[关键词]
[摘要]
目的 分析《中华医典》中含有竹沥中药方剂“病-药-量”的相应规律,为竹沥的临床诊疗应用及深入研发提供参考。方法 收集整理《中华医典》中含有竹沥的中药方剂,录入Excel 2016构建临证方药数据库,对其病症、证型、药物使用频次、功效类别、性味归经、剂型及用量等进行统计分析,运用SPSS Statistics 22.0、IBM SPSS Modeler 18.0软件进行关联规则、聚类分析等数据挖掘。结果 共收集含竹沥方剂349首,主治病证分类共99种,其中高频病证(≥20次)主要为“中风”“痰饮”“咳嗽”,治疗“中风”证型以风痰瘀阻为主,“痰饮”以饮停胃肠为主,“咳嗽”以痰热郁肺为主;组方中使用频次≥50次的药物有19味,使用频次较高的有生姜、甘草、茯苓、陈皮等,药物功效种类以化痰止咳平喘药、补虚药、清热药为主;药性使用频次最高的为寒性药,其次为温性药,药味多选用甘、苦、辛味,药物归经以脾、胃、心经为主;高频病症剂型及药物用量分析显示,治疗“中风”时,剂型多为汤剂,竹沥用量多为100 mL,核心药物配伍重用防风以祛风化痰,改善脑络痹阻;治疗“痰饮”时,剂型多为丸剂,竹沥用量为200 mL,药物配伍偏重化痰逐饮以理气消积;治疗“咳嗽”,剂型多为汤剂,竹沥用量多为200 mL,药物配伍偏重化痰清热以泻除肺热。结论 竹沥应用疾病类型广泛,但在治疗不同疾病时,化痰为其主要治则,根据不同证候特点,兼辅以清热、开窍等功效;组方配伍方面竹沥多作为佐助药物进行配伍,因其寒凉药性,宜配伍生姜汁等温性药物协同服用,建议竹沥及生姜汁用量分别为200 mL和100 mL为度,可根据证候痰热症状程度适当加减竹沥用量。对促进竹沥临床实践规范化使用具有重要意义,为竹沥临床应用及新药开发提供了理论参考及科学依据。
[Key word]
[Abstract]
Objective To analyze the “disease-medicine-quantity” corresponding pattern of traditional Chinese medicine formulas containing Zhuli (Bambusae Succus) in Chinese Medical Classics, so as to provide a reference for the clinical application and further research and development of Bambusae Succus. Methods The traditional Chinese medicine formulas containing Bambusae Succus in Chinese Medical Classics were collected and sorted out, input into Excel 2016 to construct the clinical prescription database, and statistical analysis was conducted on the symptoms, syndrome types, drug use frequency, efficacy categories, nature and flavor, dosage forms and dosage, etc. SPSS Statistics 22.0 and IBM SPSS Modeler 18.0 software were used for data mining such as association rules and cluster analysis. Results A total of 349 formulas containing Bambusae Succus were collected, and 99 kinds of symptoms were classified, among which the high frequency syndrome (≥ 20 times) were mainly “stroke” “phlegm-fluid retention” and “cough”. The syndrome type was mainly wind-phlegm stasis for treating stroke, stopping stomach and intestines for treating phlegm-fluid retention, and phlegm-heat obstructing lung for treating cough. In the formulas, 19 drugs were used more than 50 times, and Shengjiang (Zingiberis Rhizoma Recens), Gancao (Glycyrrhizae Radix et Rhizoma), Fuling (Poria), Chenpi (Citri Reticulatae Pericarpium) were used more frequently. The main types of drugs efficacy were phlegm-relieving, antitussive and antiasthmatic drugs, tonifying deficiency drugs and heat-clearing drugs. The drugs with the highest frequency of use were cold drugs, followed by warm drugs. Sweet, bitter and pungent drugs were mainly used, and the main channels of drugs were spleen, stomach and heart channels. The analysis of dosage of high frequency disease showed that the dosage form for treating stroke was mostly decoction, and the dosage of Bambusae Succus was mostly 100 mL. The compatible core drug was used with Fangfeng (Saposhnikoviae Radix) to dispel wind and remove phlegm, and improve the brain obstruction; In the treatment of phlegm-fluid retention, the dosage form was mostly pills, Bambusae Succus dosage was 200 mL, the compatibility of drugs was focused on removing phlegm and drink to regulate qi and eliminate accumulation; In the treatment of cough, the dosage form was mostly decoction, the dosage of Bambusae Succus was mostly 200 mL, and the compatibility of drugs was clearing heat and resolving phlegm to purge lung heat. Conclusion Bambusae Succus was widely used in disease types, but in the treatment of different diseases, phlegm resolving was the main treatment, according to the characteristics of different syndroms, supplemented by clearing heat, resuscitating orifices and so on. In terms of prescription compatibility, Bambusae Succus was mainly used as auxiliary medicine. Due to its cold and cooling properties, it should be used with Zingiberis Rhizoma Recens juice warm medicine. It was suggested that the dosage of Bambusae Succus and Zingiberis Rhizoma Recens juice should be 200 mL and 100 mL respectively, and the dosage of Bambusae Succus could be increased or decreased appropriately according to the degree of phlegm-heat symptoms. It was of great significance to promote the standardized use of Bambusae Succus in clinical practice and provides theoretical reference and scientific basis for the clinical application of Bambusae Succus and the development of new drugs.
[中图分类号]
R283.21;R285.1
[基金项目]
江西省中医药管理局重点研究室建设项目“药食两用产品循证评价重点研究室”(5252101005);江西中医药大学1050青年人才工程项目(5141900102)