| 摘要: |
| 目的：通过数据挖掘总结郭维琴教授辨治缓慢性心律失常的临床用药经验。方法：搜集经郭教授诊治的缓慢性心律失常有效医案，采用中医传承辅助平台对医案进行数据处理和分析，依次进行临床症状、中医证候、治则治法、单味中药使用频次和药物四气、五味、归经分析，并归纳总结常用药物组合、分析关联规则、挖掘新方等。结果：纳入有效医案36 例，处方146首，中药150味，其临床症状以乏力、胸闷胸痛、心悸为主；中医证候以心血瘀阻、心肾阳虚为多，治则治法以活血化瘀、补气活血、温补心肾、温阳活血、滋补肝肾为主。单味中药使用频率>50次者共14味；中药四气以温、寒、平为主，五味以甘、辛、苦为主，归经以肝、脾、心经为主；常用对药有19组，角药有23组，4味药物组合有16组，5味药物组合有6组，6味药物组合有1组；高置信度药物关联规则对药有5组，角药有21组，4味药组合有33组，核心处方为“党参、黄芪、丹参、红花、炙麻黄、淫羊藿”；熵层次聚类新处方有“炙麻黄-淫羊藿-川芎-生赭石”等4个。结论：郭教授认为缓慢性心律失常病机多虚实夹杂，以阳气虚弱为本，以痰湿阻络、瘀血内阻为标，临证以益气温阳活血为治疗大法，用药以补气、温阳、活血化瘀类为主，用药温和，处方精简。 |
| 关键词: 缓慢性心律失常 用药规律 中医传承辅助平台 郭维琴 |
| DOI： |
|
|
| Medication rule of Guo Weiqin in syndrome differentiation-based treatment of bradyarrhythmia |
| HOU Ailin,DAI Yanyan,ZHANG Xiuwen |
| (Dongzhimen Hospital，Beijing University of Chinese Medicine，Beijing 100700，China) |
| Abstract: |
| Objective：To investigate the clinical medication experience of Professor Guo Weiqin in the syndrome differentiation-based treatment of bradyarrhythmia based on data mining.Methods：Valid medical records were collected from the patients with bradyarrhythmia who were diagnosed and treated by Professor Guo，and Traditional Chinese Medicine Inheritance Support System was used for data analysis in terms of clinical symptoms，TCM syndrome，principle and method of treatment，frequency of use of a single Chinese herb，and four properties，five tastes，and meridian entry of drugs.Commonly used drug combinations，association rule，and new prescriptions were summarized.Results：A total of 36 valid medical records were included，involving 146 prescriptions and 150 TCM drugs.Main clinical symptoms included weakness，chest distress and chest pain，and palpitation，and main TCM syndromes included stagnant blockade of heart blood and heart-kidney Yang deficiency.Commonly used principles and methods of treatment included blood-activating and stasis-resolving therapy，Qi-tonifying and blood-activating therapy，heart-kidney warm tonification therapy，Yang-warming and blood-activating therapy，and liver-kidney nourishing therapy.A total of 14 drugs had a frequency of use of >50 times.Most drugs were warm，cold，and neutral in nature and had a sweet，pungent or bitter taste，and most drugs entered the liver，spleen，and heart meridians.There were 19 commonly used combinations of 2 drugs，23 combinations of 3 drugs，16 combinations of 4 drugs，6 combinations of 5 drugs，and 1 combination of 6 drugs.High-confidence drug association rules involved 5 combinations of 2 drugs，21 combinations of 3 drugs，and 33 combinations of 4 drugs.The core prescription was“Codonopsis pilosula，Astragalus membranaceus，Salvia miltiorrhiza，Carthamus tinctorius，scorched ephedra，Herba Epimedii”，and entropy-based hierarchical clustering obtained 4 new prescriptions including “scorched ephedra-Herba Epimedii-Rhizoma Chuanxiong-crude hematite”.Conclusion：Professor Guo thinks that the pathogenesis of bradyarrhythmia is a mixture of deficiency and excess，with Yang-Qi deficiency as the root cause and phlegm-dampness obstructing collaterals and stagnation of blood stasis as the manifestation.Qi-tonifying，Yang-warming，and blood-activating therapies are the main treatment methods in clinical practice，and Qi-tonifying，Yang-warming，blood-activating，and stasis-resolving drugs are commonly used in treatment，with the features of moderate medication and simplified prescription. |
| Key words: bradyarrhythmia medication rule Traditional Chinese Medicine Inheritance Support System Guo Weiqin |
