基于数据挖掘总结国医大师段富津“散邪清补,肺脾同调”法治疗小儿咳嗽经验

Experience of Duan Fujin(a Master of Chinese Medicine)in the Treatment of Pediatric Cough by Dispersing Pathogenic Factors,Moistening and Tonifying,and Harmonizing the Lung and Spleen Based on Data Mining

目的 基于中医传承计算平台(V3.0)建立数据库,对数据进行频数分析、关联规则、聚类分析,总结段富津教授治疗小儿咳嗽的用药规律及特点,提炼核心处方,以为临床治疗小儿咳嗽提供宝贵经验及依据。方法 选取1991—2008年经导师诊治的小儿咳嗽患者共416例,502诊次,录入中医传承计算平台(V3.0),建立数据库,分析证型分布规律、中药使用频数、聚类分析、常用药对关联频数和核心处方。结果 416例咳嗽患儿中证型以风热证为首,兼见痰湿证。药物频次使用居多的药味有桔梗、甘草、枇杷叶、陈皮、紫菀、牛蒡子,常见药对组合有桔梗-甘草,桔梗-枇杷叶,桔梗-陈皮,甘草-枇杷叶,甘草-陈皮,甘草-紫菀,桔梗-紫菀。挖掘核心处方6条。结论 段富津教授针对小儿发病风热、痰湿居多的特征,结合小儿病理生理特性,用药具有轻灵,量少效宏,散邪清补,肺脾同调的特点,谨守病机,灵活施治,其诊疗思想对临床治疗有指导意义。

Objective To establish a database using the Traditional Chinese Medicine(TCM)Inheritance Computing Platform(V3.0)and conduct frequency analysis,association rule mining,and cluster analysis of the data to summarize Professor Duan Fujin′s medication patterns and characteristics in treating pediatric cough.The paper aimed to distill core prescriptions and provide valuable insights and evidence for the clinical management of pediatric cough.Methods A total of 416 pediatric cough cases treated by Professor Duan between 1991 and 2008 were selected,encompassing 502 medical visits,which were entered into the TCM Inheritance Computing Platform(V3.0)to establish a database.The syndrome patterns,usage frequency of Chinese herbal medicine,cluster analysis,association frequency of common herbal pairs,and core prescriptions were analyzed.Results Among the 416 cough cases,wind-heat syndrome was predominant,followed by phlegm-dampness syndrome.The most frequently used herbs included Radix Platycodonis,Radix et Rhizoma Glycyrrhizae,Folium Eriobotryae,Pericarpium Citri Reticulatae,Radix et Rhizoma Asteris,and Fructus Arctii.Commonly combined herb pairs included Radix Platycodonis-Rhizoma Glycyrrhizae,Radix Platycodonis-Pericarpium Citri Reticulatae,Radix Platycodonis-Folium Eriobotryae,Rhizoma Glycyrrhizae-Pericarpium Citri Reticulatae,Rhizoma Glycyrrhizae-Pericarpium Citri Reticulatae,Rhizoma Glycyrrhizae-Radix et Rhizoma Asteris,and Radix Platycodonis-Radix et Rhizoma Asteris.Six core prescriptions were identified.Conclusion In response to common pediatric presentations of wind-heat and phlegm-dampness,Professor Duan′s approach to treatment,which aligns with the pathophysiological characteristics of children,was characterized by medication that is light and nimble,small in dosage yet profound in effect,capable of dispersing pathogenic factors,moistening and tonifying,and harmonizing the lung and spleen.His meticulous adherence to pathogenesis and flexibility in treatment provide meaningful guidance for clinical practice.