基于古代文献分析痧证外治法关键信息

Research on key information of external treatment of Sha-syndrome based on ancient literature analysis

目的:系统挖掘梳理古代医籍中关于痧证外治法的源流、概念、逻辑关系、主治病症、具体方法等关键信息进行整理研究。方法:基于中华医典数据库和安徽中医药大学青梨文献库,使用计量学方法分析相关古籍朝代、临床症状、痧证外治方法、部位选择等数据,采用统计学软件IBM SPSS Statistics27和IBM SPSS Modeler 18.0进行刮痧部位以及痧证的聚类和关联规则分析。结果:痧证外治法的古籍汉、明、清各有2、6、23部,74.19%信息记载于清代古籍。其中干预疾病之痧证外治法最多见于放痧、刮痧法,放痧应用频次占比最多为绞肠痧(21.74%)和兼痧(13.9%),刮痧应用频次占比最多为绞肠痧(16.7%)和斑痧(16.7%)。对不同痧证进行关系规则分析,可见绞肠痧与发痧呈强关联。刮痧部位的聚类分析谱系图,当度值为20时,刮痧部位分4类:颈项-两胁-背心、脉门-脑后、心窝、足心;放痧部位的聚类分析谱系图,当度值为15时,放痧部位分5类:十指头-两臂弯-两腿弯、舌下两傍-少商穴、委中穴-曲池穴、颠顶、双乳;结合古籍医案常用部位、痧证脉候、痧筋辨识,外治工具和介质等形成系统信息结构。结论:痧证外治法是中医临床经验的宝贵结晶,通过厘清古代文献关键信息,为传承和临床应用提供参考依据。

Objective:To systematically sort out the key information of the origin,concept,logical relationship,main syndrome for treatment and specific methods of external treatment of Sha-syndrome in the ancient literature for collating and studying.Methods:Based on the database of Chinese Medical Code and Qingli Document Database of Anhui University of Chinese Medicine,the data of related ancient books dynasties,clinical symptoms,various methods of external treatment of Sha-syndrome and site selection were analyzed by metrology.Statistical software IBM SPSS Statistics27 and IBM SPSS Modeler 18.0 were used to analyze the clustering and association rules of gua-sha site and Sha-syndrome.Results:There were 2,6 and 23 ancient books on external treatment of Sha-syndrome in Han Dynasty,Ming Dynasty and Qing Dynasty respectively.74.19%of the information was recorded in ancient books of the Qing Dynasty.Among them,the external treatment of the intervention of disease was most common in fang-sha and gua-sha.The application frequency of fang-sha accounted for the most of the jiaochang-sha(21.74%)and jian-sha(13.9%),and the application frequency of gua-sha accounted for the most of the jiaochang-sha(16.7%)and ban-sha(16.7%).The relationship rules of different Sha-syndromes were analyzed.The results showed that there was a strong correlation between jiaochang-sha and fa-sha.The cluster analysis pedigree diagram of gua-sha site showed that when the degree was 20,the gua-sha site was divided into 4 categories:neckhypochondrium-back,portal of pulse-back of the head,precordium,and foot heart.The cluster analysis pedigree diagram of fang-sha site showed that when the degree was 15,the fang-sha site was divided into 5 categories:ten fingers-crook of the arms-crook of the legs,sublingual sides-Shaoshang acupoint,Weizhong acupoint-Quchi acupoint,vertex and breasts.In addition,the systematic information structure of the external treatment tools and media was formed by combining the common parts,pulse of Sha-syndrome,and identification of sha-jin,the external treatment tools and media in the ancient books in the ancient books.Conclusion:External treatment of Sha-syndrome is the precious outcome of traditional Chinese clinical experience.This article clarifies the key information of ancient literature to provide reference for the inheritance and clinical application of the treatment.