名老中医治疗荨麻疹的临床用药经验研究

A study on the clinical experience of famous veteran TCM practitioner in treating urticaria

目的:基于近现代名老中医医案,探讨中药治疗荨麻疹的用药特点及组方规律,为临床处方优化提供新思路。方法:筛选辽宁中医药大学图书馆58位近现代名老中医治疗荨麻疹的完整医案共101例,选取101首处方对其进行频次、关联规则和聚类结果的分析。结果:在治疗荨麻疹的101首处方中共载入205味中药,用药总频次达1263次,当用药频率>20%时出现的高频药物有25味,其中居前十位的药物依次为防风、甘草、赤芍、蝉蜕、白鲜皮、地黄、当归、地肤子、牡丹皮、荆芥。名列前位的药物功效分类是发散风寒药、清热凉血药、补气药、补血药、发散风热药、清热燥湿药、清热解毒药等。所使用药味以甘、辛、苦为主;药性以寒性、温性为主;常用药物主归肝、脾、肺经。经此次分析可得出18条药物组合关联规则结果。聚类分析得出5类,类1:白术、黄芪、防风、桂枝、生姜、白芍、甘草;类2:何首乌、柴胡、荆芥、川芎、蝉蜕、当归;类3:苦参、苍术、地肤子、浮萍;类4:连翘、金银花;类5:赤芍、白鲜皮、地黄、牡丹皮、蒺藜、麻黄。结论:通过数据分析得出近现代名老中医治疗荨麻疹以疏风解表、清热凉血、清热解毒、燥湿止痒、益气养血为主,兼顾解表与清里,补虚以固本。

Objective:Based on the medical records of famous veteran TCM practitioners in modern times,the medication characteristics and prescription rules of TCM medicine on urticaria were explored to provide new ideas for the optimization of clinical prescriptions.Methods:A total of 101 complete medical records of urticaria from 58 well-known modern TCM practitioners were obtained after screening.It was analyzed that the frequency,association rules and clustering results of 101 prescriptions from the 101 medical records.Results:A total of 205 TCM medicines were included in 101 prescriptions for urticaria,and the total used frequency was 1263 times.When the used frequency was more than 20%,there were 25 high-frequency medicines,among which the top ten medicines were Fangfeng(Radix Saposhnikoviae),Gancao(Radix et Rhizoma Glycyrrhizae),Chishao(Radix paeoniae rubra),Chantui(Periostracum Cicadae),Baixianpi(Cortex dictamni),Dihuang(Radix Rehmanniae),Danggui(Radix Angelicae sinensis),Difuzi(Fructus kochiae),Mudanpi(Cortex Moutan)and Jingjie(Herba Schizonepetae).The top medicine efficacy categories were wind-cold dispelling medicines,heat-clearing and blood-cooling medicines,Qi(气)-tonifying medicines,blood-tonifying medicines,wind-heat dispelling medicines,heat-clearing and dampness-excreting medicines,heat-clearing and detoxification medicines,etc..The medicinal flavors were mainly sweet,pungent and bitter.The medicinal properties were mainly cold and warm.The meridian tropism of commonly used medicines were mainly liver,spleen and lung meridians.The results of this analysis gained 18 medicine combination association rules.The cluster analysis showed that there were 5 categories.Category 1:Baizhu(Rhizoma Atractylodis Macrocephalae),Huangqi(Radix Astragali),Fangfeng,Guizhi(Ramulus cinnamomi),Shengjiang(Rhizoma Zingiberis Recens),Baishao(Radix paeoniae alba),and Gancao.Class 2:Heshouwu(Radix Polygoni Multiflori),Chaihu(Radix Bupleuri),Jingjie,Chuanxiong(Rhizoma Chuanxiong),Chantui,and Danggui.Class 3:Kushen(Radix sophorae flavescentis),Cangzhu(Rhizoma Atractylodis),Difuzi,and Fuping(Herbe Spizodelae).Class 4:Lianqiao(Fructus Forsythiae),and Jinyinhua(Lonicerae Japonicae Flos).Class 5:Chishao,Baixianpi,Dihuang,Mudanpi,Jili(Tribulus terrestris),and Mahuang(Herba Ephedrae).Conclusion:Through data analysis,it can be concluded that the treatment methods of urticaria by famous veteran TCM practitioners in modern times mainly include dispelling wind and relieving exterior syndrome,clearing away heat and cooling blood,clearing away heat and toxic materials,excreting dampness and relieving itching,and benefiting Qi and nourishing blood,thereby treating both exterior syndrome and clearing away interior syndrome,supplemented by reinforcing deficiency to strengthen the foundation.