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[摘要]
目的 基于“中医传承辅助平台系统(V2.5)”探讨邓家刚教授治疗脾胃湿病的用药规律,为临床湿病治疗提供参考。方法 收集整理邓家刚教授门诊治疗脾胃湿病的经验处方,将符合标准的119张中药处方依次录入系统,通过中医传承辅助平台V2.5,运用频次统计、关联规则分析、改进互信息法等方法进行用药规律及特点的挖掘,来探索并分析出治疗脾胃湿病用药规律。结果 经分析得出,119张处方中,涉及病症以胃痛病(55例)、湿阻病(21例)、胃痞病(16例)居多,证型则以肝胃不和(45例,37.81%)、脾虚气滞证(14例,11.76%)、脾虚湿困证(18例,15.13%)为主,虚实证候以实证(73例,61.34%)所占比例最为之大;用药频率排名前十的为陈皮(67)、厚朴(64)、茯苓(59)、半夏(55)、郁金(53)、柴胡(53)、白芍(47)、石斛(46)、栀子(46)、党参(44)等;常用的药物组合为:陈皮和茯苓(45)、半夏和陈皮(41)、白芍和柴胡(40)、柴胡和厚朴(35)、白芍和厚朴(34)等;所用药物性味大多为辛、苦、寒,主归脾、胃、肝经,药物功效分类则以补虚药(22.21%)和理气药(12.90%)为多。结论 邓教授治疗脾胃湿病,始终以其“理湿勿忘通瘀滞”的思想为指导,灵活运用“反性配伍”和“寒温和合”的遣方用药方法,擅用理气化湿、疏肝健脾,兼以化瘀行滞的方药,从而形成其治疗脾胃湿病的用药特色。
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[Abstract]
Objective To explore the medication rule of Professor Deng Jiagang in the treatment of damp disease of spleen and stomach based on "traditional Chinese Medicine Inheritance auxiliary platform system (v2.5)", so as to provide reference for clinical treatment of damp disease of spleen and stomach.Methods We collected and sorted out Professor Deng Jiagang's outpatient prescriptions for the treatment of damp disease of spleen and stomach, input 119 Traditional Chinese medicine (TCM) prescriptions that meet the standard into the system in turn, and used frequency statistics, association rule analysis, improved mutual information method and other methods to explore and analyze the medication rules for the treatment of damp disease of spleen and stomach through "traditional Chinese Medicine Inheritance auxiliary platform system (v2.5)".Results Among the 119 prescriptions, most of the diseases involved were epigastric-pain disease (55 cases), dampness-retention disease (21 cases) and stomach-bloating disease (16 cases). The main syndromes involved in these prescriptions were liver-stomach disharmony syndrome (45 cases, 37.81%), spleen deficiency and qi stagnation syndrome (14 cases, 11.76%), spleen deficiency with dampness encumbrance syndrome (18 cases, 15.13%), and in terms of deficiency and excess syndromes, excess syndromes (73 cases, 61.34%) accounted for the largest proportion. The top 10 herbs used in frequency were Pericarpium Citri Reticulatae (67), Cortex Magnoliae Officinalis (64), Poria (59), Rhizoma Pinelliae (55), Radix Curcumae (53), Radix Bupleuri (53), Radix Paeoniae Alba (47), Caulis Dendrobii (46), Fructus Gardenia (46), Radix Codonopsis (44), etc. The commonly used herb combinations were Pericarpium Citri Reticulatae and Poria (45), Rhizoma Pinelliae and Pericarpium Citri Reticulatae (41), Radix Paeoniae Alba and Radix Bupleuri (40), Radix Bupleuri and Cortex Magnolia officinalis (35), Radix Paeoniae Alba and Cortex Magnoliae officinalis (34), etc. Most of the herbs used were pungent, bitter and cold, and they mainly attributed to spleen, stomach and liver meridians. In terms of drug efficacy classification, most of these drugs were herbal medicines for tonifying (22.21%) and herbal medicines for regulating qi (12.90%).Conclusion Based on the analysis of Professor Deng's medication rules in the treatment of damp disease of spleen and stomach, it is concluded that he always takes "do not forget to remove stagnation of blood stasis in regulating dampness" as the guiding ideology, flexibly use the methods of compatibility of drugs with opposite properties and cold-warm formula in medication and making prescriptions. And he is good at using the prescriptions and TCMs of regulating qi and removing dampness, soothing liver and strengthening spleen, and nourishing yin and promoting stagnation. Based on the above treatment experience, the medication characteristics in the treatment of damp disease of spleen and stomach were formed.
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[基金项目]
广西壮族自治区中医药局科研课题(GZZC2019013):健脾益胃方对CAG患者疗效及血清PG影响的临床研究,负责人:刘伟锋;广西壮族自治区中医药局科研课题(GZZC2020137):温针灸联合健脾益胃方对PU患者疗效及血清PG影响的临床研究,负责人:蒋玉萍;广西中药药效研究重点实验室科研课题(20-065-38-K3):薏苡附子败酱散治疗结肠炎临床观察,负责人:刘伟锋; 广西科技重大专项(桂科AA18118049):广西特色药用资源金花茶产业发展关键技术与应用示范研究,负责人:邓家刚;广西重点研发计划(桂科AB20036001):中-新合作开展广西特色中药壮瑶药抗新型冠状病毒活性评价及应用研究,负责人:邓家刚;广西科技基地和人才专项(桂科AD19110165):中国-东盟传统药物研究国际联合实验室建设(二期),负责人:侯小涛