中医古代肺系疫病用药规律研究
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R254.3

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国家科技重大专项子课题(2017ZX10305501-006,2019XZZX-LG003)


Study on Administration Rules of Chinese Medicine for Pulmonary Epidemic Diseases in Ancient China
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    摘要:

    目的:研究中国古代文献中防治肺系疫病方药的用药规律,为新型冠状病毒肺炎的临床防治提供参考。方法:系统检索第5 版《中华医典》数据库中的肺系疫病条文,筛选明确具有现代流行性传染病特征、发病部位在呼吸系统、且包含药物组成的条文。提取其中涉及的病名、证候、用药等信息,对提取信息进行术语规范化后,采用中医传承辅助平台进行数据挖掘,总结常用中药用药频次、分析其关联规则,获取核心处方及组方规律,结合现行新型冠状病毒肺炎中医诊疗方案进行比较分析。结果:共检索到1 869 条古代疫病条文,根据传染性评价和发病部位判断后,最终纳入含中药处方的肺系疫病条文共177 条,1 条来自唐代,4 条来自宋代,2 条来自金代,2 条来自元代,60 条来自明代,90 条来自清代,18 条来自民国。涉及药物共204 种,单药使用频次最高前3 位的为甘草、黄芩、桔梗,出现药对频次最高的组合为甘草-桔梗、黄芩-甘草、连翘-甘草。基于关联规则的组方规律分析进一步分析,设置支持度20,得到核心处方黄芩-黄连-连翘-甘草-桔梗;设置支持度16,得到核心处方为黄芩-黄连-柴胡-连翘-桔梗-牛蒡子-玄参-甘草。结论:中国古代经历多次疫灾,积累了丰富的抗疫经验,记载了大量的抗疫方药。本研究系统梳理了古代肺系疫病的诊疗经验,建立了古代肺系疫病文献数据库,发现古代肺系疫病与本次新型冠状病毒肺炎诊疗方案辨证分型虽不尽相同,但高频用药多为清热药、解表药;处方规律则改泻火解毒为辛凉宣肺,注重顾护胃气。

    Abstract:

    Abstract: Objective: To study the administration rules of prescriptions for prevention and treatment of pulmonary epidemic diseases in ancient Chinese literature,and to provide reference for clinical prevention and treatment of COVID-19. Methods:The articles about pulmonary epidemic diseases in the database of the 5th edition of Chinese Medical Code were searched systematically,and the articles with the characteristics of modern epidemic diseases,the articles in which the site of the disease is in the respiratory system, and the articles contained prescriptions were selected. The disease names, syndromes and medication involved were extracted. After standardization of terminology,the Chinese Medicine Inheritance Assistant Platform was used for data mining; the frequency of commonly used Chinese herbs was summarized; its association rules were analyzed; the core prescription and prescription rules were obtained, and the current Chinese medicine diagnosis and treatment scheme of COVID-19 was compared with and analyzed. Results:A total of 1,869 articles of ancient epidemics were retrieved. According to the evaluation of infectivity and the site of disease,a total of 177 articles of pulmonary epidemic diseases containing Chinese medicine prescriptions were finally included, including 1 from Tang Dynasty, 4 from Song Dynasty, 2 from Jin Dynasty, 2 from Yuan Dynasty, 60 from Ming Dynasty, 90 from Qing Dynasty,and 18 from the Republic of China. A total of 204 Chinese herbs were involved,and the top three herbs with the highest frequency of use were Radix et Rhizoma Glycyrrhizae,Radix Scutellariae and Radix Platycodonis;the herb pairs with the highest frequency of use were Radix et Rhizoma Glycyrrhizae-Radix Platycodonis,Radix Scutellariae-Radix et Rhizoma Glycyrrhizae,and Fructus Forsythiae-Radix et Rhizoma Glycyrrhizae. After the further exploration into the administration rule based association analysis, with a support degree set at 20, the core prescription was obtained: Radix Scutellariae- Rhizoma Coptidis-Fructus Forsythiae-Radix et Rhizoma Glycyrrhizae-Radix Platycodonis;with a support degree set at 16, the core prescription was obtained: Radix Scutellariae- Rhizoma Coptidis- Fructus Forsythiae- Radix Bupleuri- Fructus Forsythiae-Radix Platycodonis-Fructus Arctii-Radix Scrophulariae-Radix et Rhizoma Glycyrrhiza. Conclusion:Ancient China has experienced many epidemic disasters,so has accumulated rich experience in anti-epidemic,and also recorded a large number of anti-epidemic prescriptions. This study systematically sorts out the diagnosis and treatment experience of ancient pulmonary epidemic diseases and establishes the literature database of ancient pulmonary epidemic diseases. It is found that although the syndrome differentiation and classification of ancient pulmonary epidemic diseases are different from the typing of COVID-19 diagnosis and treatment plan,the high-frequency herbs are mostly for clearing hear and releasing the exterior. The administration rule of prescription is to diffuse the lung with acrid- cool herbs rather than drain fire and resolve toxins, focusing on the protection of stomach qi.

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邓雪仪,何志玲,陈雪吟,王伟斌,温万鑫,赖昕,岳萍,刘少南,杨丽虹,刘云涛,杨荣源,张忠德,吴金鹏,郭新峰.中医古代肺系疫病用药规律研究[J].新中医,2021,53(18):5-10

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  • 在线发布日期: 2021-09-24
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