摘要
目的:基于数据挖掘辨析《医案类聚》闭经案用药规律,为临床治疗闭经提供参考。方法:搜集整理《医案类聚》中符合纳入标准的闭经医案,对其药物名称进行规范处理并使用Excel建立数据库,应用古今医案云平台软件(V2.3.9)对数据库中中药基本属性进行相关分析,运用R语言数据挖掘工具对数据库进行关联分析、聚类分析、共现网络分析,得到古代医家治疗闭经的用药规律。结果:经过筛选,共收集方剂181首,涉及278味中药,药物使用总频次为1899,选取使用频次≥20的中药,共25味中药,其中用药频次最高者为当归,使用频次为117次(64.64%),其次为白芍、茯苓,使用频次分别为76次(41.99%)、74次(40.88%);药性以温为主,达621次(32.70%);药味以甘为主,达837次(44.08%),其后依次为辛、苦,分别为780次(41.07%)、778次(40.97%);主要归于脾经、肝经、心经。设置最低条件支持度10%,最小规则置信度80%,得出70条关联规则,其中二阶关联规则6条,三阶关联规则30条,选取其中置信度为100%者,共9条,四阶关联规则26条,五阶关联规则8条,支持度最高者为“白芍-当归”,置信度为100%药物组合共15组,其中支持度较高者为“熟地黄-当归”“川芎-白芍-当归”“川芎-甘草-当归”“熟地黄-白芍-当归”“人参-甘草-茯苓-白术”;聚类分析得到6组核心药物,共现网络分析得到八珍汤加减的核心处方。结论:《医案类聚》对于闭经治疗强调调和气血、脏腑,以补为主,补而不滞,同时提出大黄破血,为后世治疗提供新思路。
Objective:To analyze the medication rules of amenorrhea cases in Yian Leiju(《医案类聚》)through data mining,and provide a reference for the clinical treatment of amenorrhea.Methods:This study collected and sorted out amenorrhea medical records that met the inclusion criteria in Yian Leiju,standardized the drug names,and established a database using Excel.The basic attributes of Chinese medicines in the database were analyzed by the Ancient and Modern Medical Records Cloud Platform software(V2.3.9),and the data was analyzed by the R language data mining tool for association analysis,cluster analysis,and co-occurrence network analysis,so as to obtain the medication rules of ancient doctors in the treatment of amenorrhea.Results:After screening,a total of 181 prescriptions were collected,involving 278 kinds of Chinese materia medica(CMM).The use requency of drugs accumulated to 1899 times.CMM with a use frequency of≥20 times were selected,and 25 kinds of CMM were chosen in total.Among them,Dang Gui(Radix Angelicae Sinensis)had the highest use frequency,reaching 117 times(64.64%),followed by Bai Shao(Radix Paeoniae Alba)and Fu Ling(Poria),with use frequencies of 76 times(41.99%)and 74 times(40.88%)respectively.In terms of medicinal properties,drugs with warm nature dominated,accounting for 621 times(32.70%).Regarding medicinal flavors,drugs with sweet taste were the most common,totaling 837 times(44.08%),followed by pungent and bitter tastes,which were 780 times(41.07%)and 778 times(40.97%)respectively.The main meridians that the drugs acted on were the Spleen Meridian,Liver Meridian,and Heart Meridian.By setting the minimum condition support at 10%and the minimum rule confidence at 80%,70 association rules were obtained,including 6 two-order association rules,30 three-order association rules,26 four-order association rules,and 8 five-order association rules.Among the three-order association rules,9 had a confidence of 100%.The highest support was found in the“Bai Shao-Dang Gui”combination.There were 15 drug combinations with a confidence of 100%,among which the ones with relatively higher support were“Shu Di Huang(Radix Rehmanniae Preparata)-Dang Gui”,“Chuan Xiong(Rhizoma Ligustici Chuanxiong)-Bai Shao-Dang Gui”,“Chuan Xiong-Gan Cao(Radix et Rhizoma Glycyrrhizae)-Dang Gui”,“Shu Di Huang-Bai Shao-Dang Gui”and“Ren Shen(Radix et Rhizoma Ginseng)-Gan Cao-Ful Ling-Bai Zhu(Rhizoma Atractylodis Macrocephalae)”.Cluster analysis yielded 6 groups of core drugs,and co-occurrence network analysis identified the core prescription modified from the Bazhen decoction(八珍汤).Conclusion:Yian Leiju emphasizes regulating Qi,blood,and the Zang-Fu organs in the treatment of amenorrhea,focusing on tonification while ensuring that the tonics do not cause stagnation.At the same time,it proposes that Da Huang(Radix et Rhizoma Rhei)can break blood,providing new ideas for the treatment of amenorrhea in later generations.
出处
《中医临床研究》
2025年第30期95-104,共10页
Clinical Journal Of Chinese Medicine
