《中医方剂大辞典》中治疗乳房疾病方剂的配伍规律研究

Study on Compatibility Rules of Formulae for Breast Diseases in Encyclopedia of Chinese Medicinal Formulas

目的:探析《中医方剂大辞典》中治疗乳房疾病方剂的配伍规律。方法:将《中医方剂大辞典》中治疗乳房疾病方剂的组成药物及其四气五味、归经、功能主治等录入中医传承辅助系统,使用频次统计、关联规则和聚类分析,分析高频药物的四气、五味和归经分布,以及高频药物组合的配伍特点。结果:纳入方剂334首,主治病种主要为乳痈和吹乳,共涉及药物505种,使用频次大于50的药物有13味,从高到低依次为甘草、当归、白芍、白芷、黄芪、川芎、金银花、人参、大黄、青皮、瓜蒌、乳香和贝母。药物的四性分布无明显差异,五味方面,苦、辛和甘味占比较高,而酸、咸味占比极低,归经则以脾、肝、心、胃、肺经居多。补气养血和疏肝理气类药物使用频次最高,其余依次为活血祛瘀、祛湿化痰散结、清热祛风、拔毒生肌、收敛固涩和滋补阴阳类。运用关联规则分析得到常用药对119个,常用3味药物组合58个,4味药物组合14个,当归、川芎、芍药、黄芪、柴胡、人参、青皮、陈皮、升麻、瓜蒌、金银花、生地黄为此类方剂的核心药物组成,使用频率最高且常相互配伍。结论:《中医方剂大辞典》中治疗乳房疾病方剂以治乳痈和吹乳者居多,用药以养血补气、疏肝行气、活血化瘀和清热解毒之品为主,辅以化痰、祛湿、祛风和消肿散结之品,这些药物常相互配伍,其中以补虚药配伍泻实药的组合最为常见,提示乳房疾病多虚实夹杂,治疗当扶正和泻实兼顾。

Objective:To explore the compatibility rules of formulae for breast diseases in Encyclopedia of Chinese Medicinal Formulas.Methods:The formulae for breast diseases in Encyclopedia of Chinese Medicinal Formulas were collected.Based on the software of Traditional Chinese Medicine Inheritance Support System,data mining methods including frequency statistics,association rules and cluster analysis were adopted to analyze the frequency of four natures,five flavors and meridian tropism of high-frequency medicines,as well as common herbal pairs and groups.Results:A total of 334 formulae were collected,involving 505 kinds of Chinese herbs.A total of 13 herbs were used more than 50 times,the top 10 with frequency from high to low were Gancao(Radix Glycyrrhizae),Danggui(Radix Angelicae Sinensis),Baishao(Radix Paeoniae Alba),Baizhi(Radix Angelicae Dahuricae),Huangqi(Radix Astragali seu Hedysari),Chuanxiong(Rhizoma Ligustici Chuanxiong),Jinyinhua(Flos Lonicerae),Renshen(Radix Ginseng),Dahuang(Radix et Rhizoma Rhei),Qingpi(Pericarpium Citri Reticulatae Viride),Gualou(Fructus Trichosanthis),Ruxiang(Olibanum)and Beimu(Bulbus Fritillariae Thunbergii).There were no obvious differences in four nature distribution,while significant differences were observed in five flavors and meridian tropism.Most herbs were bitter,pungent and sweet,and enter the spleen,liver,heart,stomach and lung meridians.According to the efficacy classification,tonifying-qi,nourishing blood,soothing liver and regulating qi were used most frequently,followed by activating blood and resolving stasis,removing dampness,resolving phlegm and dissipating mass,clearing heat and dispelling wind,drawing out toxin and promoting granulation,astringing and consolidating essence,nourishing yin and tonifying yang.119 herbal pairs,58 herbal groups with 3 kinds of herbs and 14 herbal groups with 4 kinds of herbs by association rules.Most of them were the mutual combinations of high-frequently used herbs such as Danggui(Radix Angelicae Sinensis),Chuanxiong(Rhizoma Ligustici Chuanxiong),Shaoyao(Radix Paeoniae Alba),Huangqi(Radix Astragali seu Hedysari),Chaihu(Radix Bupleuri),Renshen(Radix Ginseng),Qingpi(Pericarpium Citri Reticulatae Viride),Chenpi(Pericarpium Citri Reticulatae),Shengma(Rhizoma Cimicifugae),Gualou(Fructus Trichosanthis),Jinyinhua(Flos Lonicerae)and Shengdihuang(Radix Rehmanniae Recens).Conclusion:The majority of the formulae for breast diseases in Encyclopedia of Chinese Medicinal Formulashas been created for acute purulent mastitis,the most frequently used medicines are those with the function of nourishing blood and tonifying qi,soothing liver and regulating qi,activating blood and resolving stasis,clearing heat and removing toxin,assisted with resolving phlegm,removing dampness,dispelling wind and dissipating mass.These herbs are often combined with each other,the main patern is the combination between tonifying herbs and eliminating pathogen herbs,indicating the common pathogenisis of breast diseases is deficiency-excess in complexity and then the treatment should give consideration to both eliminating pathogen and tonifying deficiency.