| 摘要: |
| 目的：探究孔伯华诊治暑湿病的用药规律和学术经验。方法：收集整理《孔伯华医案存真·暑湿》中的医案，建立孔伯华暑湿病医案数据库，对患者症状、舌象、脉象以及使用药物的性味、归经、种类、治法等进行分析，导入SpssModeler 18.0进行基于Apriori算法的关联规则分析，运用Gephi 0.9.2 进行复杂网络可视化展示。结果：共纳入医案64 则，药物143 味。使用频次较高的中药分别为知母、旋覆花、莲子心、竹茹等，药性以寒、平为主，药味以甘、苦为主，多归胃、肺、肝、脾经；药物分类中以清热药多见，其次为化痰止咳平喘药；共涉及40个治法，以和中使用频次最多，其次为清芳；出现频次最多的症状为腹泻，舌象以腻苔和厚苔居多，脉象以数脉和滑脉居多。药物关联分析显示，竹茹与知母、代赭石与旋覆花、黄连与知母等组合最为常见；支持度梯度分析显示，最核心的药物组合分别为旋覆花-知母、旋覆花-代赭石、代赭石-知母；复杂网络展示可见旋覆花、代赭石、知母、黄柏四味药之间存在用量大、关联密切的药物关系，荷叶、莲子心、杏仁、牛膝、橘核、稻芽、莱菔子、黄连、乌药、鳖甲、石决明、竹茹等药物处在网络核心区域。结论：孔伯华所治暑湿病以暑邪伤津耗气、湿邪阻滞气机为基本病机，肝热痰浊为继发病机；清热燥湿、化痰祛浊、清肝醒神、养阴扶正为主要治法。 |
| 关键词: 暑湿病 《孔伯华医案存真·暑湿》 数据挖掘 用药规律 |
| DOI： |
|
|
| Medication rule of Kong Bohua in treatment of diseases caused by summer-heat and dampness |
| DAI Zifeng,XUE Rongkun,ZHOU Zhihuan |
| (Tianjin University of Traditional Chinese Medicine，Tianjin 301617，China) |
| Abstract: |
| Objective：To investigate the medication rule and academic experience of Kong Bohua in the diagnosis and treatment of diseases caused by summer-heat and dampness.Methods：The medical records in Kong Bohua’s Medical Records：Summer-Heat and Dampness were collected to establish a database for Kong Bohua’s Medical Records for diseases caused by summer-heat and dampness.The symptoms，tongue manifestation，and pulse manifestation of patients，the nature and taste，meridian entry，and classification of the drugs used，and the methods of treatment were analyzed and imported into SpssModeler 18.0 to perform an association rule analysis based on the Apriori algorithm，and Gephi 0.9.2 was used for the visualization of complex networks.Results：A total of 64 medical records were included，involving 143 traditional Chinese medicine (TCM) drugs in total.The TCM drugs with a relatively high frequency of use included Rhizoma Anemarrhenae，inula flower，lotus plumule，and Caulis Bambusae in Taeniam，and most drugs had a cold or neutral nature and a sweet or bitter taste and mainly entered the stomach，lung，liver，and spleen meridians.As for the classification of the drugs used，most drugs were heat-clearing drugs，followed by the phlegm-eliminating，cough-relieving，and asthma-relieving drugs.A total of 40 methods of treatment were involved，among which the method of harmonizing the middle Jiao had the highest frequency of use，followed by clearing.Diarrhea was the symptom with the highest frequency，greasy tongue coating and thick tongue coating were the main tongue manifestation，and rapid pulse and slippery pulse were the main pulse manifestation.The drug association analysis showed that Caulis Bambusae in Taeniam-Rhizoma Anemarrhenae，red ochre-inula flower，and Coptis chinensis-Rhizoma Anemarrhenae were the most commonly used drug combinations；the gradient analysis for degree of support showed that the core drug combinations were inula flower-Rhizoma Anemarrhenae，inula flower-red ochre，and red ochre-Rhizoma Anemarrhenae；visualization of complex networks showed a large amount of drug used and a close association were found between inula flower，red ochre，Rhizoma Anemarrhenae，and Phellodendri Chinensis Cortex，and the drugs including lotus leaf，lotus plumule，Semen Armeniacae Amarum，Radix Achyranthis Bidentatae，tangerine seed，rice-grain sprout，Semen Raphani，Coptis chinensis，Lindera aggregata，turtle shell，Concha Haliotidis，and Caulis Bambusae in Taeniam were located at the core area of the network.Conclusion：The diseases caused by summer-heat and dampness treated by Kong Bohua have the basic pathogenesis of summer-heat evil causing body fluid impairment and Qi consumption and pathogenic dampness obstructing Qi-movement，as well as the secondary pathogenesis of liver heat and phlegm turbidity.The main methods of treatment include clearing heat and drying dampness，resolving phlegm and removing turbidity，clearing liver-fire and inducing resuscitation，and nourishing Yin and strengthening vital Qi. |
| Key words: diseases caused by summer-heat and dampness Kong Bohua’s Medical Records：Summer-Heat and Dampness data mining medication rule |
