摘要
目的挖掘分析国医大师刘祖贻治疗脑梗死恢复期的处方用药规律,总结其学术思想。方法收集整理刘祖贻治疗脑梗死恢复期的病案处方,录入中医传承辅助平台软件中构建数据库,再使用该软件相关功能进行数据挖掘,分析处方中的组方用药规律。结果①共得处方147首,涉及药物179味,累计使用频次2164次。②使用频次在20次及以上的药物,共有22味,其中前10味高频药物为黄芪、丹参、山楂、葛根、枸杞子、地龙、制何首乌、川芎、石菖蒲、淫羊藿。③黄芪用量从15 g至120 g均可见,最常用剂量为30 g,常用剂量范围主要集中于30~60 g。④药物功效分类排名靠前的为补虚药、活血化瘀药、平肝息风药等。⑤高频药组前5位为丹参-黄芪、黄芪-山楂、葛根-黄芪、葛根-丹参、丹参-山楂;关联度较高的药组有地龙-黄芪、葛根-地龙-黄芪、丹参-地龙-黄芪等。⑥通过聚类分析算法提取出核心组合12个,进而演化出潜在新方6首,如"白芍、威灵仙、桂枝、鸡血藤、白芥子""全蝎、菊花、蜈蚣、刺蒺藜"等。结论国医大师刘祖贻治疗脑梗死恢复期的用药以益气温阳、填精益髓、活血通络、息风化痰为主,重用黄芪,方以自拟芪仙通络方加减,体现出"气阳主用""脑髓阳生阴长"等学术思想。
Objective To explore the medication rule of TCM master Liu Zuyi’s prescriptions for treating recovery phase of cerebral infarction and summarize his academic thoughts.Methods Professor Liu Zuyi’s prescriptions for treating recovery phase of cerebral infarction were collected to build a database based on Traditional Chinese Medicine Inheritance Support System(TCMISS).Then TCMISS was used for data mining and the medication rule of prescription was analyzed.Results①This study totally included 147 prescriptions involving 179 medical herbs with a cumulative frequency of 2164.②There were 22 kinds of medical herbs with frequency of use more than 20 times.The top 10 were Huangqi(Radix Astragali),Danshen(Radix Salviae Miltiorrhizae),Shanzha(Fructus Crataegi),Gegen(Radix Puerariae),Gouqizi(Fructus Lycii),Dilong(Lumbricus),Zhiheshouwu(Radix Polygoni Multiflori Preparata),Chuanxiong(Rhizoma Chuanxiong),Shichangpu(Rhizoma Acori Tatarinowii)and Yinyanghuo(Herba Epimedii).(3)The dosage of Huangqi(Radix Astragali)could be seen from 15 g to 120 g,the most commonly used dosage is 30 g,and the range of commonly used dosage is mainly 30 g to 60 g.(4)The top herbs in the classification of herb efficacy were the herbs with the functions of tonifying deficiency,activating blood circulation and removing blood stasis and the herbs of calming the liver and soothing wind,etc;(5)The top 5 herb groups with high frequency of use were"Danshen(Radix Salviae Miltiorrhizae)-Huangqi(Radix Astragali)","Huangqi(Radix Astragali)-Shanzha(Fructus Crataegi)","Gegen(Radix Puerariae)-Huangqi(Radix Astragali)","Gegen(Radix Puerariae)-Danshen(Radix Salviae Miltiorrhizae)"and"Danshen(Radix Salviae Miltiorrhizae)-Shanzha(Fructus Crataegi)".The herb groups with high correlation degree were Dilong(Lumbricus)-Huangqi(Radix Astragali),Gegen(Radix Puerariae)-Dilong(Lumbricus)-Huangqi(Radix Astragali),Danshen(Radix Salviae Miltiorrhizae)-Dilong(Lumbricus)-Huangqi(Radix Astragali),etc.(6)Twelve core prescriptions were extracted by clustering analysis algorithm,and 6 potential new ones were evolved,such as a prescription including following herbs:Baishaoyao(Radix Paeoniae Alba),Weilingxian(Radix Clematidis),Guizhi(Ramulus Cinnamomi),Jixueteng(Caulis Spatholobi),Baijiezi(Semen Sinapis Albae)"and a prescripton including"Quanxie(Scorpio),Juhua(Flos Dendranthemae),Wugong(Scolopendra),Cijili(Fructus Tribuli).Conclusion The purpose of medication of TCM master Liu Zuyi in treating recovery phase of cerebral infarction is mainly nourishing qi and warming yang,replenishing essence and nourishing the kidney,activate blood circulation and dredge collaterals,calming internal wind and resolving phlegm,and the modified Qixian Tongluo prescription is used with heavy dosage of Huangqi(Radix Astragali)in it,which reflects Liu Zuyi’s academic thoughts of"Qi and yang dominating the life activities"and"mutual promotion between yin and yang in brain marrow".
作者
王琦
周胜强
刘芳
刘祖贻
WANG Qi;ZHOU Shengqing;LIU Fang;LIU Zuyi(Academy of Chinese Medicine,Hunan University of Chinese Medicine,Changsha 410208,China;National Chinese Medical Master’s Inheritance Studio,The Affiliated Hospital of Hunan Academy of Chinese Medicine,Changsha 410006,China;Hunan Academy of Chinese Medicine,Changsha 410006,Hunan,China)
出处
《上海中医药杂志》
2020年第1期21-26,共6页
Shanghai Journal of Traditional Chinese Medicine
基金
国家中医药管理局“刘祖贻国医大师传承工作室建设项目”[国中医药办人教发(2015)24号]
湖南省教育厅重点项目(18A225)
湖南省教育厅优秀青年项目(18B253)
湖南省自然科学基金面上项目(2019JJ40171)
湖南省自然科学基金青年基金项目(2019JJ50347)
湖南省研究生科研创新项目(CX2018B514)
湖南中医药大学中西医结合一流学科开放基金项目(2018ZXYJH26).
关键词
脑梗死恢复期
名医经验
数据挖掘
国医大师
刘祖贻
recovery phase of cerebral infarction
experience of famous doctors
data mining
TCM master
Liu Zuyi
作者简介
王琦,男,硕士生,主要从事脑病的中医药防治及名老中医经验传承研究工作;通讯作者:刘芳,博士,研究员,硕士生导师。E-mail:msliufang23@126.com
