《医宗金鉴》治疗心悸用药规律

Prescription Rule of Palpitations in Golden Mirror ofthe Medical Ancestors

目的挖掘并分析《医宗金鉴》中治疗心悸的方剂,探讨《医宗金鉴》治疗心悸的用药规律和特点。方法筛选《医宗金鉴》治疗心悸处方,使用Microsoft Excel将符合标准的方剂建立数据库,使用Python软件对其中药的药性、药味、归经及药物种类等进行频数分析,并进行关联规则及聚类分析。结果研究共纳入54首方剂,涉及中药72味,其中高频使用的药物为甘草、人参、茯苓、桂枝、生姜等;设置合适的支持度与置信度,得到关联规则11条,如“大枣,生姜”“白术,茯苓”“甘草,大枣+生姜”等;聚类分析得到5组组合,如“甘草”“桂枝,生姜”“人参,茯苓,白术”等。结论《医宗金鉴》治疗心悸重补益而轻攻伐,注重温通心阳、利水蠲饮,学术思想具有医崇仲景的特点,并提出悸由水饮、悸本为虚、“心痹”致悸等独到观点,拓宽了现代临床诊治思路。

Objective To mine and analyze the prescription data for treating palpitations in Golden Mirror ofthe Medical Ancestors(Yi Zong Jin Jian),to explore the prescription rule and characteristics in the book.Methods All prescriptions for treating palpitations in Golden Mirror ofthe Medical Ancestors were screened out,and those meeting the standards were used to establish a database by Microsoft Excel.Python was employed to perform frequency analysis on the herb properties,flavor,channel tropism,and types of herbs,and association rules and cluster analysis were also conducted.Results A total of 54 prescriptions were included in the study,involving 72 Chinese herbs.Among them,the high-frequency herbs were Radix Et Rhizoma Glycyrrhizae,Radix et Rhizoma Ginseng,Poria,Ramulus Cinnamomi,Rhizoma Zingiberis Recens,etc.With appropriate support and confidence,11 association rules were obtained,such as“Fructus Jujubae,Rhizoma Zingiberis Recens”,“Rhizoma Atractylodis Macrocephalae,Poria”,and“Radix Et Rhizoma Glycyrrhizae,Fructus Jujubae+Rhizoma Zingiberis Recens”.Cluster analysis yielded five combinations,such as“Radix Et Rhizoma Glycyrrhizae”,“Ramulus Cinnamomi,Rhizoma Zingiberis Recens”,and“Radix et Rhizoma Ginseng,Poria,Rhizoma Atractylodis Macrocephalae”.Conclusion In Golden Mirror ofthe Medical Ancestors,emphasis is laid on tonifying the heart,while neglecting attacking and checking,as well as on warming and tonifying the heart yang,promoting urination and expelling water in the treatment of palpitations.Following Zhang Zhongjing(medical sage)in academic ideology,the book proposes unique viewpoints of palpitations caused by water,palpitations being originally deficiency,and palpitations caused by heart impediment,which broadens the modern clinical diagnosis and treatment approach.