基于数据挖掘探讨全国名中医王行宽诊疗胸痹心痛遣方用药规律及学术经验

Medication Rules and Academic Experience of Professor WANG Xingkuan in Treatment of Chest Stuffiness and Pain Based on Data Mining

目的:运用中医传承计算平台V3.0软件,研究王行宽教授治疗胸痹心痛遣方用药规律,传承王行宽教授诊疗胸痹心痛的学术经验。方法:收集整理2017—2020年王行宽教授于湖南中医药大学门诊诊疗冠心病心绞痛患者的原始病历资料,录入中医传承计算平台V3.0,运用软件进行方药规律研究。结果:共收集王行宽教授治疗胸痹心痛处方1 044则,所用药物多为甘、苦药物,归经以肺经为主,其次为心、脾、肝、胃、肾经;所用方剂中使用最多的经方是生脉散,最高的经验方是心痛灵Ⅲ号方;高频数药物主要有麦冬、半夏、丹参、瓜蒌皮、黄连、五味子、柴胡等药物;药物的常用剂量多为3、5、10、15 g;组方规律分析得到常用药组合129个,置信度>0.99的组合有58个,并得到常见证型核心药物;药物聚类得到6个核心药物组合。结论:王行宽教授论治胸痹心痛以益气养营、豁痰化瘀、疏肝利胆为治疗思路,并根据胸痹心痛不同证型予以辨证施治,体现其“多脏调燮、综合治理”的学术思想,其核心处方可供临床从业者参考,但仍需要进一步的临床及实验研究验证其疗效。

Objective:To study the medication rules of Professor. WANG Xingkuan and inherit his academic experience in the treatment of chest stuffiness and pain with the aid of the Traditional Chinese Medicine Inheritance Computing Platform V3.0(TCMICS V3.0). Method:The original medical records of patients with angina pectoris in coronary heart disease(CHD) diagnosed and treated by Prof. WANG in the outpatient department of Hunan University of Chinese Medicine from 2017 to 2020 were collected and entered into the TCMICS V3.0. The rules of prescriptions and drugs were analyzed by the software. Result:A total of 1 044prescriptions of Prof. WANG for the treatment of chest stuffiness and pain were collected. Most of the drugs were sweet and bitter in flavor and mainly acted on the lung meridian, followed by heart, spleen, liver, stomach, and kidney meridians. Among the prescriptions, Shengmaisan was the most commonly used classic prescription, and Xintongling No. Ⅲ was the top experienced prescription. High-frequency drugs mainly included Ophiopogonis Radix, Pinelliae Rhizoma, Salviae Miltiorrhizae Radix et Rhizoma, Trichosanthis Pericarpium, Coptidis Rhizoma, Schisandrae Chinensis Fructus, and Bupleuri Radix. The common doses of drugs were 3, 5, 10, and 15 g. The analysis of formulation rules revealed 129 combinations of common drugs, 58 combinations with confidence > 0.99, and the core drugs of common syndromes. Six core drug combinations were obtained by drug clustering. Conclusion:Professor WANG treats chest stuffiness and pain based on syndrome differentiation following the principles of benefiting Qi, nourishing Yin, eliminating phlegm, resolving stasis, soothing liver, and promoting bile secretion, reflecting his academic idea of "regulation of multiple organs and comprehensive treatment". The core prescriptions can be used for reference by clinical practitioners, but further clinical and experimental studies are still needed to verify their efficacy.