基于数据挖掘的《疫喉浅论》辨治猩红热用药规律研究

Research on the Medication Patterns for the Differentiation and Treatment of Scarlet Fever in Yi Hou Qian Lun Based on Data Mining

目的探究清代喉科医家夏云治疗猩红热的用药特色及规律。方法手工检索夏云所著《疫喉浅论》中治疗猩红热的内服与外用方剂,分别建立数据库,运用古今医案云平台(V2.3.5)中统计分析、关联分析与层次聚类分析挖掘内服与外用方剂中药物频次、功效、四气五味归经、常用药对及核心药物组合规律。结果《疫喉浅论》中共有64首猩红热治疗方,其中内服方剂41首,外用方剂23首。内服方剂中使用频次最高的中药为玄参,药物功效以疏散风热为主,药物气味归经以寒性、甘味、肺经药多用,常用药对为地黄-麦冬,通过聚类分析得出3类内服核心处方。外用方剂中使用频次最高的中药为冰片,药物功效以清热解毒为主,药物气味归经以寒性、苦味、肺经药多用,常用药对为硼砂-冰片,通过聚类分析得出3类外用核心处方。结论《疫喉浅论》中治疗猩红热的内服、外用方剂均反映了夏云对猩红热病因病机及病位的认识,体现了其“清透化毒凉营泄热”的治疗原则,可为当今猩红热治疗提供参考。

Objective To explore the characteristics and laws of Xia Yun,a laryngologist of Qing dynasty,in the treatment of scarlet fever.Methods We manually searched the internal and external prescriptions for scarlet fever in Yi Hou Qian Lun and establised databases seperately.Statistical analysis,correlation analysis and hierarchical cluster analysis in the cloud platform of ancient and modern medical records(V2.3.5)were used to explore the frequency,efficacy,four natures,five flavours,meridian distribution,common drug pairs and core drug combination rules of traditional Chinese medicine in internal and external prescriptions.Results There were 64 therapeutic prescriptions for scarlet fever in Yi Hou Qian Lun,including 41 prescriptions for internal use and 23 prescriptions for external use.In the internal prescriptions,Figwort was the most frequently used traditional Chinese medicine.The drug efficacy was mainly based on dispelling wind and heat.The four natures,five flavours and meridian distribution of drugs belonged to the cold,sweet and lung meridian.The common drug pair was Rehmannia glutinosa and Dwarf lilyturf root.Three kinds of core prescriptions were obtained by cluster analysis.In external prescriptions,Borneol was the most frequently used traditional Chinese medicine.The drug efficacy was mainly to clear away heat and detoxify.The four natures,five flavours and meridian distribution of drugs belonged to the cold,bitter,and lung meridian.The common drug pair was Borax and Borneol.Three kinds of core prescriptions were obtained by cluster analysis.Conclusion The internal and external prescriptions for the treatment of scarlet fever in Yi Hou Qian Lun reflected Xia Yun's understanding of the pathogenesis and location of scarlet fever.It embodied the treatment principle of"clearing away toxins,cooling and relieving heat",and provided a reference for the treatment of scarlet fever.