邹忆怀教授从肝心论治慢性失眠的用药规律

ZOU Yihuai’s Medication Rule in Treatment of Chronic Insomnia from Liver and Heart

目的 基于中医传承计算平台(V3.0),分析邹忆怀教授对慢性失眠的用药规律。方法 收集2018年1月1日—2021年9月30日邹忆怀教授门诊治疗慢性失眠的首诊处方,运用中医传承辅助平台进行数据录入,构建邹忆怀教授诊治慢性失眠的医案数据库。运用频数统计分析、关联规则分析、聚类分析等方法,分析患者性别、年龄,用药频数,药物四气五味,归经分布,组方规律及药物组合,统计中药应用特点和组方规律分析结果。结果 共筛得有效方剂154首,涉及中药110味,累计使用频数为4732次。使用频数≥30的中药有30味,药性主要为寒性、温性、平性,药味主要为苦、辛、甘味,归经多属肝、心、脾、肺经,功效以清热类、理气类、安神类为多。常用核心药物组合共364组。聚类分析结合临床经验得到5组可以用于新处方的聚类药物组合。结论 邹忆怀教授认为治疗慢性失眠当从肝心论治,辨证应用疏肝、宁心并举的治法,兼顾调和脾胃、宣肃肺气,体现了补虚泻实、升降得宜、平调气机的整体指导思想。

Objective To analyze Professor ZOU Yihuai's medication rules for chronic insomnia based on the Traditional Chi-nese Medicine(TCM)Inheritance Computing Platform(V3.0).s Methods We collected the initial diagnosis prescription of Profes-sor ZOU Yihuai's outpatient treatment of chronic insomnia from January 1,2018 to September 30,2021,and used the TCM Inherit-ance Computing Platform for data entry to construct the database of Professor ZOU Yihuai's diagnosis and treatment of chronic in-somnia.We used frequency statistical analysis,association rule analysis,cluster analysis and other methods to analyze the patients'gender,age,medication frequency,four natures and five tastes,meridian distribution,prescription rules and drug combi-nations,and statistical characteristics of TCM application and analysis results of prescription rules.s Results A total of 154 effective prescriptions were screened,involving 110 Chinese drugs,and the cumulative use frequency was 4732 times.There were 30 kinds of Chinese drug used more than 30 times.Their properties were mainly cold,warm and flat,and their tastes were bitter,pungent and sweet.They belonged to the liver,heart,spleen and lung meridians,and their effects were mainly clearing heat,regulating Qi and tranquilizing.There were 364 groups of common core drug combinations.Cluster analysis combined with clinical experience obtained 5 groups of cluster drug combinations that could be used for new prescriptions.n Conclusion ZOU Yihuai believes that the treatment of chronic insomnia should be based on the treatment of liver and heart,and the treatment of soothing liver and calming heart should be applied in syndrome differentiation,and both spleen and stomach should be harmonized,and lung Qi should be promoted,taking into account the the coordination of spleen and stomach,promoting and eliminating lung Qi.It embodies the o-verall guiding ideology of tonifying deficiency and reducing excess,appropriately lifting and lowering Qi,and regulating the Qi mechanism.