[1]祁建华,明洪,张会择,等.基于数据挖掘法探讨《世医得效方》中治伤方剂的用药规律[J].中医正骨,2022,34(03):20-25.
　QI Jianhua,MING Hong,ZHANG Huize,et al.A data mining-based analysis of clinical medication rules of prescriptions for treatment of orthopedic and traumatic diseases in Shiyi Dexiao Fang[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2022,34(03):20-25.
点击复制

基于数据挖掘法探讨《世医得效方》中治伤方剂的用药规律()
分享到：

《中医正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第34卷
期数:
2022年03期
页码:
20-25
栏目:
文献研究
出版日期:
2022-03-20

文章信息/Info

Title:
A data mining-based analysis of clinical medication rules of prescriptions for treatment of orthopedic and traumatic diseases in Shiyi Dexiao Fang
作者:
祁建华; 明洪; 张会择; 胡友鹏; 戴泽林; 杨斐; 陈日高
(成都中医药大学附属医院,四川 成都 610072)
Author(s):
QI Jianhua; MING Hong; ZHANG Huize; HU Youpeng; DAI Zelin; YANG Fei; CHEN Rigao
Hospital of Chengdu University of TCM,Chengdu 610072,Sichuan,China
关键词:
《世医得效方》;  中医骨伤科疾病;  方剂分析; 计算机辅助;  数据挖掘
Keywords:
Shiyi Dexiao Fang;  orthopedic traumatologic diseases(TCM);  formula anal; comput assist;  data mining
摘要:
目的:探讨《世医得效方》中治伤方剂的用药规律。方法:收集《世医得效方》中第18卷“正骨兼金镞科”中的治伤方剂,建立标准化方药数据库。采用中医传承计算平台(V3.0)统计纳入方剂中药物的使用频次、功效、药性、药味及归经,采用SPSS Modeler 18.0软件对其中的高频药物进行关联规则分析,采用SPSS Statistics 26.0软件对其中的高频药物进行聚类分析。结果:共收集79首方剂,其中内服方剂40首、外用方剂39首,共涉及154味中药。内服中药115味,累计使用频次278次,使用频次≥4的中药共21味,居于前5位的中药依次为当归、川芎、乳香、大黄、甘草; 外用中药81味,累计使用频次135次,使用频次≥3的中药共15味,居于前5位的中药依次为铅丹、白芷、枫香脂、地黄、生姜。《世医得效方》治伤方剂中内服中药多采用活血化瘀、补虚、解表类药物,外用中药主要以解表、清热、活血化瘀类药物为主; 药物多归肝、脾、心经,药味多辛、苦; 内服药的药性偏温、平,外用药的药性偏温、寒。对使用频次≥4的21味内服中药进行关联规则分析,得到10条关联规则,涉及10个核心药物组合,分别为川芎→当归、没药→乳香、苏木→当归、白芍→当归、自然铜→没药、肉桂→当归、白芷→木香、白芷→川芎、白芷→当归、白芍+川芎→当归; 对使用频次≥3的15味外用中药进行关联规则分析,得到10条关联规则,涉及10个核心药物组合,分别为川芎→白芷、半夏+生姜→黄柏、半夏+黄柏→生姜、生姜+黄柏→半夏、枫香脂+铅丹→石膏、枫香脂+石膏→铅丹、枫香脂+铅丹→白芷、铅丹+白芷→枫香脂、枫香脂+石膏→白芷、石膏+白芷→枫香脂。聚类分析结果显示,使用频次≥4的21味内服中药可聚为5类,第1类包括白芷、紫金皮、木香、白芍、地黄、川芎,合用能补血活血、行气止痛; 第2类包括草乌、川乌、麝香、苏木、铅丹、大黄,合用能活血止痛; 第3类包括白术、沉香、甘草、肉桂、生姜,合用能温补脾肾、行气止痛; 第4类仅包括当归,能补血活血; 第5类包括没药、自然铜、乳香,合用能活血止痛、生肌接骨。使用频次≥3的15味外用中药可聚为4类,第1类包括牛膝、紫金皮、刘寄奴、黄柏、川芎,合用能活血化瘀; 第2类包括生姜、半夏、地黄,合用能解毒散结; 第3类包括龙骨、水松皮、降真香,合用能降气收敛; 第4类包括白芷、枫香脂、铅丹、石膏,合用能收敛生肌。结论:《世医得效方》中治伤方剂多采用辛温之药,常从肝、脾、心论治,其中内服方剂以活血化瘀、补血活血、行气止痛为主要治法,而外用方剂以解表清热、活血消肿、收敛生肌为主要治法。
Abstract:
Objective:To explore the clinical medication rules of prescriptions for treatment of orthopedic and traumatic diseases in Shiyi Dexiao Fang.Methods:The prescriptions aimed at treating orthopedic and traumatic diseases were extracted from Volume XVIII of Bonesetting&Battlefield Surgery in Shiyi Dexiao Fang and a standard database for the prescriptions was established.The normalized Chinese herbs(CHs)in the extracted prescriptions were input into the Microsoft Office Excel 2016 software for building a standard database,based on which their usage