施维群以肝为本从肝论治失眠用药规律研究

摘要/Abstract

摘要： 目的浙江省名中医施维群教授采用“以肝为本,从肝论治”方法治疗失眠有良好疗效,分析其治疗失眠的用药规律和处方思路,为名老中医经验继承和临床实践提供参考。方法收集2020年1月—2023年1月施维群教授治疗失眠的中药处方数据,标准化后建立数据资料表,使用Excel 2019对药物频次、性味归经进行统计分析;采用SPSS Modeler 18.0软件Apriori算法对药物进行关联规则分析;使用SPSS Statistic 26.0软件对频次≥20的高频药物进行聚类分析,以探索其核心用药。结果共纳入中药处方119首,涉及165味中药,药物总频次2 167次。药物使用频次前10位依次为当归、茯神、白术、梅花、甘草、白芍、柴胡、合欢花、牡丹皮、酸枣仁。药性以平、温、微寒为主,药味以甘、苦、辛为主,归经以肝经、心经、脾经为主。药物功效以疏肝解郁、宁心安神、补益脾胃为主。药物关联中高频药物组合有“白术→黄芪”“焦栀子→淡豆豉”“女贞子→墨旱莲”“当归→木香”“泽泻→山茱萸”等。药物聚类可将使用频次>30次的23味高频中药聚类成5类。复杂网络分析筛选出治疗失眠的核心中药：当归、茯神、白术、梅花、甘草、合欢花、三七花、白芍。结论施维群教授治疗失眠以肝为本,从肝论治,兼顾心、脾、肾三脏,以疏肝理气为核心,配合养心安神、健脾益气、滋补肝肾等法辨证施治。核心处方配伍严谨,理法精妙。

关键词: 失眠, 组方规律, 数据挖掘, 中医药, 名医经验, 施维群

Abstract: Objective Professor Shi Weiqun, a famous Chinese medicine doctor in Zhejiang Province, has a good curative effect on insomnia based on liver. To analyze the medication rules and prescription ideas of Professor Shi Weiqun in the treatment of insomnia, and to provide reference for the inheritance of experience and clinical practice of famous old Chinese medicine. Methods The outpatient TCM prescription data of Professor Shi Weiqun in the treatment of insomnia from January 2020 to January 2023 were collected, and the data table was established after standardization, and the drug frequency, sex and taste normalization were statistically analyzed by Excel 2019. SPSS Modeler 18.0 software Apriori algorithm was used to analyze drug association rules. SPSS Statistic 26.0 software was used for cluster analysis of high-frequency drugs with frequency ≥20 to explore their core drugs. Results A total of 119 TCM prescriptions were included, involving 165 TCM, and the total frequency of drugs was 2 167 times. The top 10 drug use frequency were Angelica sinensis, Fuzhuan, white art, plum blossom, licorice, Paeony, Bupleurum, alacia, peony bark and jujube kernel. The drug properties are mainly flat, warm and slightly cold, the taste is mainly sweet, bitter and xin, and the channel is mainly liver channel, heart channel and spleen channel. The efficacy of the drug is mainly to relax the liver and relieve depression, calm the heart and calm the mind, and tonify the spleen and stomach. The high frequency drug combination in drug association includes “white art → astragalus” “scorched gardenia → light tempeh” “ligustrine fruit → mohan lotus” “angelica → wood fragrance” “alisma → dogwood” and so on. Drug clustering can cluster 23 high frequency Chinese medicines used more than 30 times into 5 categories. The core prescriptions for insomnia were as follows: Angelica sinensis, Fuzhuan, white art, plum blossom, licorice, alacia, Notoginseng and Paeony. Conclusion Professor Shi Weiqun’s treatment of insomnia is based on liver, from liver to liver, taking into account the three viscera of heart, spleen and kidney, with soothing liver and regulating qi as the core, with nourishing heart and calming, invigorating spleen and qi, nourishing liver and kidney. The core prescription is rigorously compatible and delicate.

Key words: insomnia, composing rules, data mining, Traditional Chinese Medicine, experience of famous doctors, Shi Weiqun

中图分类号:

R256.23

周纯子, 胡竞文, 张翔, 施维群. 施维群以肝为本从肝论治失眠用药规律研究[J]. 中华养生保健, 2024, 42(20): 153-157.

ZHOU Chun-zi, HU Jing-wen, ZHANG Xiang, SHI Wei-qun. Study on the Rule of Medication in Treating Insomnia from the Liver of Shi Weiqun[J]. ZHONGHUA YANGSHENG BAOJIAN, 2024, 42(20): 153-157.

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