基于数据挖掘技术探讨张景岳治疗淋浊用药规律

Discussion on Medication Rules of ZHANG Jingyue in Treating Strangury with Turbid Discharge Based on Data Mining Technology

目的:基于数据挖掘技术探讨张景岳治疗淋浊的用药规律。方法:收集并规范《景岳全书》中张景岳治疗淋浊的方药信息,建立数据库。利用SPSS Modeler18.0、SPSS Statistics26.0、Cytoscape3.9.1等软件进行药物频次、频率分析,以及药物关联、聚类分析。结果:共获得方剂55首,使用中药105味,105味中药使用总频次为386次。28味高频中药(频次≥5次)中茯苓使用频次最高,按功效统计,补虚药有13味,居第一,其次为利水渗湿药6味。药物关联分析得到茯苓→远志、人参,山药→山萸肉等8个药物关联规则,药物关联网状图得到茯苓、人参,山药、山萸肉,茯苓、远志,木通、栀子等关联度较高的药对。聚类分析得到“山药、山萸肉、熟地黄、肉桂、菟丝子、韭菜子、杜仲、巴戟天、牛膝、五味子、牡丹皮”“当归、白术、人参、远志、茯苓、炙甘草”“黄芩、麦冬、生地黄、泽泻、猪苓、车前子、灯心草、木通、栀子、甘草”3首核心处方。结论:张景岳治疗淋浊主张补虚治本,利湿治标。补虚治本重在脾肾,脾肾亏虚型淋浊以温补升提为主,稍佐甘淡渗利,并根据证候特点运用收涩、宁心、助阳等药物。利湿治标不拘寒热,首推茯苓甘淡渗利,膀胱湿热型淋浊以清热、利湿为主,亦灵活辅以牛膝活血通淋。

Objective:To explore the medication rules of ZHANG Jingyue in treating strangury with turbid discharge based on data mining technology.Methods:The information of prescriptions and medicinals for treating strangury with turbid discharge by ZHANG Jingyue in Jing Yue Quan Shu(The Complete Works of ZHANG Jingyue)was collected and standardized,and a database was established.SPSS Modeler18.0,SPSS Statistics26.0,Cytoscape3.9.1 and other softwares were used for medicinal frequency,frequency distribution analysis,medicinal association and cluster analysis.Results:A total of 55 prescriptions were obtained;105 kinds of Chinese medicinals were used,and the total frequency of the 105 kinds of Chinese medicinals was 386 times.Among 28 high-frequency Chinese medicinals(frequency≥5 times),Poria was at the highest frequency.According to the statistics of effects,there were 13 kinds of Chinese medicinals for supplementing deficiency,ranking the first,followed by 6 kinds of Chinese medicinals for promoting urination and percolating dampness.According to the medicinal association analysis,8 medicinal association rules were obtained,such as Poria-Polygalae Radix and Ginseng Radix et Rhizoma,Dioscoreae Rhizoma-Corni Fructus,and so on.The drug association mesh obtained higher degree of medicinal pairs,such as Poria-Ginseng Radix et Rhizoma,Dioscoreae Rhizoma-Corni Fructus,Poria-Polygalae Radix,Akebiae Caulis-Gardeniae Fructus,and so on.Cluster analysis obtained three core prescriptions,namely,“Dioscoreae Rhizoma,Corni Fructus,Rehmanniae Radix Praeparata,Cinnamomi Cortex,Cuscutae Semen,Allii Tuberosi Semen,Eucommiae Cortex,Morindae Officinalis Radix,Achyranthis Bidentatae Radix,Schisandrae Chinensis Fructus,Moutan Cortex”“Angelicae Sinensis Radix,Atractylodis Macrocephalae Rhizoma,Ginseng Radix et Rhizoma,Polygalae Radix,Poria,Glycyrrhizae Radix et Rhizoma Praeparata cum Melle”“Scutellariae Radix,Ophiopogonis Radix,Rehmanniae Radix,Alismatis Rhizoma,Polyporus,Plantaginis Semen,Junci Medulla,Akebiae Caulis,Gardeniae Fructus,Glycyrrhizae Radix et Rhizoma”.Conclusion:ZHANG Jingyue advocated to treat strangury with turbid discharge by supplementing deficiency to treat the root and by draining dampness to treat the branch.When supplementing deficiency to treat the root,the spleen and kidney is emphasized.When treating strangury with turbid discharge of spleen-kidney depletion type,the main treatment is to warm and supplement,and to raise center qi,supplemented by percolating and draining dampness with mild medicinals.Besides,according to the syndrome characteristics,the medicinals for astringing,calming the heart,and assisting yang were applied.When draining dampness to treat the branch,it is not limited to use cold or heat medicinals;the first recommendation is to use Poria to percolate and drain dampness.When treating strangury with turbid discharge of bladder damp-heat type,the main treatment is to clear heat and drain dampness,flexibly supplemented by Achyranthis Bidentatae Radix to invigorate blood and relieve strangury.