frequency,efficacy,medicinal property,medicinal flavor and meridian tropism were statistically analyzed by using traditional Chinese medicine inheritance support system(TCMISS)software(V3.0).The high-frequency CHs were then subjected to association rule analysis by using SPSS Modeler 18.0 software and cluster analysis by using SPSS Statistics 26.0 software.Results:Seventy-nine prescriptions(154 CHs)were included in the final analysis,including 40 oral prescriptions(115 CHs)and 39 external-applied prescriptions(81 CHs).Among the 115 oral CHs(appeared 278 times),21 ones displayed a usage frequency of ≥4,and the top 5 ones with high usage frequency included Angelica sinensis,Chuanxiong Rhizoma,Frankincense,Rhei Radix et Rhizoma and Glycyrrhiza Uralensis.Among the 81 external-applied CHs(appeared 135 times),15 ones displayed a usage frequency of ≥3,and the top 5 ones with high usage frequency included Plumbum Rubrum,Angelicae Dahuricae Radix,Liquidambaris Resina,Rehmannia Glutinosa and Zingiberis Rhizoma Recens.The CHs are often the ones presented with pungent flavor and bitter flavor and mainly act on liver meridians,spleen meridians and heart meridians in the prescriptions aimed at treating orthopedic and traumatic diseases in Shiyi Dexiao Fang,among which,the oral CHs are mainly the ones for promoting blood circulation to remove blood stasis,tonifying deficiency as well as relieving superficies with properties mainly as warm and neutral; while the external-applied CHs are mainly the ones for relieving superficies,clearing heat and promoting blood circulation to remove blood stasis with properties mainly as warm and cold.The association rule analysis on the 21 oral CHs with a usage frequency of≥4 yielded 10 association rules,involving 10 core CHs combinations,namely Chuanxiong Rhizoma→Angelica sinensis,Myrrha→Frankincense,Sappan Lignum→Angelica sinensis,Paeoniae Radix Alba→Angelica sinensis,Pyritum→Myrrha,Cinnamomi Cortex→Angelica sinensis,Angelicae Dahuricae Radix→Aucklandiae Radix,Angelicae Dahuricae Radix→Chuanxiong Rhizoma,Angelicae Dahuricae Radix→Angelica sinensis and Paeoniae Radix Alba+Chuanxiong Rhizoma→Angelica sinensis.The association rule analysis on the 15 external-applied CHs with a usage frequency of≥3 yielded 10 association rules,involving 10 core CHs combinations,namely Chuanxiong Rhizoma→Angelicae Dahuricae Radix,Pinelliae Rhizoma+Zingiberis Rhizoma Recens→Phellodendri Chinensis Cortex,Pinelliae Rhizoma+Phellodendri Chinensis Cortex→Zingiberis Rhizoma Recens,Zingiberis Rhizoma Recens+Phellodendri Chinensis Cortex→Pinelliae Rhizoma,Liquidambaris Resina+Plumbum Rubrum→Gypsum Fibrosum,Liquidambaris Resina+Gypsum Fibrosum→Plumbum