基于中医古籍挖掘孟河医派费氏治疗慢性咳喘的用药规律

Medication rule of the Fei family of Menghe Medical School in treatment of chronic cough and asthma:A study based on data mining of Chinese medical classics

目的:基于中医古籍挖掘孟河医派费氏治疗慢性咳喘的用药规律。方法:从《孟河四家医集》中筛选费伯雄、费绳甫治疗慢性咳喘的医案,建立方药数据库,运用Excel进行药物频次、性味、归经分析,运用中医传承辅助平台V 3.0进行药物关联分析,采用词频分析法对特色用药进行研究。结果:纳入54首处方,涉及121味中药,高频药物23味,药性以寒、温偏多,药味以苦、辛、甘居多,归经以肺、胃、脾、肾经居多,治疗慢性咳喘的核心处方为苦杏仁、炙麻黄、浙贝母、黄芩、前胡、炙紫菀、紫苏子、莱菔子。词频分析显示,寒证在核心处方基础上加细辛、五味子等治疗,热证用桑白皮、天竺黄、鱼腥草等治疗,虚证根据不同脏腑之虚治疗,重视调理脾胃,瘀证用丹参、银杏叶、水红花子、矮地茶、川芎、地龙等治疗。结论:孟河医派费氏治疗慢性咳喘,以肺虚痰伏为基本病机,以宣肺止咳、化痰平喘为治疗大法,注重寒、热、虚、瘀的不同,用药寒温并用、散中寓收,体现了其醇正和缓的学术思想。

Objective:To investigate the medication rule of the Fei family of Menghe Medical School in the treatment of chronic cough and asthma based on data mining of Chinese medical classics.Methods:The medical records of Fei Boxiong and Fei Shengfu in the treatment of chronic cough and asthma were collected from Medical Records of Four Members of Menghe Medical School,and a database was established for the prescriptions and drugs.Excel was used to perform the analysis of frequency,nature and taste,and meridian entry;Traditional Chinese Medicine Inheritance Support System V3.0 was used to perform the drug association analysis;the word frequency analysis method was used to analyze the use of characteristic drugs.Results:A total of 54 prescriptions were included,involving 121 traditional Chinese medicine drugs,there were 23 high-freguency drug.Most drugs were cold or warm in nature and had a bitter,pungent or sweet taste,and they mainly entered the lung,stomach,spleen,and kidney meridians.The core prescription for the treatment of chronic cough and asthma were Armeniacae Semen Amarum,honey-fried Herba Ephedrae,Fritillaria thunbergii,Scutellaria baicalensis,Radix Peucedani,honey-fried Aster tataricus,Perillae Fructus,and Semen Raphani.The word frequency analysis showed that Asarum and Schisandra chinensis were added to the core prescription for the treatment of cold syndrome,while white mulberry root-bark,Bambusae Concretio Silicea,and Houttuynia cordata were added for heat syndrome;deficiency syndrome was treated based on the viscera and bowels with deficiency,with an emphasis on regulating spleen and stomach;Salvia miltiorrhiza,ginkgo leaf,Fructus Polygoni Orientalis,Japanese Ardisia Herb,Rhizoma Chuanxiong,and Pheretima were used for the treatment of stasis syndrome.Conclusion:In the treatment of chronic cough and asthma by the Fei family of Menghe Medical School,lung deficiency with hidden phlegm are the main pathogenesis,and facilitating the flow of lung Qi,relieving cough,resolving phlegm,and relieving asthma are the main treatment methods,with a focus on the differences between cold,heat,deficiency,and stasis syndromes.The application of both cold and warm drugs and to dispel pathogenic factors while nurturing the center reflect the academic thinking of“being harmonious,gentle,moderate,and right”.