[关键词]
[摘要]
目的 基于“病-药-量”分析《中华医典》中含有丹参的中药方剂的用药规律,为丹参的临床应用及药品开发提供科学依据。方法 从《中华医典》中收集含有丹参的中药方剂,采用Excel 2020建立丹参临证方药数据库,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 共收集含丹参方剂1 196首,主治病证分类共511种,其中高频病证(频次≥9)主要为“中风”“脚气”“虚劳”“痹痛”“腰痛”。治疗“中风”证型以阴虚风动为主,“脚气”证型以湿热蕴结为主,“虚劳”证型以肾阳虚为主,“痹病”证型以风寒湿痹为主,“腰痛”证型以寒湿腰痛为主。组方中使用频次≥150的药物有16味,使用频次较高的有当归、人参、茯苓等。药物功效种类以活血调经药、补气药、发散风寒药、补血药、利水消肿药较多;药性使用频次由高到低为温、寒、平;药味多选用苦、甘、辛味;药物归经以肝、肺、肾、心经为主。高频病症剂型及药物用量分析显示,治疗“中风”时,丹参常用剂量为41.31 g,剂型多为汤剂和散剂,核心药物配伍防风以祛风止痉;治疗“脚气”时,丹参常用剂量为123.93 g,剂型多为汤剂,核心药物配伍防风以除湿止痉;治疗“虚劳”时,丹参常用剂量为41.31 g,剂型多为散剂,核心药物配伍熟地黄以滋阴补血;治疗“痹病”时,丹参常用剂量为37.3 g,剂型多为酒剂,核心药物配伍肉桂以温经散寒;治疗“腰痛”时,丹参常用剂量为41.31 g,剂型多为酒剂,核心药物配伍牛膝以通血下行。结论 丹参可治疗多系统疾病,在诸多疾病中主要发挥活血化瘀、通经止痛功效。根据不同疾病特点,与其他药物相配伍时,丹参又被赋予“祛风”“壮骨”“祛湿”“止痉”等功效,为丹参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 medication rules of traditional Chinese medicine formulas containing Danshen (Salviae Miltiorrhizae Radix et Rhizoma, SMRR) in Chinese Medical Classics based on “disease-medicine-dosage”, so as to provide scientific basis for clinical application and drug development of SMRR. Methods The traditional Chinese medicine formulas containing SMRR in Chinese Medical Classics were collected and input into Excel 2020 to construct the clinical prescription database. Symptoms, syndrome types, drug use frequency, efficacy categories, drug nature and flavor, dosage forms and dosage of SMRR were analyze using SPSS Statistics 21.0 and IBM SPSS Modeler 18.0 for data mining such as association rules and cluster analysis. Results A total of 1 196 prescriptions containing SMRR were collected, and 511 kinds of symptons were classified, among which the high frequency syndrome (≥ 9 times) were mainly “stroke syndrome” “beriberi syndrome” “consumptive diseases” “bi-diseases” “lower back pain”. The syndrome type was mainly yin deficiency and wind stirring for treating stroke, dampness and heat accumulation and binding for treating beriberi syndrome, kidney yang deficiency for treating consumptive diseases, wind and cold and dampness impediment for treating bi-diseases, cold syndromes for lower back pain; In the prescriptions, 16 drugs were used more than 150 times, and Danggui (Angelicae Sinensis Radix), Renshen (Ginseng Radix et Rhizoma), Fuling (Poria) were frequently used. The main types of drugs efficacy were blood-activating and menstruation-regulating drugs, qi-tonifying drugs, divergent wind-cold drugs, blood-tonifying drugs, and water-dispelling and swelling drugs. The drugs with the highest frequency were warm drug, cold drug and flat drugs. Bitter, sweet and pungent drugs were mainly used, and the main channels of drugs were liver, lung, kidney and heart meridian. The analysis of dosage of high frequency disease showed: In treating stroke, the frequent dosage of SMRR was 41.31 g, the frequent dosage form was decoction, and the compatible core drug was used with Fangfeng (Saposhnikoviae Radix) to expel wind and stop spasm; In treating beriberi syndrome, the most frequent dosage of SMRR was 123.93 g, the most frequent dosage form was decoction and the compatible core drug was used with Saposhnikoviae Radix to dry dampness and stop spasm; In treating consumptive diseases, the most frequent dosage of SMRR was 41.31 g, the frequent dosage form was powder, and the compatible core drug was used with Shudihuang (Rehmanniae Radix Praeparata) to enrich yin and nourish blood; In treating bi-diseases, the frequent dosage of SMRR was 37.3 g, the most frequent dosage form was liquor, and the compatible core drug was used with Rougui (Cinnamomi Cortex) to warm meridians and dissipat cold; In treating lower back pain, the most frequent dosage of SMRR was 41.31 g, the frequent dosage form was liquor, and the compatible core drug was used with Niuxi (Achyranthis Bidentatae Radix) to move blood downward. Conclusion SMRR can be used in the treatment of multiple system diseases with the effect of apromoting blood circulation and removing blood stasis and channelling menstruation and relieving pain. According to the characteristics of different diseases, when combined with other drugs, SMRR was endowed with the effects of “dispelling wind” “trengthening bones”, “dispelling dampness” and “antispasmodic”, which provides theoretical reference and scientific basis for clinical application of SMRR and the development of new drugs.
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[基金项目]
国家自然科学基金项目(81973904);河南省特色骨干学科中医学学科建设项目(STG-ZYX06-202144,STG-ZYXKY-2020023);2023年度河南省中医学“双一流”创建科学研究专项课题(HSRP-DFCTCM-2023-2-08,HSRP-DFCTCM-2023-2-08)