Rubrum,Liquidambaris Resina+Plumbum Rubrum→Angelicae Dahuricae Radix,Plumbum Rubrum+Angelicae Dahuricae Radix→Liquidambaris Resina,Liquidambaris Resina+Gypsum Fibrosum→Angelicae Dahuricae Radix and Gypsum Fibrosum+Angelicae Dahuricae Radix→Liquidambaris Resina.As revealed by the cluster analysis,the 21 oral CHs with a usage frequency of≥4 were clustered into 5 categories,with Angelicae Dahuricae Radix,Glaucousback Threewingnut Root-bark,Aucklandiae Radix,Paeoniae Radix Alba,Rehmannia Glutinosa and Chuanxiong Rhizoma into Category I,which served together can tonify and activate blood and promot qi circulation to relieve pain; Aconiti Kusnezoffii Radix,Aconiti Radix,Moschus,Sappan Lignum,Plumbum Rubrum and Rhei Radix et Rhizoma into CategoryⅡ,which served together can promot blood circulation to arrest pain; Atractmlodis Macrocephalae Rhizoma,Aquilariae Lignum Resinatum,Glycyrrhiza Uralensis,Cinnamomi Cortex and Zingiberis Rhizoma Recens into CategoryⅢ,which served together can warmly tonify the spleen and kidney and promot qi circulation to relieve pain; Angelica sinensis alone into CategoryⅣ,which can tonify and activate blood; and Myrrha,Pyritum and Frankincense into CategoryⅤ,which served together can promot blood circulation to arrest pain,promote granulation and reunite fractured bone.The 15 external-applied CHs with a usage frequency of≥3 were clustered into 4 categories,with Achyranthes Bidentatae Radix(TCD),Glaucousback Threewingnut Root-bark,Herba Artemisia Anomala,Phellodendri Chinensis Cortex and Chuanxiong Rhizoma into Category I,which served together can promot blood circulation to remove blood stasis; Zingiberis Rhizoma Recens,Pinelliae Rhizoma and Rehmannia Glutinosa into CategoryⅡ,which served together can resolve toxin and dissipate binds; Os Draconis,Glyptostrobus pensilis Cortex and Acronychia pedunculata into CategoryⅢ,which served together can descend qi and astringe; and Angelicae Dahuricae Radix,Liquidambaris Resina,Plumbum Rubrum and Gypsum Fibrosum into CategoryⅣ,which served combinedly can astringe and promote granulation.Conclusion:The CHs with pungent flavor and warm property mainly act on liver meridians,spleen meridians and heart meridians are more preferred in the prescriptions aimed at treating orthopedic and traumatic diseases in Shiyi Dexiao Fang,among which,the oral CHs are mainly the ones for promoting blood circulation to remove blood stasis,tonifying and activating blood as well as promoting qi circulation to relieve pain,and the external-applied CHs are mainly the ones for relieving superficies and clearing heat,activating blood and alleviating edema as well as astringency and promoting granulation.

