基于数据挖掘研究新安王氏内科治疗不寐的用药规律

Medication Rule of Xin’an Wang’s(新安王氏)Internal Medicine for the Treatment of Insomnia:Based on Data Mining

目的:基于数据挖掘手段研究以王仲奇、王任之为代表的新安医学王氏内科治疗不寐的用药规律;方法:根据十二五教材《中医内科学》第三版中不寐病的病证标准,将《王仲奇医案》《王任之医案》中符合标准的处方纳入研究范围,建立方药数据库,通过Microsoft Excel 2010进行频次分析,通过SPSS Modeler 18.0、SPSS Statistics 22.0对方药分别进行药物的二项、三项关联分析、系统聚类、复杂网络、决策树模型分析。结果:133首中药处方中包含中药189种,茯神、远志、龙齿使用频次居前3位,排名前30味药物主要体现了养心安神,重镇固摄,补肾宁心,育阴潜阳,化痰降浊,交通心肾等治法;药物剂量上除重镇潜阳类药物用量颇重外,多数药物用量轻灵;二项、三项关联结果显示药物多为养心安神,交通心肾,滋阴潜阳类;系统聚类分析得出12组药物组合;复杂网络核心处方主要由安神定志丸组成;决策树模型分析中以茯神作为因变量,龙齿、珍珠母、龟甲、甘草在药物配伍中具有重要地位。结论:新安王氏内科在治疗不寐时,注重恢复脏腑功能,虚则补益,如养心、补肾、健脾、养阴;实则损之,如化痰、清心、镇逆,总则以守神固精为本,以养髓海,安脑神,以达安神助眠之效。

Objective:This paper aims to study the medication rule of Wang Zhongqi and Wang Renzhi in the treatment of insomnia in the Wang’s Internal Medicine Department of Xin’an Medicine.Methods:According to the textbook Internal Medicine of Traditional Chinese Medicine(3 rd Edition)for the"Twelfth Five-Year Plan",eligible Chinese medicine prescriptions in Case Records of Wang Zhongqi and Case Records of Wang Renzhi were retrieved and a database for the prescriptions was established,followed by frequency analysis with Microsoft Excel 2010.SPSS Modeler 18.0 and SPSS Statistics 22.0 were employed for analysis of the associations between any two medicinals and among any three medicinals,hierarchical clustering,complex network analysis,and decision tree model analysis.Results:A total of 133 Chinese medicine prescriptions were screened out,involving 189 Chinese medicinals.Among them,Fushen(茯神),Yuanzhi(远志),and Longchi(龙齿)were most frequently used.The top 30 medicinals mainly reflected the treatment principles of Yangxin(养心)and Anshen(安神),Zhongzhen(重镇)and Gushe(固摄),Bushen(补肾)and Ningxin(宁心),Yuyin(育阴)and Qianyang(潜阳),Huatan(化痰)and Jiangzhuo(降浊),and Jiaotongxinshen(交通心肾).As for the dosage,medicinals with the effect of Zhongzhen(重镇)and Qianyang(潜阳)were used at high dose,with other medicinals were used at low dose.The frequently used medicinal pairs and medicinal combinations(three medicinals)mainly had the effects of Yangxin(养心)and Anshen(安神),Jiaotongxinshen(交通心肾),and Ziyin(滋阴)and Qianyang(潜阳).Hierarchical clustering yielded 12 medicinal combinations.In the complex network,the core prescription was composed of Anshen Dingzhi Pills(安神定志丸).In the decision tree model analysis,Fushen(茯神)was used as the dependent variable and Longchi(龙齿),Zhenzhumu(珍珠母),Guijia(龟甲),and Gancao(甘草)were verified to pay a crucial part in medicinal compatibility.Conclusion:In the treatment of insomnia,Xin’an Wang’s Internal Medicine focuses on restoring Zangfu(脏腑)function.To be specific,Buyi(补益)is performed in the case of Xu(虚),such as Yangxin(养心),Bushen(补肾),Jianpi(健脾),and Yangyin(养阴).Elimination is adopted in the instance of Shi(实),such as Huatan(化痰),Qingxin(清心),and Zhenni(镇逆).The overall treatment principle is Shoushen(守神)and Gujing(固精)to Yangsuihai(养髓海)and Annaoshen(安脑神),thereby soothing the nerves to help sleep.