基于数据挖掘的方鸣教授治疗不寐用药规律研究

Study on the Medication Patterns of Professor Fang Ming's Treatment For Insomnia Based on Data Mining

目的通过数据挖掘及统计学方法,整理方鸣教授针对不寐的临证用药规律及学术思想,探索核心药物的作用机制。方法收集方鸣教授2021年12月至2023年1月在黄山市中医院接诊的不寐患者临床资料及所用方剂信息,借助中医传承辅助平台3.5软件进行相应分析药物四气、五味、归经、功效、频次、关联规则、聚类等。结果共收集病案处方211首,其中有18味中药的使用频次多于40次,前3位中药分别为远志、茯神、夏枯草;药性以寒性为多,其次为温、平、凉;药味多甘,其次为苦、辛;多以心、肝、肺经归;经聚类共有核心处方8个。结论方鸣教授治疗不寐,强调补虚、清热与安神,务在调整脏腑阴阳,配合养神、调神、安神法,或佐滋阴降火、交通阴阳,或合潜降肝火、除烦安神,或参辛开苦降、调理中州,或配活血化瘀、化痰利湿,或以介类沉降、养血补心、宁神定志,务在使全身气血和调,精神内守,心安志舒则易寐。

Objective To organize Professor Fang Ming's clinical medication patterns and academic thoughts on insomnia through data mining and statistical methods,and to explore the mechanisms of core drugs.Methods Clinical data and prescription information for insomnia patients treated by Professor Fang Ming at Huangshan City Hospital of Traditional Chinese Medicine from December 2021 to January 2023 were collected.The data was analyzed using the Traditional Chinese Medicine Inheritance Support System(TCMISS)3.5 software,focusing on the four natures,five flavors,meridian tropism,efficacy,frequency,association rules,and clustering of the drugs.Results A total of 211 prescriptions were collected,with 18 herbs used more than 40 times.The top 3 herbs were Polygalae Radix(Yuanzhi),Poria Sclerotium Pararadicis(Fushen),Prunellae Spica(Xiakucao),among others.The properties of these herbs were mostly cold,followed by warm,neutral,and cool.The most common flavors were sweet,followed by bitter and pungent.Most herbs entered the heart,liver,and lung meridians.Cluster analysis identified eight core prescriptions.Conclusions Professor Fang Ming's treatment for insomnia emphasizes replenishing deficiency,clearing heat,and calming the mind,aiming to adjust the yin and yang of the viscera.The treatment includes nourishing the spirit,regulating the mind,and calming the mind,supplemented with methods to nourish yin and reduce fire,balance yin and yang,suppress liver fire and calm the mind,stimulate acrid and bitter flavors to regulate the middle jiao,activate blood circulation,remove blood stasis,resolve phlegm,and drain dampness.Additionally,mineral substances are used to settle the mind,nourish the blood,supplement the heart,and stabilize the will,ensuring the balance of qi and blood throughout the body,with the spirit remaining internalized,leading to ease of sleep.