明代医家龚廷贤治疗皮炎湿疹类疾病的用药规律研究

Prescription Rule of Gong Tingxian of Ming Dynasty in the Treatment of Dermatitis and Eczema Diseases

目的对明代龚廷贤治疗皮炎湿疹类疾病的方药进行数据分析,为临床治疗皮炎湿疹类疾病提供参考。方法全面搜集《龚廷贤医学全书》中应用龚氏方剂治疗皮炎湿疹类疾病的文献,构建方药数据库,运用SPSS Statistics 22.0统计学软件对其药物的使用频次、来源、毒性、性味归经、功效等进行统计分析,运用SPSS Modeler 18.0统计学对高频药味进行关联规则分析。运用Origin 2022b对高频药味进行系统聚类分析和数据可视化。结果共纳入方剂110首。其中内服方29首,涉及76味中药,总频次为309次,以甘草、荆芥、川芎、当归、防风、连翘、黄芩、苦参、黄连使用频次最高。功效以清热、解表为主。通过关联分析,得到核心组合为:荆芥-川芎-甘草-连翘。聚类分析获得5个药组。外用方81首,涉及118味中药,总频次为360次,以白矾、水银、硫黄、砒霜、雄黄、大枫子、花椒、铅华使用频次最高,功效以攻毒杀虫止痒、拔毒化腐生肌为主。通过关联分析,得到核心组合为:白矾-水银。聚类分析获得4个药组。无论内服外用,药性寒温比例相当,药味多苦、辛、甘,归经以肺经、胃经、脾经、肝经为主。结论龚氏辨证治疗皮炎湿疹类疾病针对风、热主要病因,内服药注重调理气机,外用药注重减毒增效,另外,龚氏讲究给药时间和方法、用药调护;内外合治,对于治疗的有效性和安全性并重,值得研究和借鉴。

Objective To analyze the prescription data in the treatment of dermatitis and eczema diseases by Gong Tingxian of Ming Dynasty,to provide reference for clinical treatment of the diseases.Methods Literature involving the application of Gong′s prescriptions for the treatment of dermatitis and eczema diseases was collected from Gong Tingxian′s Complete Medical Book(Gong Ting Xian Yi Xue Quan Shu)to establish a database of the prescriptions.The frequency of usage,source,toxicity,nature,flavor,channel tropism,and efficacy of the medicinal herbs were analyzed by SPSS Statistics 22.0.Association rules of high-frequency herbs were mined by SPSS Modeler 18.0,and Origin2022b was used for hierarchical cluster analysis of high-frequency herbs and data visualization.Results A total of 110 prescriptions were collected,including 29 ones for internal use and involving 76 Chinese medicinal herbs with a total frequency of 309.Radix Et Rhizoma Glycyrrhizae,Herba Schizonepetae,Rhizoma Chuanxiong,Radix Angelicae Sinensis,Radix Saposhnikovia,Fructus Forsythiae,Radix Scutellariae,Radix Sophorae Flavescentis,and Rhizoma Cptidis were most frequently used.The main efficacy was to clear heat and resolve the exterior.The core combination obtained through association analysis was Herba Schizonepetae-Rhizoma Chuanxiong-Radix Et Rhizoma Glycyrrhizae-Fructus Forsythiae.Five herb groups were obtained through cluster analysis.There were 81 prescriptions for external use,involving 118 Chinese medicinal herbs with a total frequency of 360.Alum,mercury,sulfur,arsenic,realgar,maple,pricklyash peel and red lead were most frequently used,with the efficacy of counteracting toxic substance,killing worms,relieving itching,drawing out toxin,suppuration and promoting granulation.The core combination was alum-mercury.Four herb groups were obtained through cluster analysis.Whether for internal use or external use,the medicinal herbs had equal proportion in cold and warm property,and they were mainly bitter,pungent and sweet,predominantly acting on lung,stomach,spleen and liver.Conclusion In Gong′s differentiation and treatment of dermatitis and eczema diseases,the main causes of wind and heat were emphasized.For internal therapy,Gong pays attention to regulating qi movement,while for external therapy,he focuses on reducing toxin and enhancing efficacy.In addition,Gong takes into account the medication time and method,with regulation and prevention emphasized.Internal and external therapies are combined,and both efficacy and safety are considered,which deserves further study and reference.