基于数据挖掘《幼科杂病心法要诀》治疗小儿泄泻组方用药规律

The prescription rules in Youke Zabing Xinfa Yaojue for the treatment of pediatric diarrhea based on data mining

目的:探讨《幼科杂病心法要诀》中治疗小儿泄泻的组方用药规律。方法:通过对《幼科杂病心法要诀》治疗小儿泄泻原文进行精读,对涉及的9种泻证进行分析与整理,建立病-证-方-药数据库,借助中医传承计算平台(V3.0)进行系统分析。结果:统计共17首方剂,涉及51味中药,药物频次累计148次,药物频次≥6次的有7味,依次是甘草、白术、陈皮、茯苓、生姜、人参、砂仁。功效分类位于前3位的是补虚药、利水渗湿药及理气药,四气五味以甘平、辛温为主,多归于脾胃二经。进一步通过关联规则及聚类分析得出常用药物组合有25组,以补虚药与补虚药、补虚药与温中药、补虚药与行气药配伍为多。药物聚类可分为3类,第一类:砂仁、陈皮、甘草、人参、麦芽,第二类:茯苓、甘草、泽泻、白术、灯心草,第三类:甘草、人参、白术、陈皮、生姜。得到新处方2个,以健脾清热利湿为主,核心处方为异功散加味。结论:《幼科杂病心法要诀》中认为小儿泄泻核心病机为脾虚湿盛,兼有寒、热、虚、食、惊之因;治疗时健脾补虚,常参辛温祛湿法;选方以名方为基础,注重调理脾胃气滞,重视“健脾以运脾为贵”的思想,其药物配伍巧妙灵活,切实合用。

Objective:To investigate the prescription and medication rules for the treatment of pediatric diarrhea in Youke Zabing Xinfa Yaojue(《幼科杂病心法要诀》).Methods:Through intensive reading of the original text in Youke Zabing Xinfa Yaojue,the 9 kinds of diarrhea involved were analyzed and sorted,and a disease-certificate-prescription-drug database was established,and the data was systematically analyzed by Traditional Chinese Medicine inheritance calculation platform(V3.0).Results:A total of 17 formulas were counted,involving 51 flavors of TCM medicine,a total of 148 drug frequencies,and 7 flavors of drug frequency≥6 times,followed by Gancao(Radix Glycyrrhizae),Baizhu(Rhizoma Atractylodis Macrocephalae),Chenpi(Pericarpium Citri Reticulatae),Fuling(Poria),Shengjiang(Rhizoma Zingiberis Recens),Renshen(Rhizoma Zingiberis Recens)and Sharen(Amomi Fructus).The top 3 efficacy classifications were deficiency medicine,water and moisture medicine and Qi(气)medicine,and the four Qi and five flavors were mainly Ganping(甘平)and Xinwen(辛温),mostly attributed to the spleen and stomach meridians.Furthermore,through association rules and cluster analysis,it was concluded that there were 25 groups of commonly used drug combinations,most of which were the combination of deficiency medicine and deficiency medicine,deficiency medicine and warm medicine,and deficiency medicine and Qi medicine.Drug clustering were divided into 3 categories,the first category:Sharen,Chenpi,Gancao,Renshen,Maiya(Fructus Hordei Germinatus),the second category:Fuling,Gancao,Zexie(Rhizoma Alismatis),Baizhu,Dengxincao(Medulla Junci),and the third category:Gancao,Renshen,Baizhu,Chenpi,Shengjiang.There were 2 new prescriptions,mainly to strengthen the spleen and clear heat and moisture,and the core prescription was Yigong San(异功散).Conclusion:In Youke Zabing Xinfa Yaojue,it is believed that the core pathogenesis of pediatric diarrhea is spleen deficiency and dampness,accompanied by cold,heat,deficiency and food panic.The treatment pays attention to strengthening the spleen and nourishment,often supplemented by the Xinwen Qushi method(辛温祛湿法).The selection is based on the famous party,pays attention to regulating spleen and stomach stagnation,and attaches importance to the idea of strengthening and transporting the spleen.Its drug combination is ingenious and flexible,and it is effective and practical.