汉代至民国著名医家治疗喘证方剂用药规律的数据挖掘研究

周建国 丁宇坤 何庆勇

摘要 目的：探討汉代至民国著名医家治疗喘证方剂的用药规律。方法：从医学典籍中共获得119条方剂，录入数据库并借助“中医辅助传承系统（V2.5）”对证候、单药、对药、角药频次等进行深度研究。结果：喘证最常见证候为：痰热郁肺证，痰浊阻肺证，肺气虚耗证;出现最多的药物是：甘草，杏仁，陈皮;出现最多的对药是：麻黄-杏仁，半夏-陈皮，陈皮-甘草;出现最多的角药是：甘草-麻黄-杏仁，半夏-陈皮-甘草，半夏-陈皮-茯苓;核心药物是陈皮，半夏，生姜，甘草，麻黄，杏仁;候选处方优选为竹茹-升麻-生地黄-玄参等。结论：喘证证候优先以痰热郁肺证，痰浊阻肺证为适应证;药物使用可优选甘草，杏仁;对药可优选麻黄-杏仁，半夏-陈皮;角药优选麻黄-杏仁-甘草，半夏-陈皮-甘草;核心药物为麻黄，杏仁，陈皮，半夏，生姜，甘草;候选药物可优选竹茹-升麻-生地黄-玄参等药物。

关键词 喘证;数据挖掘;中医辅助传承系统;关联规则;核心组合;复杂网络;学术思想;新药研究

Abstract Objective：To study prescription regularity on asthma symptom treatment by famous traditional Chinese medicine（TCM）doctors from the Han Dynasty to the Republic of China.Methods：A total of 119 prescriptions were obtained from medical books，and were entered into the database.The syndromes，single drugs，pairs of drugs and frequency of horn medicines were studied in depth with the help of “Chinese medicine auxiliary inheritance system（V2.5）”.Results：The most common syndromes of asthma were phlegm heat depressing the lung，phlegm turbid obstructing the lung，lung qi deficiency.The most common drugs were Radix Glycyrrhizae，Semen Armeniacae Amarum and Pericarpium Citri Reticulatae.The most commonly used drug pairs were Herba Ephedrae-Armeniacae Amarum，Rhizoma Pinelliae-Pericarpium Citri Reticulatae，Pericarpium Citri Reticulatae-Radix Glycyrrhizae.The most common triangle medicines were Radix Glycyrrhizae-Herba Ephedrae-Armeniacae Amarum，Rhizoma Pinelliae-Pericarpium Citri Reticulatae-Radix Glycyrrhizae，Rhizoma Pinelliae-Pericarpium Citri Reticulatae-Poria; the core medicines were Pericarpium Citri Reticulatae，Rhizoma Pinelliae，Rhizoma Zingiberis Recens，Radix Glycyrrhizae，Herba Ephedrae，Armeniacae Amarum; the best candidate prescription was Caulis Bambusae in Taenia，rhizoma-Rhizoma Cimicifugae-Radix Rehmanniae Recens-Radix Scrophulariae.Conclusion：1）The syndromes of asthma syndrome are preferential for phlegm heat depressing the lung syndrome，phlegm turbid obstructing the lung syndrome as indications. 2）Radix Glycyrrhizae and Semen Armeniacae Amarum may be preferred for drug use. 3）Paired drugs may be preferred for Herba Ephedrae-Armeniacae Amarum，Rhizoma Pinelliae-Pericarpium Citri Reticulatae. 4）Triagle medicines may be preferred for Radix Glycyrrhizae-Herba Ephedrae-Armeniacae Amarum，Rhizoma Pinelliae-Pericarpium Citri Reticulatae-Radix Glycyrrhizae. 5）The core drugs are Herba Ephedrae，Armeniacae Amarum，Pericarpium Citri Reticulatae，Rhizoma Pinelliae，Rhizoma Zingiberis Recens，Radix Glycyrrhizae. 6）The candidate prescription can select Caulis Bambusae in Taenia，rhizoma-Rhizoma Cimicifugae-Radix Rehmanniae Recens-Radix Scrophulariae.

Key Words Asthma; Data mining; Chinese medicine auxiliary inheritance system; Association rules; Core combination; Complex network; Academic thoughts; New drug study

中图分类号：R289.9文献标识码：Adoi：10.3969/j.issn.1673-7202.2019.08.023

喘证是以呼吸困难，甚至张口抬肩，鼻翼扇动，不能平卧为临床特征的病证[1]。喘证既可出现在急性肺炎，急性支气管哮喘，急性心力衰竭等急性疾病中，也可以出现在慢性阻塞性肺疾病，肺气肿，肺结核等慢性疾病。以钟南山院士、王辰院士等在2019年4月发表的慢性阻塞性肺疾病为例，我国患有慢性阻塞性肺疾病的人群已经接近1亿[2]，并且患病率正在逐年攀升。中医单独从喘证这一临床表现入手，提出了“肺病者，喘息鼻张”等贴合临床的经验理论。……