名老中医柯干治疗失眠用药规律探析

Analysis of the Medication Rules of Famous Chinese Medicine Physician KE Gan in Treating Insomnia

目的:探析名老中医柯干治疗失眠用药规律,为临床提供参考。方法:搜集名老中医柯干门诊失眠病历,参照纳入与排除标准,共纳入205首处方建立数据库,使用中医传承计算平台(TCMICS) V3.0,采用k均值和聚类统计方法,对所纳处方进行数据分析,总结其用药规律及学术思想。结果:所录处方共涉中药125味,其中酸枣仁、柏子仁、合欢皮、生地黄、百合、远志、茯神等使用频次较高。通过四气五味及归经功效分析得出以性平、味甘、归心肝经、安神、补虚及清热类药物为主。通过关联规则得出7个核心药物:酸枣仁、柏子仁、合欢皮、生地黄、百合、远志、茯神;以酸枣仁-柏子仁组合频次最高;通过聚类分析得出经验方:酸枣仁、柏子仁、合欢皮、生地黄、百合、远志、茯神、当归。结论:名老中医柯干治疗失眠以补虚泻实、调整阴阳为原则,首重安神补虚法,其中,注重养心益肝、滋阴养血、疏肝等法的运用,同时辨证使用“清热、祛湿、化瘀、平肝、理气”等泻实数法。

Objective:To explore the medication rules of famous Chinese medicine physician KE Gan in the treatment of insomnia,and to provide reference for clinical practice.Methods:The medical records of patients with insomnia in the outpatient department of famous Chinese medicine physician KE Gan were collected,and 205 prescriptions were included in the database according to the inclusion and exclusion criteria.The Traditional Chinese Medicine Inheritance Calculate System(TCMICS) V3.0 was used to analyze the data of all prescriptions,and the medication rules and academic thoughts were summarized by using kmeans and cluster statistics.Results:A total of 125 kinds of Chinese medicinals were involved of the prescriptions,among which the frequency of use was relatively high,such as Ziziphi Spinosae Semen,Platycladi Semen,Albiziae Cortex,Rehmanniae Radix,Lilii Bulbus,Polygalae Radix and Poria cum Radix Pini.Through the analysis of the four properties and five flavors and the effect of meridian tropism,the main drugs were mild in nature,sweet in flavor,enter the heart and liver meridians,with functions of calming the mind,supplementing deficiency and clearing heat.According to the association rules,7 core drugs were obtained:Ziziphi Spinosae Semen,Platycladi Semen,Albiziae Cortex,Rehmanniae Radix,Lilii Bulbus,Polygalae Radix and Poria cum Radix Pini.The combination of "Ziziphi Spinosae Semen and Platycladi Semen" has the highest frequency.Through cluster analysis,the empirical formula was obtained:Ziziphi Spinosae Semen,Platycladi Semen,Albiziae Cortex,Rehmanniae Radix,Lilii Bulbus,Polygalae Radix,Poria cum Radix Pini and Angelicae Sinensis Radix.Conclusion:The principle of famous Chinese medicine physician KE Gan treating insomnia is to supplement deficiency and drain excess,adjust yin and yang,and first emphasize the method of calming the mind and supplementing deficiency,among which,pay attention to the application of nourishing the heart and liver,enriching yin and blood,soothing the liver,and at the same time use the method of "clearing heat,removing dampness,dissolving blood stasis,calming the liver and regulating qi".