儿童抽动障碍用药规律

Medication rule of Shu Lan in treatment of childhood tic disorder:A study based on the Traditional Chinese Medicine Inheritance Support System

目的:基于中医传承辅助系统分析舒兰教授治疗儿童抽动障碍的用药规律。方法:收集2020年7月至2021年7月在湖南中医药大学第一附属医院国医堂门诊经舒教授诊治的儿童抽动障碍的中药处方,采用中医传承辅助系统(V2.5)建立数据库,基于药物频数统计、规则分析和熵聚类等算法,总结药物的频次、性味、归经、药对组合、新方组合,分析舒教授治疗儿童抽动障碍的用药经验。结果:获得处方237首,涉及中药145味。频次>30次的药物30味,其中排前10位的依次为:甘草、鸡内金、蝉蜕、钩藤、白芍、桔梗、辛夷、木瓜、射干、苍术,药性以寒、平、温为主,药味以甘、辛、苦为主,排前4位的归经分别是肝、肺、脾、胃经。获得常用药物组合52组,核心药物组合18组,新处方9首。结论:舒教授认为五脏均能致抽,临证需在辨明五脏致病主次及核心病机的基础上再根据患儿症状之主次灵活加减用药治疗。

Objective: To investigate medication rule of Professor Shu Lan in the treatment of childhood tic disorder based on the Traditional Chinese Medicine Inheritance Support System.Methods: Traditional Chinese medicine(TCM) prescriptions were collected from the children with tic disorder who were diagnosed and treated by Professor Shu Lan in The First Affiliated Hospital of Hunan University of Chinese Medicine from July 2020 to July 2021,and a database was established by the Traditional Chinese Medicine Inheritance Support System(V2.5).The algorithms including drug frequency statistics, rule analysis, and entropy clustering were performed to summarize drug frequency, nature/flavor, meridian entry, drug combination, and new prescription combinations and analyze the medication experience of Professor Shu Lan in the treatment of tic disorder in children.Results: A total of 237 prescriptions were obtained, which involved 145 herbs.There were 30 herbs with a frequency of >30,and the top 10 herbs in terms of frequency were Radix Glycyrrhizae, Chicken’s Gizzard-membrane, cicada slough, uncaria, Radix Paeoniae Alba, Platycodon grandiflorus, Flos Magnoliae, Chaenomeles sinensis, blackberry lily rhizome, and Rhizoma Atractylodis.Most herbs were cold, neutral or warm in nature and had a sweet, pungent or bitter flavor, and in terms of meridian entry, most herbs entered the liver, pulmonary, spleen, and stomach meridians.A total of 52 combinations of commonly used herbs, 18 combinations of core herbs, and 9 new prescriptions were obtained.Conclusion: Professor Shu believes that all five viscera can cause tics, and in clinical practice, modified prescriptions can be given based on the symptoms of children after clarifying the role of five viscera and the core pathogenesis.