《小儿药证直诀》辨治急惊风和慢惊风用药规律探析

An analysis of the pattern of medication used in the treatment of acute and chronic infantile convulsions in the Xiao'er Yaozheng Zhijue

关键词:  钱乙  《小儿药证直诀》  急惊风  慢惊风  数据挖掘  用药规律

Key words:  QIAN Yi  Xiao'er Yaozheng Zhijue  acute infantile convulsions  chronic infantile convusion  data mining  medication rule

摘要:

[目的] 运用数据挖掘方法探析《小儿药证直诀》辨治急、慢惊风的组方应用规律。[方法] 收集《小儿药证直诀》中治疗急、慢惊风的处方，应用Excel 2021统计单味中药的使用频数及性味归经，IBM SPSS Modeler 18.0进行药物关联规则分析，SPSS statistics 26.0对治疗急、慢惊风的高频药物进行系统聚类分析。[结果] 急惊风共筛选出49首方剂，包括中药112味，排名前五的中药分别为朱砂、冰片、麝香、轻粉、牛黄；性味以辛寒为主，甘苦温次之，归经以肝、心、肺经为主；药物以清热药最多，其次为安神药、平肝息风药；得出药物关联规则20条，6个聚类方。慢惊风共筛选出17首方剂，包括中药60味，排名前五的中药分别为炙甘草、人参、白术、陈皮、茯苓；性味以辛温为主，甘苦平次之，归经以脾、肺、胃经为主；药物以补虚药最多，其次为平肝息风药、化痰止咳平喘药；得出药物关联规则148条，5个聚类方。两者剂型以丸、散为主，使用无毒药物居多。[结论] 《小儿药证直诀》中急惊风治疗以清热安神、息风开窍为主，采用内外兼治法；慢惊风治疗以温中补虚、息风化痰为主，同调脾肺二脏。钱乙在治疗中审慎运用有毒药物，从用法用量、赋形剂、服药饮品、炮制等方面减轻药物毒性，增强疗效。

Abstract:

[Objective] To use data mining methods to explore the pattern of formula application of Xiao'er Yaozheng Zhijue in the identification and treatment of acute and chronic infantile convulsions.[Methods] We collected the prescriptions for treating acute and chronic infantile convulsions in the Xiao'er Yaozheng Zhijue, applied Excel 2021 to count the frequency of using single TCM and their property and meridian tropism, IBM SPSS Modeler 18.0 to perform the analysis of the drug association rules, and SPSS statistics 26.0 to perform systematic cluster analysis on the high-frequency medicines used for treating acute and chronic infantile convulsions.[Results] A total of 49 prescriptions were screened out, including 112 TCM. The top 5 TCM were Cinnabar, Borneol, Musk, Calomelas and Bezoar;The properties and flavors were mainly pungent and cold, followed by sweet, bitter and warm, and the meridian tropism were mainly the liver, heart, and lungs;The most common TCM were heat-clearing, followed by liver-calming and wind-extinguishing;and 20 drug-association rules were obtained, and 6 clustering prescriptions were used.A total of 17 prescriptions were screened out, including 60 TCM. The top 5 TCM were Glycyrrhizae RadixEt Rhizoma, Ginseng, Rhizoma Atractylodis Macrocephalae, Citri Reticulatae Pericarpium, and Poria;The properties and flavors of the TCM were mainly pungent and warm, followed by sweet, bitter, and neutral and meridian tropism were mainly the spleen, lungs, and stomach;the TCM were most frequently used for tonifying and deficiency-replenishing herbs, followed by liver-calming and wind-extinguishing, and phlegm-resolving and antitussive herbs;and 148 drug-association rules were obtained, and 5 clustering prescriptions were used. The dosage forms of the two are mainly pills and dispersant, and non-toxic drugs are mostly used.[Conclusion] The treatment of acute infantile convulsions in Xiao'er Yaozheng Zhijue is based on clearing heat and tranquilizing the mind, resting the wind and opening the orifices, and adopting both internal and external treatments;the treatment of chronic infantile convulsions is based on warming the middle and tonifying deficiency, resting the wind and resolving phlegm, and treating the spleen and lungs at the same time. QIAN Yi prudently used toxic drugs in treatment to reduce drug toxicity and enhance curative effect in terms of usage and dosage, excipients, medicine drinks, processing, etc.