| 引用本文: |
陈晨,史军,朱慧兰,乔植,刘玉.国医大师干祖望治疗分泌性中耳炎用药规律分析[J].湖南中医药大学学报,2022,42(4):521-527[点击复制] |
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| 国医大师干祖望治疗分泌性中耳炎用药规律分析 |
| 陈晨,史军,朱慧兰,乔植,刘玉 |
| (南京中医药大学附属南京市中西医结合医院, 江苏 南京 210014;江苏省中医院, 江苏 南京 210029) |
| 摘要: |
| 目的 分析国医大师干祖望治疗分泌性中耳炎的用药规律，以便更好地指导临床。方法 筛选出国医大师干祖望5000余份医案手稿中治疗分泌性中耳炎的医案102份，通过“中医传承计算平台（V3.0）”分析治疗分泌性中耳炎的用药频次、四气五味、药物归经、药物核心组合、药物关联规则、证型分布，解析干教授治疗分泌性中耳炎的用药规律。结果 102份治疗分泌性中耳炎的医案中，所用中药共119味，常用中药为石菖蒲、路路通、甘草、茯苓、陈皮、白术、半夏、葛根、升麻、柴胡、党参、防己、乌药。药性以温、平、寒性为主，药味以甘、苦、辛居多，多归肺、脾、胃经。对处方用药进行关联规则分析，得到药物组合34组，常用药对为“石菖蒲，半夏→陈皮”“路路通，升麻→石菖蒲”“茯苓，半夏→陈皮”等。基于k-means算法进行用药聚类分析，提取出3组核心药物组合：茯苓-陈皮-半夏-白术-党参，乌药-升麻-葛根-柴胡，石菖蒲-路路通-甘草-防己。证型分布以风邪外袭型为主，其次为清阳不升型、脾虚湿困型。结论 国医大师干祖望治疗分泌性中耳炎多用补气药、开窍药、利水药，以宣肺理气、健脾化痰、升清开窍为常用治法。 |
| 关键词: 分泌性中耳炎 宣肺理气 健脾化痰 升清开窍 石菖蒲 路路通 陈皮 半夏 干祖望 |
| DOI：10.3969/j.issn.1674－070X.2022.04.001 |
| 投稿时间：2021-10-22 |
| 基金项目:高层次卫生人才“六个一工程”拔尖人才科研项目（LGY2020022）。 |
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| Medication rule of TCM master Gan Zuwang in the treatment of secretory otitis media |
| CHEN Chen,SHI Jun,ZHU Huilan,QIAO Zhi,LIU Yu |
| (Nanjing Hospital of Integrated Traditional Chinese and Western Medicine Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu 210014, China;Jiangsu Province Hospital of Chinese Medicine, Nanjing, Jiangsu 210029, China) |
| Abstract: |
| Objective To analyze the medication rule of Gan Zuwang, a master of traditional Chinese medicine (TCM), in the treatment of secretory otitis media, so as to better guide clinical practice treatment. Methods 102 medical records for the treatment of secretory otitis media were selected from more than 5000 medical records of TCM master Gan Zuwang. The "traditional Chinese medicine inheritance computing platform (V3.0)" was used to analyze the medication frequency, four Qi and five flavors, drug meridian, drug core combination, drug association rule and syndrome type distribution of secretory otitis media, and to analyze professor Gan Zuwang's medication rule in treating secretory otitis media. Results Among the 102 selected medical records of treatment of secretory otitis media, a total of 119 TCM were used. The commonly used TCM were Shichangpu (Acori Tatarinowii Rhizoma), Lulutong (Liquidambaris Fructus), Gancao (Glycyrrhizae Radix Et Rhizoma), Fuling (Poria), Chenpi (Citri Reticulatae Pericarpium), Baizhu (Atractylodis Macrocephalae Rhizoma), Banxia (Pinelliae Rhizoma), Gegen (Puerariae Lobatae Radix), Shengma (Cimicifugae Rhizoma), Chaihu (Bupleuri Radix), Dangshen (Codonopsis Radix), Fangji (Stephaniae Tetrandrae Radix), Wuyao (Linderae Radix). The medicine properties were mainly warm, flat and cold. The medicine tastes were mainly sweet, bitter and pungent, mostly belonging to the lung, spleen and stomach meridian. Through association rule analysis of prescription drugs, 34 groups of core combinations were evolved, and common drug pairs such as "Shichangpu (Acori Tatarinowii Rhizoma), Banxia (Pinelliae Rhizoma)→Chenpi (Citri Reticulatae Pericarpium)" "Lulutong (Liquidambaris Fructus), Shengma (Cimicifugae Rhizoma)→Shichangpu (Acori Tatarinowii Rhizoma)" "Fuling (Poria), Banxia (Pinelliae Rhizoma)→Chenpi (Citri Reticulatae Pericarpium)" were obtained. Drug cluster analysis was carried out based on k-means algorithm, and three groups of core drug combinations were extracted: Fuling (Poria)-Chenpi (Citri Reticulatae Pericarpium)-Banxia (Pinelliae Rhizoma)-Baizhu (Atractylodis Macrocephalae Rhizoma)-Dangshen (Codonopsis Radix), Wuyao (Linderae Radix)-Shengma (Cimicifugae Rhizoma)-Gegen (Puerariae Lobatae Radix)-Chaihu (Bupleuri Radix), Shichangpu (Acori Tatarinowii Rhizoma)-Lulutong (Liquidambaris Fructus)-Gancao (Glycyrrhizae Radix Et Rhizoma)-Fangji (Stephaniae Tetrandrae Radix). The distribution of syndrome types was mainly external attack of wind evil, followed by lucid Yang failing to rise, spleen deficiency and dampness stagnation. Conclusion Professor Gan Zuwang often uses Qi tonifying drugs, resuscitation drugs and diuretic drugs in the treatment of secretory otitis media. The common treatment methods are to disperse lung and regulate Qi, strengthen spleen and dissipate phlegm, and promote the clear and resuscitation. |
| Key words: secretory otitis media disperse lung and regulate Qi strengthen spleen and dissipate phlegm promote the clear and resuscitation Shichangpu(Acori Tatarinowii Rhizoma) Lulutong(Liquidambaris Fructus) Chenpi(Citri Reticulatae Pericarpium) Banxia(Pinelliae Rhizoma) Gan Zuwang |
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