中国中药杂志

2020, v.45(19) 4784-4791

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基于隐结构模型的古代痹证辨证分型及用药规律研究
Study on syndrome differentiation of ancient arthralgia syndrome and drug use rules based on latent structure model

李秦;李桓;李松伟;
LI Qin;LI Huan;LI Song-wei;the First Affiliated Hospital of Henan University of Chinese Medicine;

摘要(Abstract):

通过收集古医集中痹证治疗方药,运用Lantern 3.2软件构建古代痹证用药隐结构模型并对其进行分析,归纳总结得出古代痹证10个证型,分别是寒凝经脉证(偏阳虚),寒湿痹阻证(寒重),湿热痹阻证,肝肾亏虚证,精髓亏虚证,痰瘀互结证,脾胃气虚证,湿邪内蕴、痹阻经脉证,寒湿束肺、经脉痹阻证,风寒湿痹证(风寒湿兼有)。该辨证更加强化了八纲辨证思想,对隐结构模型中隐类的核心药物展现了不同辨证分型的用药特点,主要体现在重视用辛散之品逐瘀消痰,强调对滋阴生髓以补先天不足,健脾益气调理后天脾胃,扶正与驱邪兼顾。另外运用Python 3.7软件对古代痹证高频用药进行频繁项集及关联规则挖掘,用药配伍规律的特色之处在于善用养血药,活血药常与散寒药、补肝肾、祛风湿药配伍,多种药物配伍遵循祛风散寒兼顾补益肝肾的配伍原则。古代痹证辨证分型的归纳,用药特色及配伍规律的探讨为临床辨证论治提供新的思路借鉴,对中成药新药研发具有一定参考价值。
In this study, the ancient doctors′ concentrated prescriptions for arthralgia syndrome were collected and Lantern 3.2 software was used to construct and analyze the latent structure model of ancient arthralgia syndrome. A total of 10 syndrome types of ancient arthralgia syndrome were obtained, namely, cold-coagulation meridian syndrome(partial Yang deficiency), cold-dampness obstruction syndrome(cold weight), damp-heat obstruction syndrome, liver and kidney deficiency syndrome, essence deficiency syndrome, phlegm and blood stasis syndrome, spleen and stomach Qi deficiency syndrome, dampness evil accumulation syndrome, arthralgia meridian syndrome, cold-dampness binding lung syndrome, meridian obstruction syndrome, and wind-cold-dampness arthralgia syndrome(both wind-cold and dampness). This syndrome differentiation method further strengthened the thought on eight-class syndrome differentiation, and showed the characteristics of different syndrome differentiation types of the core drugs in the latent structure model, which was mainly reflected in paying attention to removing blood stasis and eliminating phlegm with use of pungent taste products having dispersing effect, emphasizing the effect of nourishing Yin and generating marrow to supplement congenital deficiency, invigorating spleen and replenishing Qi to regulate the spleen and stomach functions, nourishing vital energy and expelling evil. In addition, Python 3.7 software was used to mine the frequent item sets and association rules for the frequently used drugs for ancient arthralgia syndrome. The drug compatibility law is characterized by making good use of blood-nourishing drugs. Blood-activating drugs are often compatible with cold-dispelling drugs, liver and kidney tonifying drugs, and wind-dampness-dispelling drugs, following the compatibility principle of dispelling wind and dispelling cold as well as tonifying liver and kidney. The induction of syndrome differentiation types of ancient arthralgia syndrome and the discussion on the characteristics of drug use and compatibility law provide a new way for clinical syndrome differentiation and treatment, with certain reference value for the research and development of new Chinese patent medicines.

关键词(KeyWords): 痹证;隐结构模型;辨证分型;用药规律;数据挖掘
arthralgia syndrome;latent structure model;syndrome differentiation;medication rule;data mining

Abstract:

Keywords:

基金项目(Foundation): 国家自然科学基金面上项目(81874465);; 河南省中医药科学研究专项(2017ZY1014);; 河南省科技攻关计划项目(172102310287)

作者(Author): 李秦;李桓;李松伟;
LI Qin;LI Huan;LI Song-wei;the First Affiliated Hospital of Henan University of Chinese Medicine;

Email:

DOI: 10.19540/j.cnki.cjcmm.20200726.501

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