基于名医传承辅助平台探讨姚乃礼治疗胃食管反流病用药规律

Exploration on Medication Rule of YAO Naili in Treatment of Gastroesophageal Reflux Disease Based on Platform of Mining TCM Empirical Prescriptions

目的基于名医传承辅助平台分析姚乃礼教授治疗胃食管反流病的用药特点和规律,为总结名老中医学术思想、传承名老中医经验提供参考。方法通过对姚乃礼教授治疗胃食管反流病的病案进行统计收集,在名医传承辅助平台中建立医案和队列,对数据进行标准化处理后,采用该平台分析模块建立“症状-药物”“药物-药物”的关联网络,分析处方中药物的性味、归经、用药频次,并进行药物聚类分析以及药症关联,明确姚教授临床实践的核心用药,探索其用药特点和规律。结果通过名医传承辅助平台,分析了姚教授100个医案,其中用药146味,药物以性温、寒居多,主要为味甘之品,多归于脾、肝经,用药频次居前五位的药物为:茯苓、黄连、法半夏、白术、浙贝母,对药物聚类分析得到八类潜在的药物群。结论姚乃礼教授治疗胃食管反流病抓住其“脾虚失运,气机失畅,胃失濡润,痰热互结,气病及血”的基本病机,注重辨病期、辨病因、辨气血,治以健脾和胃,疏肝降逆,化痰清热,调理气血。

Objective To analyze the medication characteristics and rules of Professor YAO Naili in the treatment of gastroesophageal reflux disease based on the Platform of Mining TCM Empirical Prescriptions and provide reference for summarizing the academic thoughts of famous experts of TCM and inheriting their experience.Methods Through statistical collection of medical records of Professor YAO Naili's treatment of gastroesophageal reflux disease,medical records and queues were established on the Platform of Mining TCM Empirical Prescriptions.After standardizing the data,the platform's analysis module was used to establish an association network of“symptoms-drugs”and“drugs-drugs”.The characteristics,meridians and frequency of medication in the prescription were analyzed,and drug cluster analysis and drug symptom correlation were conducted to clarify the core medication of Professor YAO Naili's clinical practice and explore its medication characteristics and patterns.Results Through the Platform of Mining TCM Empirical Prescriptions,it analyzed Professor YAO Naili's 100 medical records,including 146 drugs used.The majority of the drugs were warm and cold in nature,mainly sweet in taste,attributed to the spleen and liver meridians.The top five drugs with the highest frequency of use were Fuling(Poria),Huanglian(Coptidis Rhizoma),Fabanxia(Pinelliae Rhizoma Praeparatum),Baizhu(Atractylodis Macrocephalae Rhizoma)and Zhebeimu(Fritillariae Thunbergii Bulbus).Through clustering analysis of the drugs,we identified eight potential drug groups.Conclusion Professor YAO Naili's treatment of gastroesophageal reflux disease focuses on the basic pathogenesis of“spleen deficiency and failing to transport,Qi stagnation,loss of nourishing of stomach,phlegm-heat accumulation,Qi disease involving blood”.He pays attention to distinguishing the disease stage,etiology,Qi and blood and treats it by strengthening spleen and stomach,soothing liver and lowering adverse reactions,resolving phlegm and clearing heat,and regulating Qi and blood.