摘要
目的通过分析名老中医施今墨治疗痹证的中药处方,总结施师治疗痹证的组方用药规律。方法基于《施今墨临床经验集》《施今墨医案解读》《施今墨对药》,收集并筛选书中诊治的风湿病患者的医案以及处方,由双人审核后建立数据库。对所有纳入的处方药物运用Microsoftexcel 2021、SPSSStatistics 25.0统计软件及SPSSModeler 18.0数据挖掘软件以及apriori算法,经过标准化后进行药物频次、药物属性、药物聚类及药物关联分析,探索名老中医施今墨治疗痹证的用药规律。结果经过筛选,使用频数最多的前5项为桑寄生,桑枝,细辛,桂枝,秦艽。药性多为温性和寒性,药味以辛、苦共用,以肝、肾、脾三经为主要归经。得到3味药药物组合1组,4味药药物组合2组,6味药药物组合1组;关联分析可以看出施师善用桑寄生和桑枝、白芍,草节配伍。结论施师善将多药配伍运用,治疗痹证以散风、逐寒、祛湿、清热、补虚、行气、活血、通络立法为主。采用多元化的诊断治疗思路且擅长运用药对,发挥它们各自独特的药效用药不拘泥,方药灵活,运用适当即效。
Objective To analyze traditional Chinese medicine(TCM)prescriptions used by the renowned TCM master Shi Jinmo for treating Bi syndrome and summarize the medication patterns in his formula compositions.Methods Clinical case records and prescriptions related to rheumatic diseases from the books Shi Jinmo Clinical Experience Collection,Interpretation of Shi Jinmo's Medical Cases,and Shi Jinmo's Pairing of Herbs were collected and screened.After dual review,a database was established.Using Microsoft Excel 2021,SPSS Statistics 25.0,and SPSS Modeler 18.0 with the Apriori algorithm,medication frequency,properties,clustering,and association analyses were conducted after data standardization to explore the prescribing rules.Results After screening,the top five most frequently used herbs were Sangjisheng(Taxillus chinensis),Sangzhi(Mulberry twig),Xixin(Asarum),Guizhi(Cinnamon twig),and Qinjiao(Gentiana macrophylla).The herbs predominantly exhibited warm and cold properties,with spicy and bitter tastes,mainly entering the liver,kidney,and spleen meridians.Clustering analysis identified one combination of three herbs,two combinations of four herbs,and one combination of six herbs.Association analysis showed Shi Jinmo's frequent use of Sangjisheng,Sangzhi,Baishao(Paeonia lactiflora),and Caojie(Herba Dichroae).Conclusion Shi Jinmo favors multi-herb combinations to treat Bi syndrome focusing on dispersing wind,expelling cold,removing dampness,clearing heat,tonifying deficiency,promoting qi movement,activating blood circulation,and unblocking collaterals.His diversified diagnostic and therapeutic approach emphasizes flexible application of herb pairs,leveraging their unique effects without rigid adherence to fixed prescriptions,resulting in effective clinical outcomes.
作者
王彤彤
卞志庆
董宇昂
黄子琴
程方俊
李睿
张珺
WANG Tongtong;BIAN Zhiqing;DONG Yu ang;HUANG Ziqin;CHENG Fangjun;LI Rui;ZHANG Jun(First Clinical Medical College,Anhui University of Chinese Medicine,Hefei 230038,China;School of Medical Information Engineering,Anhui University of Chinese Medicine,Hefei 230012,China;School of Traditional Chinese Medicine,Anhui University of Chinese Medicine,Hefei 230012,China)
出处
《陕西中医药大学学报》
2025年第4期110-115,共6页
Journal of Shaanxi University of Chinese Medicine
基金
国家自然科学基金面上项目(82174160)
省级大学生创新创业训练项目(S202310369162)。
关键词
施今墨
痹证
用药规律
数据挖掘
聚类分析
Shi Jinmo
Bi syndrome
medication patterns
data mining
cluster analysis
