基于数据挖掘王肯堂辨治头痛组方用药规律研究

Research on the medication rule of TCM master WANG Kentang’s prescription for treating headache based on data mining

目的:对《王肯堂医学全书》中关于王肯堂诊治头痛病证的方药进行数据分析,为现代中医临床诊治头痛病证提供参考。方法:收集《王肯堂医学全书》中王肯堂治疗头痛疾病的文献,构建临证方药数据库,运用IBM SPSS Modeler 18.0和SPSS Statistics 26.0软件对其药物的使用频数、药物功效、性味归经等进行统计分析。结果:根据纳入及排除标准进行清洗,最终符合条件的方剂共计66首,包括中药120味,用药总频数共计472次。数据结果显示,王氏辨治头痛高频常用药物中,川芎使用频数最高,细辛和防风位居其后;药物功效使用位于前三的依次为解表药、清热药和补虚药;药性以温性药使用频率最高,药味则多选用辛、苦、甘味;按药物归经划分,使用频率最高的为归脾经和肺经药,其次为归肝经药。通过中药复杂网络进行模块化等级分析,得到4个药物组合,可见补中益气汤结构、麻黄附子细辛汤结构等。高频药物聚类分析得到“川芎茶调散”类似方,“补中益气汤”类似方,“麻黄附子细辛汤”结构,这与中药复杂网络分析具有一致性;因子分析可得到7个公因子,其中因子贡献率最高的为F1:柴胡、黄芪、升麻。结论:王氏治疗头痛多从风、痰、虚论治,以风痛居多,善用风药,清窍止痛;补脾养肝,调畅气机,养血和血,升阳补气,充养脑窍;组方思路多以解表透邪、清热化痰、补虚温中,调理气血等为主。

Objective:Data analysis was carried out on the prescriptions of TCM master WANG Kentang for diagnosing and treating headache syndrome in WANG Kentang Yixue Quanshu(《王肯堂医学全书》)to provide a reference for the clinical diagnosis and treatment of headache syndrome in modern TCM.Methods:The prescriptions treating headache were selected from WANG Kentang Yixue Quanshu to construct the database of clinical prescriptions and medicines.The data of the frequency and efficacy of medicinals,the proprty,flavor and meridim tropism were analyzed by SPSS statistics 26.0 and IBM SPSS Modeler 18.0 software.Results:According to the inclusion and exclusion crteria,a total of 66 prescriptions were included in the study,involving 120 traditional Chinese medicines.The total frequency of medication was 472 times.The data results showed that among the frequently used drugs for the treatment of headaches,Chuanxiong(Rhizoma Ligustici Chuanxiong)was most frequently used,followed by Xixin(Herba Asari)and Fangfeng(Radix Saposhnikoviae).The top three medicinals for efficacy are superficies-relieving medicines,heat-clearing medicines and tonify deficienccy medicines;warm medicinals are most frequently used,while medicinal tastes are mostly acrid,bitter and sweet;according to the meridian tropisms of the drug,medicines for the spleen and lung meridians are the most frequently used,followed by medicines for the liver meridian.Through the modular grade analysis of traditional Chinese medicine complex network,four drug combinations can be obtained,including the structure of the Buzhong Yiqi decoction(补中益气汤),the Mahuang Fuzi Xixin decoction(麻黄附子细辛汤),etc..The cluster analysis of high-frequency drugs obtained the similar formula of“Chuanxiong Cha Tiao San”(川芎茶调散),“the Buzhong Yiqi decoction”and“the Mahuang Fuzi Xixin decoction”.This is consistent with the complex network analysis of TCM medicine;seven common factors can be obtained by factor analysis,among which F1 has the highest contribution rate:Chaihu(Radix Bupleuri),Huangqi(Radix Astragali seu Hedysari),and Shengma(Rhizoma Cimicifugae).Conclusion:WANG’s treatment of headache is mainly based on the theory of wind,phlegm and deficiency,most of which are wind.He is good at using wind drugs to clear orifices and relieve pain,replenish spleen and liver,regulate Qi(气),nourish blood,raise Yang(阳)and replenish Qi,and replenish brain orifices;the main idea is to eliminate pathogenic factors,clear away heat and dissipate phlegm,supplement deficiency and warm heart,and regulate Qi and blood.