摘要
目的 本研究采用R语言技术,分析张冰教授治疗胸痹的用药规律和临证思想,探讨其学术特色。方法 收集其571例首诊处方,构建结构化数据库,进行药物频次、药性、证候统计,以及关联规则挖掘和聚类分析。结果 张冰教授治疗胸痹常用药物前10位为麸炒白术、川芎、太子参、砂仁、黄芩、赤芍、炒酸枣仁、桂枝、丹参、生蒲黄;药性以寒、温为主,五味以苦、甘为主,归经以肝、肺、脾经为主。基于数据挖掘的聚类结果,归纳出其治疗胸痹的5大药物组合模式:宽胸利气组(枳壳、薤白、桂枝、瓜蒌)调达肝气、温振心阳;活血养阴组(赤芍、白芍、生蒲黄)活血化瘀、养阴和络;气阴双补组(麦冬、五味子)清心润燥、敛阴止汗;健脾益气组(太子参、麸炒白术等)补气健脾,固本扶正;多靶点整合组(党参、红景天等)多通路协同调节脏腑功能,体现“疏肝行气、通调五脏”的核心治法思想。结论 张冰教授治疗胸痹的临证经验融合孟河京派颜系医学理论,具有鲜明的学术特色,为中医防治胸痹提供了临床参考。
Objective To analyze Professor ZHANG Bing's medication patterns and clinical philosophy in treating chest bi-impediment and explore his academic characteristics by R language technology.Methods A total of 571 initial consultation prescriptions were collected to construct a structured database.Statistical analyses of medication frequency,medicinal properties,and disease patterns were conducted,along with association rule mining and cluster analysis.Results Top 10 commonly used Chinese medicines by Professor ZHANG Bing for chest bi-impediment were wheat bran-fried Baizhu(Atractylodis Macrocephalae Rhizoma),Chuanxiong(Chuanxiong Rhizoma),Taizishen(Pseudostellariae Radix),Sharen(Amomi Fructus),Huangqin(Scutellariae Radix),Chishao(Paeoniae Radix Rubra),stir-fried Suanzaoren(Ziziphi Spinosae Semen),Guizhi(Cinnamomi Ramulus),Danshen(Salviae Miltiorrhizae Radix Et Rhizoma), fresh Puhuang (Typhae Pollen), which were mainly cold or warm in property, bitter or sweet in flavor, and primarily enter liver, lung, and spleen meridians. Based on data mining cluster results, five major medication combination patterns for treating chest bi-impediment were summarized: chest-soothing and qi-smoothing group, including Zhiqiao (Aurantii Fructus), Xiebai (Allii Macrostemonis Bulbus), Guizhi (Cinnamomi Ramulus), and Gualou (Trichosanthis Fructus), can regulate liver qi and warm and tonify heart yang;blood-circulating and yin-nourishing group, including Chishao (Paeoniae Radix Rubra), Baishao (Paeoniae Radix Alba), and fresh Puhuang (Typhae Pollen), can circulate blood, transform stasis, nourish yin and harmonize meridians;qi-tonifying and yin-nourishing group, including Maidong (Ophiopogonis Radix) and Wuweizi (Schisandrae Chinensis Fructus), can clear heart heat, moisten dryness, astringe yin, and stop sweating;spleen-strengthening and qi-tonifying group, including Taizishen (Pseudostellariae Radix) and wheat bran-fried Baizhu (Atractylodis Macrocephalae Rhizoma), can supplement qi, strengthen the spleen, and reinforce healthy qi to strengthen the body;multi-target integration group, including Dangshen (Codonopsis Radix), Hongjingtian (Rhodiolae Crenulatae Radix Et Rhizoma) etc., can synergistically regulate visceral functions through multiple pathways. These medication combinations reflected Professor ZHANG's core treatment philosophy of "soothe the liver, circulate qi, and regulate five zang organs". Conclusion Professor ZHANG Bing's clinical experience in treating chest bi-impediment integrates the medical theories of the Yan Lineage of Menghe (Beijing) School, demonstrating distinct academic characteristics and providing clinical references for the prevention and treatment of chest bi-impediment by Chinese medicine.
作者
瞿婷婷
张蕊
张冰
QU Tingting;ZHANG Rui;ZHANG Bing(School of Chinese Materia Medica,Beijing University of Chinese Medicine,Beijing 102488,China;Xuanwu Hospital of Traditional Chinese Medicine,Beijing 100050,China)
出处
《湖南中医药大学学报》
2025年第5期962-969,共8页
Journal of Hunan University of Chinese Medicine
基金
国家中医药领军人才支持计划“岐黄学者”项目(1040063320004)
张冰全国名老中医药专家传承工作室建设项目(国家中医药人教函[2022]75)
北京中医药薪火传承“新3+3”工程示范案例项目(2023-ZYSF-13)。
关键词
胸痹
中医处方分析
数据挖掘
高频药物
药性统计
关联规则
孟河京派颜系
临床参考
chest bi-impediment
Chinese medicine prescription analysis
data mining
high-frequency medications
medicinal property statistics
association rules
Yan Lineage of Menghe(Beijing)School
clinical reference
作者简介
通信作者:张冰,女,博士,二级教授,主任医师,博士研究生导师,E-mail:zhangbing6@263.net。
