基于中医传承辅助平台探讨胡凯文教授治疗肺结节用药规律

Medication Rules of Professor Hu Kaiwen in Treatment of Pulmonary Nodules Based on Traditional Chinese Medicine Inheritance Support System

目的借助中医传承辅助平台(V2.5)软件,研究胡凯文教授治疗肺结节的用药经验与组方规律,传承胡凯文教授临床诊疗肺结节的经验。方法收集并整理胡凯文教授2021年4月—2022年2月期间治疗肺结节的医案处方,通过中医传承辅助平台,录入肺结节相关治疗方剂,对处方中药物的性味、归经、应用频次、药对组合等进行统计、关联规则分析与新方发现。结果共收集胡凯文教授治疗肺结节医案51个,处方216则,中药133味,多为甘味,其次为辛味、苦味、酸味、涩味,末位为咸味;四气频次首位是温,其次为平、寒、热,末位为凉;归经则以脾经为主,其次为肝、肺、胃、心、肾经。使用单药频次最高的茯苓、生姜、黄芪、当归、半夏,高频对药为生姜-茯苓83次等;常用角药为生姜-竹茹-茯苓56次等。核心药物组合8组,新处方4组。结论胡凯文教授治疗肺结节重视五行生克规律的使用,培土生金、防木旺侮金、肺肾同治,重视疏肝健脾补肾,兼以治肺,同时化痰祛瘀,标本兼治,临床获效颇佳,临床诊疗时随病、证、症进行用药加减。

Objective To study Professor Hu Kaiwen′s medication experience and prescription rules in the treatment of pulmonary nodules with the help of the Traditional Chinese Medicine Inheritance Support System(TCMISS)(V2.5),thus inheriting Professor Hu Kaiwen′s experience in clinical diagnosis and treatment of pulmonary nodules.Methods The medical records of Professor Hu Kaiwen for the treatment of pulmonary nodules from 2021 to 2022 were collected and sorted out,and the related prescriptions for pulmonary nodules were recorded through the TCMISS.Statistics,association rule analysis,and new prescription discovery were carried out on the nature and flavor,meridian tropism,application frequency,drug pair combination,and so on.Results Fifty-one medical records of Professor Hu Kaiwen for the treatment of pulmonary nodules were collected,including 216 prescriptions and 133 Chinese medicines.The most frequent flavor was sweet,followed by pungent,bitter,sour,astringent,and salty.The most frequent nature was warm,followed by flat,cold,hot,and cool.The meridian tropism was mainly spleen meridian,followed by liver,lung,stomach,heart,and kidney meridians.The single drug Poria,Zingiberis Rhizoma Recens,Astragali Radix,Angelicae Sinensis Radix,and Pinelliae Rhizoma were used with the highest frequency.The drug pair Zingiberis Rhizoma Recens-Poria was frequently used for 83 times,and Zingiberis Rhizoma Recens-Bambusae Caulis in Taenias-Poria was commonly used for 56 times.There were 8 core drug combinations and 4 new prescriptions.Conclusion Professor Hu Kaiwen attaches great importance to the generation and restriction rule of five elements in the treatment of pulmonary nodules,such as banking up earth to generate metal,preventing wood restricting metal,treating both lung and kidney,soothing liver,invigorating spleen,treating lung at the same time,resolving phlegm,dispelling stasis,and treating the origin and superficiality,thus gain good clinical effects.In the clinical treatment,the prescriptions should be modified with the changes in symptoms and diseases.