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论著.中医药与民族医药诊疗 | 更新时间:2024-04-25
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《普济方》治疗肢体痹的用药规律分析
Pujifang for the treatment of extremity arthralgia: an analysis of medication rules

广西医学 页码:90-95

作者机构:何心愉,在读博士研究生,住院医师,研究方向为脊柱与四肢退行性疾病的中医治疗研究。

基金信息:广西壮族自治区中医药管理局自筹经费科研课题(GXZYZ20210112,GXZYA20220117)

DOI:10.11675/j.issn.0253⁃4304.2024.01.15

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  • 参考文献

目的 采用数据挖掘方法分析《普济方》治疗肢体痹症的用药规律。方法 筛选《普济方》中治疗肢体痹的组方。采用Microsoft Excel 软件统计组方中中药的使用频次,以及药性、药味、归经的频次分布;针对高频中药(使用频次≥30次的中药),运用SPSS 21.0软件进行聚类分析,采用SPSS Clementine 12.0软件建立可视化网络关联图,并采用Aprior算法进行关联规则分析;采用SPSS Statistics 20.0软件中的CHAID、CRT、QUEST决策树方法进行规律识别的挖掘。结果 共筛选271首方剂,涉及272味中药;高频中药有24味,使用频次位居前5的中药依次为肉桂、防风、附子、当归、川芎。272味中药的药性以温性、寒性为主,药味以辛味、苦味为主,归经以肝经、肾经、肺经常见。网络关联图提示防风、当归、川芎、肉桂、附子与其他药物的关联性较强,其中防风是核心用药。聚类分析将高频中药聚为5类。关联规则分析得到15组2味药有效组合和3组3味药有效组合。以当归为因变量的决策树筛选出川芎、防风,其中川芎为最佳识别中药。结论 《普济方》中治疗肢体痹的组方以防风、川芎为核心配伍药物。该方剂既有寒性药物以清热通利,又有温性药物以散寒止痛,同时包含宣畅气机、活血化瘀的辛苦类药物,其侧重于活血祛风、温阳散寒,并兼顾行气活血、补气利水和补益肝肾。

Objective To analyze the medication rules of Pujifang for the treatment of extremity arthralgia by using data mining method. Methods The prescriptions for the treatment of extremity arthralgia was screened from Pujifang. The use frequency, and frequency distributions of drug property, drug flavor, meridian entries of Traditional Chinese Medicines in prescriptions were statistically analyzed by employing the Microsoft Excel software. For high⁃frequency Traditional Chinese Medicines (with use frequency of Traditional Chinese Medicines≥30 times), the SPSS 21.0 software was used to perform cluster analysis. The SPSS Clementine 12.0 software was used to establish visual network association chart, and the Aprior algorithm was used to perform the association rule analysis. CHAID, CRT and QUEST decision tree methods of SPSS Statistics 20.0 software were used to perform mining for pattern recognition. Results A total of 271 prescriptions were screened, involving 272 flavors of Traditional Chinese Medicines. There were 24 flavors of high⁃frequency Traditional Chinese Medicines, and the top 5 most frequently used Traditional Chinese Medicines were successively Cinnanmomi cortex, Saposhnikoviae radix, Aconiti lateralis radix praeparata, Angelicae sinensis radix, and Chuanxiong rhizoma. The drug properties of 272 flavors of Traditional Chinese Medicines were mainly warm and cold, drug flavors were mainly acrid and bitter, meridian entries were commonly liver meridian, kidney meridian, and lung meridian. The network association chart indicated that Saposhnikoviae radix, Angelicae sinensis radix, Chuanxiong rhizoma, Cinnanmomi cortex, Aconiti lateralis radix praeparata were strongly associated with other drugs, therein Saposhnikoviae radix was the core drug. Cluster analysis clustered high⁃frequency Traditional Chinese Medicines into five categories. By association rule analysis, 15 groups of 2 effective combinations of drugs and 3 groups of 3 effective combinations of drugs were obtained. Chuanxiong rhizoma and Saposhnikoviae radix were screened out by the decision tree with Angelicae sinensis radix as the dependent variable, among which Chuanxiong rhizoma was the optimal recognized Traditional Chinese Medicine. Conclusion In the prescriptions of Pujifang for the treatment of extremity arthralgia, the core combination drugs are Saposhnikoviae radix and Chuanxiong rhizoma. This prescription includes both cold drugs of clearing heat and promoting benefits, and warm drugs of dissipating cold and relieving pain; at the same time, it includes acrid and bitter drugs for activating qi, promoting blood circulation and removing blood stasis. It focuses on promoting blood circulation and dispelling wind, warming yang and dispersing cold, and takes into account both promoting qi circulation and blood circulation, invigorating qi and water, and nourishing liver and kidney.

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