张仲景治疗妇人病用药规律探究

Exploration on the medication rule for treatment of gynecological diseases by ZHANG Zhong-jing

目的:应用数据挖掘方法探索张仲景治疗妇人病的用药规律,为临床诊治提供参考。方法:以《金匮要略》为资料来源,筛选治疗妇人病的内服中药复方建立数据库,采用频次、关联规则、聚类分析等方法分析张仲景治疗妇人病的用药规律。结果:纳入方剂29首,共涉及中药61味;使用频次≥2的药物有白芍、甘草、桂枝、生姜、当归等24味;挖掘得到关联规则25项(2味药6项,3味药15项,4味药4项),高置信度规则有“川芎→白术”“桂枝→牡丹皮”“甘草→大枣”等。网络拓扑分析可得核心药物为甘草、桂枝、白芍、生姜、大枣。聚类分析可得9个聚类组合,其中有1个单味药物组,2组药对聚合组和6组多味药物聚合组。结论:张仲景治疗妇人病用药以甘、苦、辛味为主,多用益气、补血、温通、活血法,以脾胃为根本,配伍精妙,运用灵活,临证可加以优化借鉴。

Objective:To analyze the regularity of ZHANG Zhong-jing’s medicinal treatment for gynecological diseases using data mining,and provide references for clinical diagnosis and treatment.Methods:Using Jingui Yaolue as a data source,we screened the oral Chinese medicine compound for treating gynecological diseases to establish a database,and analyzed ZHANG Zhong-jing’s medication rules for treating gynecological diseases by frequency,association rules,and cluster analysis.Results:A total of 29 prescriptions were included,involving 61 traditional Chinese medicines;Drugs with frequency≥2 include 24 kinds such as Paeoniae Radix Alba,Glycyrrhizae Radix Et Rhizoma,Cinnamomi Ramulus,Zingiberis Rhizoma Recens and Angelicae Sinensis Radix.Mining 25 association rules(6 for 2 herbs,15 for 3 herbs and 4 for 4 herbs),and high confidence rules are‘Chuanxiong Rhizoma→Atractylodis Macrocephalae Rhizoma’,‘Cinnamomi Ramulus→Moutan Cortex’,‘Glycyrrhizae Radix Et Rhizoma→Jujubae Fructus’and so on.Network topology analysis shows that the core drugs are Glycyrrhizae Radix Et Rhizoma,Cinnamomi Ramulus,Paeoniae Radix Alba,Zingiberis Rhizoma Recens and Jujubae Fructus.Nine cluster combinations can be obtained by cluster analysis,including one single drug group,two drug pair polymerization groups and six multi-drug polymerization groups.Conclusion:ZHANG Zhong-jing’s medicinal treatment for treating gynecological diseases are mainly sweet,bitter,and pungent,and using the methods of replenishing qi,nourishing blood,warmly dredging and activating blood.The spleen and stomach are the foundation,the compatibility is exquisite,the application is flexible,and the clinical symptoms can be optimized for reference.