摘要
目的探析国医大师李济仁辨治痿病虚证的用药规律。方法收集李济仁门诊病历系统中2013年1月-2018年12月李老治疗的195个痿病虚证病案,通过FP-Growth加强数据运算模型,确定病案中的临床症状频次及药物组合,分别应用频次分析、聚类分析和关联规则分析。结合临床及中医理论,总结李老辨治痿病虚证的用药经验。结果195个病案中主要症状有121个,频次前5位依次为肌肉萎缩(79次)、肌力下降(69次)、行走困难(52次)、肢体痿软无力(43次)、寐差(33次);舌象以淡红、淡白、红、紫黯居多;脉象多见细脉、弦脉、沉脉、滑脉。共涉及药物159种,频次前5位依次为黄芪(140次)、当归(103次)、肉苁蓉(93次)、补骨脂(87次)、巴戟天(81次)。用药以补虚药、祛风湿药、活血化瘀药为主,归经以入肝、肾、脾经为多,药性以温为主,药味以甘、苦为多。关联分析显示,黄芪是处方的配伍核心,高频药物与李老的临床用药经验符合。最后通过K均值聚类分析得到3类高频组方。结论李老治疗痿病虚证,以新安医学所特有的培本固元思想,在应用补益药的基础上,辨证配伍祛风通络、活血化瘀的药物。
Objective To study the application of herbs of National TCM Master Li Jiren on treating atrophy with deficiency syndrome.Methods By collecting 195 cases of atrophy-disease treated by Professor Li in Out-patient Medical Record System dated from January 2013 to December 2018,and FP-Growth computing paradigm was used to analyze frequency,FP-Growth enhanced computing paradigm was used to analyze the frequencyand association of symptoms and herbal pairs.Professor Li’s experience was accordingly summurized with clinic situation and Traditional Chinese Medicine theory.Results There are 121 main symptoms among 195 selected cases,and amyotrophy(79 times),decreased muscle strength(69 times),difficulty in walking(52 times),weakness of upper extremities(43 times)and poor sleeping quality(33 times)rank the top 5 symptom.In terms of tongue manifestations,the color pink,pale,red and purple are the most;while in terms of pulses,weak,thread,deep and stringy were frequent.A total of 159 sorts of herbs were collected and Astragali Radix(140 times),Angelicae Sinensis Radix(103 times),Cistanches Herba(93 times),Psoraleae Fructus(87 times),Morindae Officinalis Radix(81 times)were the top 5.The herbs used are mainly with the function of tonifying deficiency,dispelling wind and dampness promoting blood circulation and removing blood stasisand.most of the herbs belong to liver,kidney and spleen meridians with warm character,sweet and bitter in taste.Association analysis between high-frequency herbs indicated that Astragali Radix is the core of most formulas,which conformed to Li’s clinical experience.Three prescriptions were also obtained through cluster analysis.Conclusion Professor Li treated atrophy diseases with deficiency syndrome by the unique idea of strengthening primordial qi and consolidating body resistance of Xin’an Medicine school.On the ground of using herbs to tonify,synergy of herbs,which were able todispel pathogenic wind,dredge channels and promote blood circulation for removing blood stasis,was achieved based on differentiation.
作者
史潮
王一苇
李艳
Shi Chao;Wang Yiwei;Li Yan(Department of Chinese Medicine,Yijishan Hospital,First Affiliated Hospital of Wannan Medical College,Wuhu 241001,China;Research Center of Integrated Traditional Chinese and Western Medicine,Wannan Medical College,Wuhu 241002,China)
出处
《国际中医中药杂志》
2021年第3期280-284,共5页
International Journal of Traditional Chinese Medicine
基金
国家中医药管理局重点学科中医痹病学建设项目(国中医药人教发﹝2012﹞32号)。
关键词
痿证
虚证
李济仁
名医经验
用药规律
数据挖掘
Flaccidity syndrome
Deficiency syndrome complex
Li Jiren
Famous doctor’s experience
Rules of Chinese medicine formula
Data mining
