中医古籍中治疗嗅觉障碍的用药规律分析

Prescription regularity analysis in treating olfactory dysfunction from ancient Chinese medicine literature

目的采用数据挖掘方法对中医古籍中记载治疗嗅觉障碍的复方用药规律进行分析,提供一定的遣方用药参考来探讨治疗嗅觉障碍的方法。方法检索中医典海软件中治疗嗅觉障碍的中药(TCM)处方,导入Excel 2016软件中形成嗅觉障碍方剂数据库,将数据导入古今医案云平台进行方剂频次、TCM频次、TCM属性、TCM聚类分析、关联分析及复杂网络分析。结果共得到明确记载有方剂名称的方剂115首,其中辛夷散频次最高。TCM频次统计中,排前13味的中药包括细辛、防风、川芎、升麻、木通、瓜蒂、白芷、羌活、甘草、炙甘草、黄芪、麻黄、人参。中药四气统计中以温性、微温、寒性的中药为主。五味以辛、甘、苦为主。肺脾两经为归经统计中频次最高的经脉。祛风止痛、温肺化饮、祛风散寒、通窍等为功效统计中前几位的功效。对前10味TCM进行聚类分析可得到3组中药(Ⅰ:细辛、瓜蒂;Ⅱ:木通,川芎,炙甘草;Ⅲ:升麻、防风、羌活、白芷、甘草)。调整置信度和支持度进行关联分析筛选出13组关联性最强的TCM配伍,其中升麻-防风、川芎-细辛为最核心的配伍。复杂网络分析可以得到核心的9味TCM(川芎、细辛、升麻、防风、木通、白芷、羌活、瓜蒂、甘草),主要为具有发散外邪、宣通鼻窍的中药,其组成与辛夷散最相似。结论中医古籍治疗嗅觉障碍的TCM主要以归于手太阴肺经、足太阴脾经的解表药为主,同时也需注意,如结合患者病因病机,为机体虚弱(气血阴阳不足、宗气虚损)引起的嗅觉障碍,亦可施以补虚药。

Objective Data mining method was used to analyze the prescription regularity of olfactory dysfunction recorded in ancient Chinese medicine literature.We aimed to provide a prescription reference for the way for treating olfactory dysfunction.Methods Traditional Chinese medicine(TCM)prescriptions from the Zhong Yi Dian Hai software for the treatment of olfactory dysfunction were retrieved,and the Excel 2016 software was utilized to form an olfactory dysfunction prescription database by importing the original data.Data were imported into the ancient and modern medical case cloud platform for prescription frequency,TCM frequency,TCM attributes,and TCM cluster,correlation,and complex network analyses.Results A total of 115 clearly recorded prescriptions were obtained,among which Xinyi San had the highest recorded frequency.In the TCM frequency statistics,the top 13 herbs included Asarum,Saposhnikovia divaricata,Ligusticum wallichii,Rattletop,Akebia quinata,Muskmelon pedicel,Radix angelicae dahuricae,Notopterygium root,liquorice,Prepared radix glycyrrhizae,Astragalus membranaceus,Ephedra,and Ginseng.It was found that warm,mild warm,and cold were the main characteristics among the four natures of herbs.Spicy,sweet,and bitter are the most common flavors among the five flavors of herbs.Lung and spleen meridians were the predominant meridians.According to data statistics,the most common uses for TCM include the following:dispelling wind and relieving pain,warming lungto reduce watery phlegm,dispelling wind and dispersing cold,and relieving stuffy nose.Three groups of TCM were obtained by conducting a cluster analysis of the top 10 TCM(I:Asarum and Muskmelon pedicel;II:Akebia quinata,Ligusticum wallichii,and Prepared radix glycyrrhizae;III:Rattletop,Saposhnikovia divaricate,Notopterygium root,Radix angelicae dahuricae,and liquorice).Correlation analysis was conducted by adjusting the confidence and support degrees to select 13 groups with the most relevant TCM compatibility,among which Rattletop,Saposhnikovia divaricata,Ligusticum wallichii,and Asarum were the most compatible.Based on the complex network analysis,nine core TCMs were obtained(Ligusticum wallichii,Asarum,Rattletop,Saposhnikovia divaricata,Akebia quinata,Radix angelicae dahuricae,Notopterygium root,Muskmelon pedicel,and liquorice),which functions in dispersing external evil and promoting clearance of nasal passages,the composition of which is similar to Xinyi San.Conclusion The ancient TCM treatments used for olfactory dysfunction are drugs for the diaphoretic drug,which is represented by the lung meridian of hand-taiyin and the spleen meridian of foot-taiyin.Moreover,attention should be paid to the etiology and pathogenesis of the disease and it should be determined whether the olfactory dysfunction was caused by the deficiency of Qi-Xue-Yin-Yang and qi deficiency so that treatment can be administered accordingly.