摘要
目的探析叶天士治内风的用药特点。方法检索《临证指南医案》中风篇、肝风篇、眩晕篇、头风篇、虚劳篇、肝火篇、不寐篇、痉厥篇、癫痫篇、头痛篇医案,统计医案中证候要素、证候要素靶位、中药频次、性味、归经,分析关联规则和高频药物聚类。结果本研究纳入167篇医案,提取证候要素241个、证候要素靶位333个;纳入183首处方,涉及132味药物,药物总频次1309次。高频中药前5位依次是生地黄、茯神、阿胶、茯苓、熟地黄;药性以寒性最多,其次是温、平;药味以甘性最多,其次是苦、温;归经前5位依次是肝、肾、肺、心、脾。药物关联规则分析得到14项,高频药物聚类得到9类。结论叶天士治内风紧扣“阳化内风”,治疗基础原则为滋液熄风、清上实下、疏肝和胃,兼以辛甘化风、清肝泄热、祛风化痰、益气实卫、清热安神等,调和脏腑经络、平息内风。
Objective To examine of Ye Tianshi’s approach to managing internal wind through herbal remedies.Methods A comprehensive search was conducted for medical cases pertaining to internal wind,liver wind,dizziness,head wind,deficiency labor,liver fire,insomnia,convulsions,epilepsy,and headache within the Clinical Guidelines in Medical Cases.Statistical analysis of symptom elements,target locations of symptom elements,frequency of Chinese medicinal substances,their properties,and meridian affiliations was performed using Excel.Prescription patterns were further analyzed through association rules and high-frequency drug clustering.Results The study included a total of 167 medical cases,from which 241 symptom elements and 333 target locations were extracted.A total of 183 prescriptions were analyzed,comprising 132 medicinal substances with an overall frequency of 1309 occurrences.The five most frequently used Chinese medicines were Sheng Di Huang,Fu Shen,E Jiao,Fu Ling,and Shu Di Huang.The predominant property observed was cold,followed by warm and neutral;the most common flavor was sweet,succeeded by bitter and warm.The leading meridian affiliations identified were liver,kidney,lung,heart,and spleen.The drug association rule analysis revealed 14 items,while high-frequency drug clustering resulted in 9 distinct categories.Conclusion Ye Tianshi's therapeutic approach to internal wind emphasizes the concept of“yang transforming into internal wind.”The core principles of this treatment strategy involve nourishing bodily fluids to mitigate wind,addressing excess conditions in the upper body while rectifying deficiencies in the lower body,and promoting tranquility in the liver and stomach.Additionally,the use of pungent and sweet flavors is employed to facilitate the transformation of wind,to clear the liver and dispel heat,to eliminate wind and resolve phlegm,to tonify qi and enhance defensive qi,and to clear heat in order to soothe the spirit.This methodology seeks to achieve harmony among the organs and meridians while pacifying internal wind.
作者
白云先
杨恩发
温灵芝
黄建平
BAI Yunxian;YANG Enfa;WEN Lingzhi;HUANG Jianping(Department of Neurology,Wenzhou Hospital of Traditional Chinese Medicine,Zhejiang University of Traditional Chinese Medicine,Wenzhou 325000,Zhejiang,China;Department of Neurology,Wenzhou Central Hospital,Wenzhou 325000,Zhejiang,China)
出处
《中国现代医生》
2025年第5期72-75,共4页
China Modern Doctor
基金
浙江省中医药科技计划项目(2024ZL994)
中央高水平医院临床科研业务项目(BJ-2023-067)。
关键词
叶天士
《临证指南医案》
数据挖掘
内风
用药规律
Ye Tianshi
Clinical Guidelines in Medical Cases
Data mining
Internal wind
Medication patterns
