从湿论治鼻病古代文献用药规律的研究

Study on medication rule of treatment of nasal disease form dampness pathogenesis based on ancient literature

关键词:  鼻病  湿  古代医案  用药规律

Key words:  nasal disease  dampness  ancient medical cases  medication rule

摘要:

[目的] 总结从湿论治鼻病的古代医案用药规律。[方法] 收集《中华医典》（第五版）、《古今医案云平台》及涉及鼻病的古籍中从湿论治鼻病的医案，基于中医传承辅助平台系统（V2.5）、IBM SPSS Modeler 18.0、Cytoscape 3.10.0、IBM SPSS Statistics 26软件，对药物进行频次分析、关联规则分析、网络关系分析和系统聚类分析等数据挖掘方法。[结果] 筛选出符合标准的方剂49首共涉及130味中药，药物以辛温、苦寒为主，归经于肺胃脾3经居多，使用频率前5位的中药为茯苓、辛夷、甘草、黄芩和白芷，常用药对为“白芷、川芎-辛夷”“陈皮、甘草-茯苓”“白芷-辛夷”等，核心组方为茯苓、辛夷、甘草、黄芩、白芷、桔梗、苍耳子、陈皮8味药。[结论] 古代文献从湿论治鼻病药物归经以肺胃脾为主，涉及鼻渊、鼻痔、鼻疳、鼻鼽与鼻衄5类鼻病，以鼻渊为主；证型以湿热证为主，湿证、兼证外感证及气虚证次之。外感邪气用药，祛风通窍兼顾清利头目，升发清阳恢复肺脾气机，佐以祛风抗过敏药预防复发。内生湿邪用药，首当健补脾胃，阻断生湿之源，重视脾胃重要地位；再者防生湿化热之变，尤重中上二焦；次者防湿热入络入血而动血耗血，佐以凉血止血、滋阴养血之品。古文献鼻病治疗用药特色对现代中医鼻病防治具有一定参考价值。

Abstract:

[Objective] To summarize the medication rule of the treatment of nasal disease from dampness pathogenesis based on ancient medical cases. [Methods] The medical cases of nasal disease from dampness pathogenesis in Chinese Medical Dictionary(fifth edition),dictionary of traditional Chinese medicine prescriptions and ancient books related to nasal diseases were collected. Based on the V2.5 software of traditional Chinese medicine(TCM) inheritance system,IBM SPSS Modeler 18.0,Cytoscape 3.10.0 and IBM SPSS Statistics 26,data mining methods such as frequency analysis,association rule analysis,network relationship analysis and system cluster analysis were applied to analyze related drugs. [Results] The 49 prescriptions that meet the standard were screened out,involving 130 Chinese herbal medicines. These Chinese herbal medicines were mainly based on pungent-warm and bitter and cold,and most of them were belonged to the three meridians of lung,stomach and spleen. And the top five Chinese herbal medicines with frequency from high to low were Fuling,Xinyi,Gancao,Huangqin and Baizhi. The commonly used medicine pairs were "Baizhi,Chuanxiong-Xinyi" "Chenpi,Gancao-Fuling" "Baizhi-Xinyi",etc. The core ingredients are Fuling,Xinyi,Gancao,Huangqin,Baizhi,Jiegeng,Cang'erzi and Chenpi. [Conclusion] Ancient literature from the dampness treatment of nasal disease drugs are mainly based on the three meridians of lung,stomach and spleen. Five kinds of nasal diseases,including nasosinusis,hemorrhoids,chancre,epistaxis and epistaxis,are involved,mainly nasosinusis. The main syndrome type is damp heat syndrome,followed by damp syndrome,concurrent exogenous syndrome and qi deficiency syndrome. For exogenous evil qi,use medicine to dispel the wind,clear the leader,ascend qingyang to restore the lung and spleen qi movement and add anti-allergic drugs to prevent recurrence. For endogenous dampness,the first step is to strengthen the spleen and stomach,block the source of dampness,and attach importance to the important position of the spleen and stomach. In addition,to prevent the change of humidity heat,especially the middle and upper two focal points. The third is to protect against moist heat from entering the meridians and blood to casue bleed and consumption,and accompanied by cool blood to stop bleeding,nourish yin and nourish blood. The characteristics of medication in ancient literature have a reference role in enlightening prevention and treatment nasal disease in modern Chinese medicine.