[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.
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基于数据挖掘法探讨《世医得效方》中治伤方剂的用药规律()
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《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.

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(收稿日期:2021-06-16 本文编辑:时红磊)

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