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基于数据挖掘分析叶天士辛润通络法方剂构成因子

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目的:通过对《临证指南医案》中辛润通络法相关医案的分析,提炼辛润通络法的核心构成因子,归纳此治法的组方用药规律。方法:遴选《临证指南医案》中使用辛润通络法的医案,建立辛润通络法医案数据库。采用SPSS 19。0软件对遴选医案的药物结构进行因子分析,用R4。2。1进行聚类分析并绘制可视化图谱;用方剂计量学方法对高频药物的药性、药味、归经、三焦归属进行统计并绘制可视化图谱;使用CytoSpace 5。8软件构建辛润通络-病名-证型网络可视化表达。结果:纳入医案220则,发现辛润通络法共涉药物177味,大于10次的高频用药39味,其中以当归、桃仁应用频数最高,分别为97与90次。选取出现频数大于4次的病名、病证形成病名-证型可视化网络。降维分析后提取出12个有效公因子,对12个公因子进行系统聚类,得到3个方剂构成因子。药物以性温,味平、辛、甘,归脾、肝、肾经,归属中焦、下焦为主。结论:辛润通络法多选用药性温平,药味辛甘的药物,体现"味辛体润"的基本原则;在药物归经和三焦分属上多选用归脾、肝、肾经,归中、下二焦的药物;在体现"味辛体润"的基本原则上,叶天士多考虑升举奇阳与和少阳木火的兼复病因;在润燥养阴的配伍组成上,除应用子仁类养阴润燥外,叶天士还应用石斛清补法与营卫生会之理从阴阳互根论治。
Analysis of the Composition Factors of YE Tianshi's Xinrun Tongluo Formula Based on Data Mining
Object:To extract the core composition factors of the Xinrun Tongluo method and summarize the prescription and medication rules of the treatment method through the analysis of relevant medical cases in Clinical Guide Medical Records.Methods:The medical cases using Xinrun Tongluo method in Clinical Guide Medical Records were selected and the database of Xinrun Tongluo method was established.SPSS 19.0 software was used for factor analysis on the drug structure of selected medical cases,R4.2.1 was used for cluster analysis and visualization map was drawn.The medicinal properties,medicinal taste,meridian distribution,and San Jiao distribution of high-frequency drugs were statistical analysed by formulaic metrology methods,and the visualization map was drawn.The visual expression of Xinrun Tongluo-disease name-syndrome type network was constructed by CytoSpace 5.8 software.Results:220 medical cases were included,and a total of 177 drugs were found to be involved in the Xinrun Tongluo method.39 drugs were frequently used more than 10 times,among them,Danggui(Angelicae Sinensis Radix)and Taoren(Persicae Semen)being the most frequently used,with 97 and 90 times,respectively.The disease names and syndromes that appeared more than 4 times were selected to form a disease name-syndrome type visualization network.After dimensionality reduction analysis,12 effective common factors were extracted,and the 12 common factors were systematically clustered to obtain 3 prescription composition factors.The main types of drugs were warm in nature,mild,spicy,and sweet in taste,belong to the spleen,liver,and kidney meridians,and classified as the middle and lower jiao.Conclusion:The Xinrun Tongluo method mainly selected drugs with mild properties and a sweet and spicy taste,reflecting the basic principle of"wei xin ti run";In terms of drug meridians and the classifi-cation of the san jiao,drugs that belong to the spleen,liver,and kidney meridians,as well as the middle and lower jiao,were often selected.On the basis of embodying the basic principle of"wei xin ti run",YE Tianshi mostly considered the concurrent causes of uplift Qi Yang and Shao Yang wood fire.In terms of the combina-tion composition of nourishing dryness and nourishing Yin,in addition to using the Ziren class to nourish Yin and moisten dryness,YE Tianshi also applied the Shihu Qingbu method and the principles of Yingwei Shenghui to treat from the root of Yin and Yang.

Xinrun Tongluo methodYE TianshiClinical Guide Medical Recordsprescription and medication rulesfactor analysisdata mining

蒋啸、李鑫辉、李彩云、夏旭婷、刘贵淳、史建辰

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湖南中医药大学中医学院,湖南 长沙 410208

辛润通络法 叶天士 《临证指南医案》 组方规律 因子分析 数据挖掘

国家自然科学基金面上项目湖南省中医药局重点项目湖南省自然科学基金

82074392A20230132023JJ50036

2024

中医药导报
湖南省中医药学会 湖南省中医管理局

中医药导报

CSTPCD
影响因子:0.952
ISSN:1672-951X
年,卷(期):2024.30(5)
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