基于《中华医典》分析清代医家治疗水肿的用药规律

Medication rule of the doctors in Qing Dynasty in treatment of edema:An analysis based on Chinese Medical Classics

目的:挖掘《中华医典》中治疗水肿的相关内容,探讨清代医家治疗水肿的用药及配伍规律。方法:检索《中华医典》医案部分中清代医家诊疗水肿的相关著作,采用SPSS Modeler 18.0进行关联规则分析,采用SPSS 21.0对高频药物进行聚类分析。结果:共收录280首处方,包含44本医家著作,涉及中药260味,其中频次≥21次的药物34味,药性以温、平为主,药味多辛、苦、甘,归经多为肺、脾、肾经;使用频率最高的是利水渗湿药、补虚药和理气药;高频药对为泽泻-猪苓、白术-附子;聚类分析得到7个核心处方。结论:清代医家治疗水肿注重攻补兼施,遣方用药以利水渗湿为主,同时兼健脾理气、温补脾肾、宣肺解表。

Objective:To investigate the medication and compatibility rules of the doctors in Qing Dynasty in the treatment of edema by analyzing the contents associated with edema in Chinese Medical Classics.Methods:The medical records in Chinese Medical Classics were searched to obtain the works on the treatment of edema by the doctors in Qing Dynasty.SPSS Modeler 18.0 was used to perform the association rule analysis,and SPSS 21.0 was used to perform a cluster analysis of high-frequency drugs.Results:A total of 280 prescriptions and 44 medical works were obtained,involving 260 traditional Chinese medicine(TCM) drugs,among which there were 34 drugs with a frequency of ≥21.Most drugs were warm or neutral in nature and had a pungent,bitter or sweet taste,and they mainly entered the lung,spleen,and kidney meridians.The drugs with the highest frequency of use were diuresis-inducing and dampness-draining drugs,deficiency-tonifying drugs,and Qi-regulating drugs.Alisma orientalis-Polyporus umbellatus and Atractylodes macrocephala Koidz.-Radix Aconiti Lateralis Preparata were high-frequency drug combinations.The cluster analysis obtained 7 core prescriptions.Conclusion:In the treatment of edema,the doctors in Qing Dynasty focus on tonification and purgation in combination and mainly use diuresis-inducing and dampness-draining prescriptions,giving consideration to strengthening the spleen and regulating Qi,tonifying the spleen and kidney,and facilitating the flow of lung Qi and relieving exterior syndrome.