中医药研究论丛

264.1 中医临床治疗上消化道疾病的用药规律分析──以《丹溪心法》为例

 TJ TCM.26(4) : 1-15, 2023

DOI : 10.6516/TJTCM.202309_26(4).0001
 
中医临床治疗上消化道疾病的
用药规律分析——以《丹溪心法》为例
Analysis of the Regularity of Traditional Chinese medicines Used in the Clinical Treatment of Upper Gastrointestinal Diseases –
Taking Danxi’s Mastery of Medicine as an Example
林致廷 1,3 林立伟 1 吴龙源 1,2,*
 1 义守大学学士後中医系,高雄,台湾
2 吴龙源中医诊所,台北,台湾
3 义大癌治疗医院中医科,高雄,台湾
【摘要】
目的:整理、分析《丹溪心法》治疗上消化道疾病之方药,以阐释其临床辨证思维、用药配方特点以及药物关联组合,作为临床中医师治疗上消化道疾病叁考。
方法与材料:比较并蒐集《丹溪心法》中与上消化道疾病有关之中医病症名章节及其相对应的中医内科方药,用 Microsoft 365 Excel 统计相关中药资讯的频 次。利用 IBM SPSS Statistics 18及 Cytoscape 3.9.0进行药物复杂网路分析,并归 纳出核心高频用药模组。针对高频核心药物进行 Apriori 演算法以及皮尔森相关系数阶层式集聚分析法的关联规则分析,找出书中关联规则中药组合与其对应方剂。
结果:《丹溪心法》治疗上消化道系统疾病用方的高频核心用药包含炙甘草、 陈皮、半夏、白术、人叁、茯苓、砂仁、苍术、香附、黄连;功效分类以补气、理气、温里、化湿药为多;药性为温、寒、平性;药味则以辛、甘、苦平均;归经则以脾胃经为宗。由 Apriori 演算法获得的关联分析组合可归类为四君子 汤、二陈汤之加减,而皮尔森相关系数阶层式集聚分析法则获得八种药物关联规则组合。
结论:归纳发现朱丹溪之脾胃病辨证思维,注重脾虚、痰湿及气郁等病因病机 ,治法以温补脾胃为主,调畅气机及祛湿化痰为辅,符合研究之复杂药物网络 、核心用药模组及药物关联规则组合分析的结果。
【关键词】丹溪心法、上消化道疾病、用药规律、关联分析组合、复杂网络分析
Chih-Ting Lin1,3 Li-Wei Lin1 Lung-Yuan Wu11,2,*
1 The School of Chinese Medicine for Post-Baccalaureate of I-Shou University, Kaohsiung, Taiwan
2 Wu, Lang-Yuan Tradition Chinese Medicine Clinic. Taipei, Taiwan
3 Department of Chinese Medicine, E-Da Cancer Hospital, Kaohsiung City , Taiwan
【Summary】
Objective: The intention of this study was to organize the prescriptions and TCMs, used in Danxi’s Mastery of Medicine (DMM), to treat upper gastrointestinal diseases (UGID). Also, we expounded the cogitation of clinical syndrome differentiation, the distinguishing feature of prescriptions, and correlation analysis of TCMs. To provide clinical guidelines Chinese medical physicians can consult to treat UGIDs.
Method: In this study, we collected and sorted the chapters of chinese medicine disease names related to UGIDs in DDM, and their corresponding Chinese internal medicine prescriptions. We also exerted Microsoft 365 Excel to statisticize the frequency of TCM information. IBM SPSS Statistics 18 and Cytoscape 3.9.0 were utilized for complex network analysis of TCMs to find high-frequency core medication module. For the high-frequency core TCMs, Apriori algorithm and Pearson correlation coefficient hierarchical agglomeration analysis methods were used to analyze the association rules to find out the combination of TCM association rules and their corresponding prescriptions.
Result: The high-frequency core drugs used in the treatment of UGIDs in DDM included Zhigancao, Tangerine peel, Pinellia, Atractylodes, Ginseng, Poria, Amomum, Atractylodes, Cyperus officinalis, Rhizoma Coptidis. High-frequency efficacy classifications included Qi-invigorating, Qi-regulating, internal-warning, dampness-removing. Commonly used medicinal properties were warm, cold, and mild. Frequently used medicinal flavors were evenly distributed with acrid, sweet and bitter. Main meridians were spleen and stomach meridians. The association analysis combinations obtained by the Apriori algorithm can be classified as the addition and subtraction of Sijunzi decoction and Erchen decoction. While, eight drug association rules were obtained by the Pearson-correlation-coefficient hierarchical agglomeration analysis method.
Conclusion: Zhu Danxi’s syndrome-differentiating thoughts of gastrointestinal diseases paid attention to the etiology and pathogenesis of spleen deficiency, phlegm, dampness, and Qi stagnation. The treatment method mainly focuses on warming and supplementing the spleen and stomach, regulating Qi, and removing dampness and phlegm. In conclusion, these concepts were consistent with the results of our study.
Keywords
Danxi’s Mastery of Medicine, Upper Gastrointestinal Diseases, Association Analysis Combinations, Regularity of Traditional Chinese medicines, Complicated Network Analysis.