清代名医陈念祖“重视气血”治疗月经病用药规律及特点研究

A Study on the Medication Rules and Characteristics of CHEN Nianzu——A Famous Doctor of Qing Dynasty Who “Emphasized Qi and Blood” in the Treatment of Menstrual Diseases

[目的]探讨研究陈念祖治疗月经病的用药规律及特点。[方法]收集陈氏《女科要旨》《南雅堂医案》《医学从众录》中治疗月经病的处方81首,构建处方数据库。运用Excel 2010与SPSS Statistics 26.0软件对高频药物进行频数和聚类分析,并结合理论分析,提炼出陈氏治疗月经病的用药规律及特点。[结果]收集的81首处方中,涉及药物共121味。≥6次的高频药物共32味,使用频数排前3位的是当归、白芍、茯苓。高频药物种类以补血药、补气药为主;四气以温性为首;五味以甘、苦、辛为主;归经以脾经为首,肝经次之,心经再次。聚类分析得出5组核心药组,涉及归脾汤、六君子汤、越鞠丸等方剂。用药特点:使气血化生而调和脾胃,畅气血运行而疏理心肝,守气血循经而调理冲任。[结论]陈氏治疗月经病以气血为核心,调和脾胃气血、调畅心肝气机、调理冲任气血,多运用补血药、补气药、理气药。

[Objective] To explore the medication rules and characteristics of CHEN Nianzu’s treatment of menstrual diseases. [Methods]Total 81 prescriptions for the treatment of menstrual diseases in Female Subjects Essentials, Nanyatang Medical Case and Medical Conformity Record were collected, and the prescription database was constructed. Excel 2010 and SPSS Statistics 26.0 software were used for frequency and system cluster analysis of high-frequency drugs, combined with theoretical analysis. The rules and characteristics of CHEN’s treatment of menstrual diseases were extracted. [Results] Among the 81 prescriptions collected, 121 drugs met the criteria,including 32 high frequency drugs ≥6 times, and the top 3 were Angelica Sinensis, Paeonia Lactiflora and Poria Cocos. In the highfrequency drugs, blood tonic drugs and Qi tonic drugs were the main part. The four properties were led by warm;the five tastes were mainly sweet, bitter and spicy. The Spleen meridian was the first, the Liver meridian was the second, and the Heart meridian was the third. Five core drug groups were obtained by systematic cluster analysis, including Guipi Decoction, Liujunzi Decoction and Yueju Pill. The characteristics of CHEN’s treatment of menstrual diseases included regulating the spleen and stomach by transforming Qi and blood,smoothing Qi and blood movement and regulating the heart and liver, keeping Qi and blood circulation and regulating Chongren.[Conclusion] CHEN’s treatment of menstrual diseases takes Qi and blood as the core, reconciling Qi and blood of the spleen and stomach,regulating Qi movement of the heart and liver, regulating Qi and blood of Chongren, and using blood tonic drugs, Qi tonic drugs and Qi regulating drugs.