基于数据挖掘《妇科玉尺》调经方剂的用药规律及学术特色探析

Research on medication regularity and academic characteristics of the prescriptions for regulating menstruation in Fuke Yuchi based on data mining

目的:探讨沈金鳌所著《妇科玉尺》调经方剂的用药规律及学术特色。方法:纳入《妇科玉尺·月经篇》所载方剂,对方中使用药物的用药频次、药物性味、药物归经进行统计,应用SPSS Modeler 18.3软件构建复杂网络,然后运用Apriori算法设置支持度为10%、置信度为0.8,进行用药关联规则分析,最后运用SPSS 25.0对高频药物进行系统聚类分析。结果:共纳入72首处方、134味药物。用药频次居前3位的药物分别为当归、白芍、川芎,药物性味以温、苦、辛为主,药物归经以肝、脾、心为主。通过复杂网络构建得到3组强关联药物组合:白芍-当归、川芎-当归、白芍-川芎。关联规则分析得到15组药物组合,置信度居前2位的分别红花-当归、延胡索-当归。系统聚类分析得到两类药物组合,类1:当归、川芎、白芍、熟地黄、人参、肉桂、桃仁、牡丹皮、延胡索;类2:香附、地黄、甘草、黄芩。结论:本研究通过对《妇科玉尺·月经篇》治疗月经不调的72首方剂进行分析,发现沈金鳌辨治月经病强调血凝致病,调经方法多为补益气血、活血化瘀、理气止痛,处方常以四物汤为基础灵活化裁。沈氏调经的进步性在于调心,常用柏子仁丸、菖蒲饮等。此外,沈氏调经重视调肝,兼顾心脾,指出肝与冲脉同为血室,对后世治疗妇科病有所启发。

Objective:To explore the medication rules and academic characteristics of the prescriptions for regulating menstruation in Fuke Yuchi(《妇科玉尺》).Methods:The prescriptions contained in the menstrual chapter of Fuke Yuchi were extracted,and medication frequency,medical natures and medical flavors,and channel entry were calculated.SPSS Modeler 18.3 software was used to build a complex network,and then the Apriori algorithm was used to analyze the association rules of herbs with support degree set as 10 and the confidence degree as 0.8.Finally,SPSS 25.0 was used to conduct systematic cluster analysis on high-frequency herbs.Results:A total of 72 prescriptions and 134 herbs were included for analysis.The top 3 herbs were Dangdui(Radix Angelicae Sinensis),Baishao(Radix Paeoniae Alba),and Chuanxiong(Rhizoma Chuanxiong).In terms of the medical natures and medical flavors,the herbs were mainly warm,bitter and acrid,and the liver channel,the spleen channel,and the heart channel were the mostly frequent entry channels.Complex network construction obtained 3 strongly associated combinations:Baishao-Danggui,Chuanxiong-Danggui,and Baishao-Chuanxiong.Association rules analysis found 15 herb pairs,and the top 2 with highest confidence degree were Honghua(Flos Carthami)-Danggui,Yanhusuo(Rhizoma Corydalis)-Danggui.Two herb combinations were obtained through hierarchical cluster analysis:①Danggui,Chuanxiong,Baishao,Shudihuang(Radix Rehmanniae Preparata),Renshen(Radix Ginseng),Rougui(Cortex Cinnamomi),Taoren(Semen Persicae),Mudanpi(Cortex Moutan),Yanhusuo.②Xiangfu(Rhizoma Cyperi),Dihuang,Gancao(Radix Glycyrrhizae),Huangqin(Radix Scutellariae).Conclusion:In this study,through the analysis of 72 prescriptions for the treatment of irregular menstruation in Fuke Yuchi,it is found that SHEN Jin’ao emphasized the pathogenesis of menstruation caused by blood coagulation,and the methods of regulating menstruation are tonifying Qi(气)and blood circulation,activating blood circulation and removing blood stasis,and regulating Qi and relieving pain were mainly used to regulate menstruation.The prescription is often flexibly added and subtracted on the basis of the Siwu decoction(四物汤).SHEN’s progress in regulating menstruation lies in regulating the heart,often using Baiziren Wan(柏子仁丸),Changpu Yin(菖蒲饮)and so on.In addition,SHEN’s regulating menstruation attaches importance to regulating the liver auompanied by regulating the heart and spleen,pointing out that the liver and Chong(冲)channel are both blood chambers,which has some inspiration for the treatment of gynecological diseases.