赵绍琴治疗呼吸系统疾病的用药规律研究

Analysis of ZHAO Shaoqin's Prescription in the Treatment of Respiratory System Diseases

目的 基于数据挖掘分析并总结赵绍琴教授治疗呼吸系统疾病的用药规律。方法 收集《赵绍琴临证验案精选》《赵绍琴医案实录》《赵绍琴临床经验辑要》《赵绍琴内科学》《跟名师学临床系列丛书—赵绍琴》《赵绍琴临证400法》中所记载的治疗呼吸系统疾病的医案和处方,运用中医传承计算平台(V3.0)中的统计分析、频次分析、关联规则、K-means算法聚类分析模块等分析方法进行数据分析与挖掘,对处方中核心药物的性味归经、核心用药和类方等进行总结分析。结果 共筛选出90首方剂,涉及169种中药。治疗最多的呼吸系统疾病分别为上呼吸道感染、支气管炎和哮喘,将疾病分成这三类进行数据分析。赵绍琴教授治疗上呼吸道感染喜用寒性药物,其次是温性药物和平性药物。药味多为苦味药,其次是辛味药、甘味药。使用频次在前10位的中药分别是前胡、芦根、栀子、杏仁、淡豆豉、连翘、半夏、佩兰、浙贝母、广藿香。药物组合频次前3的是“芦根-前胡”“前胡-栀子”“芦根-栀子”。聚类药物组合3种。治疗支气管炎药物的药性与治疗上呼吸道感染疾病一样,而其药味用得最多的是辛味药。用药频次前8的中药分别是前胡、杏仁、紫苏子、紫苏叶、半夏、枇杷叶、麦芽、莱菔子。药物组合频次前4的是“前胡-杏仁”“前胡-紫苏子”“杏仁-紫苏子”“前胡-杏仁-紫苏子”。生成3个赵绍琴教授治疗支气管炎的类方。治疗哮喘的药物药性以温性药居多,药味以辛味药为主。使用频次前十的药物分别是半夏、杏仁、紫苏子、前胡、紫苏叶、陈皮、枇杷叶、六神曲、麦芽、山楂。用药频次前4的药对分别是“杏仁-紫苏子”“杏仁-紫苏叶”“半夏-陈皮”“杏仁-前胡”。生成3个赵绍琴教授治疗哮喘的类方。结论 赵绍琴教授治疗上呼吸道感染疾病治以辛凉,佐以苦甘,宣降肺气、通畅三焦、注意固护脾胃。治疗支气管炎多将前胡、杏仁、紫苏叶与紫苏子同用,降气祛痰,透热外出。治疗哮喘时不仅用大量温性祛痰之品,还注重饮食的调摄,喜用焦三仙消食导滞。通过调理脏腑,恢复肺的宣发肃降功能从而止咳、祛痰、平喘等。

Objective Based on data mining,this paper analyzed and summarized the prescription principle of professor Zhao Shaoqin in the treatment of respiratory system diseases.Methods Medical cases and prescriptions for the treatment of respiratory system diseases recorded in Selected Clinical Cases of ZHAO Shaoqin,Records of ZHAO Shaoqin′s Clinical Cases,Clinical Experience Collection of ZHAO Shaoqin,Internal Medicine written by ZHAO Shaoqin,Clinical Se-ries Books on Famous Teachers-ZHAO Shaoqin,and Clinical 400 Method of ZHAO Shaoqin were collected.The statistical analysis,frequency analysis,association rules,K-means algorithm cluster analysis module,and other analytical methods in the traditional Chinese medicine inheritance computing platform(V3.0)were adopted for data analysis and mining,and the property,flavor,and meridian tropism of the core drugs in the prescription,the core drugs,and the associated prescriptions were summarized.Results A total of 90 prescriptions were screened out,involving 169 kinds of traditional Chinese medi-cine.The most treated respiratory system diseases were upper respiratory tract infections,bronchitis,and asthma,which were used for data analysis.Zhao Shaoqin treated upper respiratory tract infections with the medicine cold in the property,followed by that warm and peaceful in the property.Most of the medicine is bitter,followed by spicy and sweet.The top ten kinds of traditional Chinese medicine used frequently were Radix Peucedani,Rhizoma Phragmitis,Fructus Gardeniae,Se-men Armeniacae Amarum,Semen Sojae Preparatum,Fructus Forsythiae,Rhizoma Pinelliae,Herba Eupatorii,Bulbus Fritil-lariae Thunbergii,and Herba Pogostemonis.The top three drug combination frequencies were Rhizoma Phragmitis-Radix Peucedani,Radix Peucedani-Fructus Gardeniae,and Rhizoma Phragmitis-Fructus Gardeniae.There were three drug combinations in the cluster.The medicinal properties of bronchitis drugs were the same as those of upper respiratory tract infections,and the drug ingredients were mainly spicy.The top eight kinds of traditional Chinese medicines used frequently were Radix Peucedani,Semen Armeniacae Amarum,Fructus Perillae,Folium Perillae,Rhizoma Pinelliae,Folium Eriobot-ryae,Fructus Hordei Germinatus,and Semen Raphani.The top four drug combination frequencies were Radix Peucedani-Semen Armeniacae Amarum,Radix Peucedani-Fructus Perillae,Semen Armeniacae Amarum-Fructus Perillae,and Ra-dix Peucedani-Semen Armeniacae Amarum-Fructus Perillae.Three similar prescriptions of Professor Zhao Shaoqin for treating bronchitis were generated.The medicinal properties of the medicine for treating asthma are mostly mild,and the main medicinal taste is spicy.The top ten drugs used were Rhizoma Pinelliae,Semen Armeniacae Amarum,Fructus Peril-lae,Radix Peucedani,Folium Perillae,Pericarpium Citri Reticulatae,Folium Eriobotryae,Massa Medicata Fermentata,Fructus Hordei Germinatus,and Fructus Crataegi.The top four drug combination frequencies were Semen Armeniacae Ama-rum-Fructus Perillae,Semen Armeniacae Amarum-Folium Perillae,Rhizoma Pinelliae-Pericarpium Citri Reticulatae,and Semen Armeniacae Amarum-Radix Peucedani.Three similar prescriptions of Professor Zhao Shaoqin for treating asth-ma were generated.Conclusion Professor Zhao treats upper respiratory tract infections with pungent and cool drugs,sup-plemented with bitter and sweet drugs,so as to diffuse lung qi,unblock the triple burner,and strengthen the spleen and stomach.In the treatment of bronchitis,Radix Peucedani,Semen Armeniacae Amarum,Folium Perillae,and Fructus Perillae are often used together to direct qi downward to resolve phlegm and make external pathogens out.When treating asthma,Zhao Shaoqin not only uses a lot of warm drugs to resolve phlegm but also pays attention to the adjustment of diet and in-take.Zhao Shaoqin often uses Jiao Sanxian to promote digestion and remove food stagnation.In general,by regulating the viscera,Zhao Shaoqin relieves cough,dispels phlegm,and relieves asthma by restoring the function of the lung governing ascent and dispersion,as well as purification and descent.