参考文献/References:

[1] 徐春娟,陈荣,陈建章.对元代名著《世医得效方》的研究[J].中国实验方剂学杂志, 2012,18(14):317-319.
[2] 邹来勇,涂国卿,汤群珍.《世医得效方》伤科证治特色[J].上海中医药杂志,2010,44(3):56-57.
[3] 国家药典委员会.中华人民共和国药典:一部[M].北京:中国医药科技出版社,2020.
[4] 国家中医药管理局.中华本草[M].上海:上海科学技术出版社,1999.
[5] 南京中医药大学.中药大辞典[M].上海:上海科学技术出版社,2006.
[6] 涂鹏程,郭杨,马勇,等.马勇以“阴阳为纲,气血为本,阳气为先”思想指导骨伤科疾病治疗[J].中华中医药杂志, 2020,35(2):732-734.
[7] 陈二林,李喜香,伍珊娜,等.基于活血生物效价的当归质量评价研究[J].中药材,2019,42(4):818-821.
[8] 蒲忠慧,代敏,彭成,等.川芎生物碱的物质基础及药理作用研究进展[J].中国药房,2020,31(8):1020-1024.
[9] 刘志强,王博龙.计算机模拟研究肝素联合川芎嗪的协同抗血栓药理机制[J].中国医院药学杂志,2019,39(3):247-254.
[10] 刘迪,张冰洋,姚铁,等.乳香化学成分及药理作用研究进展[J].中草药,2020,51(22):5900-5914.
[11] 杨炀,税丕先,陈滟,等.中药大黄在临床应用中的功效以及对其药理作用[J].基因组学与应用生物学,2017,36(3):1226-1231.
[12] 邓桃妹,彭灿,彭代银,等.甘草化学成分和药理作用研究进展及质量标志物的探讨[J].中国中药杂志,2021,41(11):2660-2676.
[13] 王蕊,刘军,杨大宇,等.白芷化学成分与药理作用研究进展[J].中医药信息,2020,37(2):123-128.
[14] 连靖娉,刘溯,王倩.生地黄煎剂对脓毒症患者血小板及凝血功能的影响[J].实用临床医药杂志,2016,20(7):166-167.
[15] 莫琼,郝二伟,覃文慧,等.平性活血化瘀中药物质基础与药理作用的研究进展[J].中国实验方剂学杂志,2020,26(1):205-216.
[16] 高樱,杨龙飞,翟阳,等.具有活血化瘀功效的中药药理作用及机制研究进展[J].中华中医药杂志,2018,33(11):5053-5056.
[17] 周鸿,黄含含,张静泽,等.川芎-当归药对研究进展[J].中成药,2015,37(1):184-188.
[18] 蒋海峰,宿树兰,欧阳臻,等.乳香、没药提取物及其配伍对血小板聚集与抗凝血酶活性的影响[J].中国实验方剂学杂志,2011,17(19):160-165.
[19] 刘陆,安玉芳.中药川乌与草乌的研究进展[J].黑龙江中医药,2019,48(2):175-177.
[20] 蒋燕萍,甘彦雄,严鑫,等.自然铜的研究进展[J].中药与临床,2016,7(1):62-64.
[21] 林远茂,施荣聪,孙诚攻,等.基于网络药理学分析北刘寄奴的活性成分及其药效作用机制[J].中医药导报,2020,26(10):46-51.
[22] 张晓娟,张燕丽,左冬冬.川芎的化学成分和药理作用研究进展[J].中医药信息,2020,37(6):128-133.
[23] 林俊涛,刘俊,徐紫丹,等.降真香不同溶剂萃取物对口腔常见菌的抑菌活性研究[J].生物化工,2021,7(1):40-43.
(收稿日期:2021-06-16 本文编辑:时红磊)

相似文献/References:

[1]郎永,杨力,张玉良,等.张玉柱先生诊治骨伤疾病经验总结[J].中医正骨,2015,27(06):67.
[2]吴子健,何俊君,洪振强.阳和汤在骨伤科疾病治疗中的应用和基础研究进展[J].中医正骨,2017,29(04):39.
[3]胡海,雷孝勇,陈怀安,等.金葡素注射液在骨伤科领域的应用研究进展[J].中医正骨,2017,29(06):42.
[4]陈圣华,郑润杰.肖鲁伟教授运用附子治疗骨伤科疾病的经验[J].中医正骨,2021,33(09):76.
　CHEN Shenghua,ZHENG Runjie.Experience of Professor XIAO Luwei in treatment of orthopedic-traumatologic diseases with Fuzi[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2021,33(03):76.
[5]左世国,李姣姣,向昱阳.《医宗金鉴·正骨心法要旨》中骨伤外治处方的用药规律分析[J].中医正骨,2022,34(02):40.
　ZUO Shiguo,LI Jiaojiao,XIANG Yuyang.Clinical medication rules of the prescriptions for external treatment of orthopedic and traumatic diseases in Yizong Jinjian,Essentials of Bone Orthopedics[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2022,34(03):40.
[6]吴海洋,吴军豪,许金海,等.石氏伤科运用解表药治疗骨伤科疾病的经验[J].中医正骨,2023,35(06):61.
[7]黄明翥,周红海,何心愉,等.《医宗金鉴·正骨心法要旨》中治疗伤科瘀肿疼痛方剂的用药规律分析[J].中医正骨,2023,35(10):37.
　HUANG Mingzhu,ZHOU Honghai,HE Xinyu,et al.A data mining-based analysis of clinical medication rules of traumatologic prescriptions for treatment of blood stasis,swelling and pain in Yizong Jinjian,Essentials of Bone Orthopedics[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2023,35(03):37.

备注/Memo

备注/Memo:
通讯作者:陈日高 E-mail:4118510@qq.com
更新日期/Last Update: 1900-01-01