基于数据挖掘探析从痰论治眩晕的临证经验

Exploring the clinical experience of treating vertigo from phlegm theory based on data mining

目的探讨吕国雄主任中医师从痰论治眩晕的用药规律,为中医药治疗眩晕提供诊疗方案及科学依据。方法收集2023年10月至2024年3月于江西中医药大学附属医院神经内科门诊就诊并诊断为眩晕患者的诊疗信息,构建符合纳入标准的中药处方数据库,对中药的使用频次、四气、药味、归经、关联规则和聚类等进行分析。结果共纳入符合标准的眩晕患者150例,录入处方150首。涉及中药114味,共计中药使用频次1846次。其中,16味中药的使用频次>30次,依次为黄连、茯苓、甘草、白术、陈皮、半夏、竹茹、延胡索、香附、牛膝、钩藤、珍珠母、黄芩、柴胡、首乌藤等。高频药物功效以清热燥湿化痰、利湿健脾、降气化痰除痞、行气和胃、活血化瘀等为主,性味多以辛苦温、甘平、苦寒为主,归经以脾、肝经为主。最常用药对分别为茯苓-竹茹、黄连-法半夏、陈皮-竹茹、茯苓-甘草等。关联支持度和置信度较高的药对分别为黄连-陈皮、法半夏-陈皮、枳实-竹茹、竹茹-法半夏、茯苓-陈皮、甘草-陈皮等。结论从痰论治眩晕,治眩以清热化痰、清胆和胃为法,常用黄连温胆汤等方剂化裁加减,随证治之。

Objective To explore the medication pattern of Chinese medicine practitioner LYU Guoxiong in treating vertigo from the phlegm theory,and to provide diagnostic and therapeutic solutions and scientific basis for the treatment of vertigo by traditional Chinese medicine.Methods To collect the diagnosis and treatment information of patients who attended the outpatient clinic of the Department of Neurology,Affiliated Hospital of Jiangxi University of Chinese Medicine and diagnosed with vertigo from October 2023 to March 2024,to construct a database of the inclusion criteria,and to analyse the frequency of use of traditional Chinese medicines,the four Qi,the flavour of a drug,the attribution of the meridians,the rules of association,and the clustering.Results A total of 150 patients with vertigo who met the criteria were included,and 150 prescriptions were recorded.Involving 114 flavours of traditional Chinese medicine,the total frequency of traditional Chinese medicines using was 1846 times.Among them,16 Chinese medicines were used>30 times,in the order of Huanglian,Fuling,Gancao,Baizhu,Chenpi,Banxia,Zhuru,Yanhusuo,Xiangfu,Niuxi,Gouteng,Zhenzhumu,Huangqin,Chaihu,Shouwuteng etc.The efficacy of high-frequency drugs was based on clearing heat and drying dampness to resolve phlegm,inducing dampness to strengthen the spleen,lowering Qi to resolve phlegm and remove lumps,relieving Qi stagnancy in stomach,activating blood circulation and removing blood stasis,etc.The tastes of the drugs were mostly to be hard and warm,sweet and flat,and bitter and cold,and the attributing meridians were mainly the spleen and liver meridians.The most commonly used drug pairs were Fuling-Zhuru,Huanglian-Fabanxia,Chenpi-Zhuru,Fuling-Gancao,etc.The drug pairs with high association support and confidence level were Huanglian-Chenpi,Fabanxia-Chenpi,Zhishi-Zhuru,Zhuru-Fabanxia,Fuling-Chenpi,Gancao-Chenpi.Conclusion Treating dizziness from the perspective of phlegm,the method of treating dizziness is to clear heat and phlegm,clear the gallbladder and stomach.Commonly used formulas such as Huanglian Wendan decoction are modified and adjusted according to the syndrome.