Xin’an doctors’ records of treating lung distention based on the "symptoms-patterns-medicines" model: A data mining study

Qinjun YANG; Zhenhao HE; You SHI; Jie ZHU; Yating GAO; Jiabing TONG; Mengyao SHI; Huanzhang DING; Di WU; Dengdi SUN; Zegeng LI; Mingxiang HAN

doi:10.3969/j.issn.1006-2157.2022.06.008

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Xin’an doctors’ records of treating lung distention based on the "symptoms-patterns-medicines" model: A data mining study

Science & Technology Theme | 更新时间：2022-07-11

- Xin’an doctors’ records of treating lung distention based on the "symptoms-patterns-medicines" model: A data mining study
- Journal of Beijing University of Traditional Chinese Medicine Vol. 45, Issue 6, Pages: 594-602(2022)
- 作者机构：
  
  1.安徽中医药大学　合肥　230038
  2.安徽省中医药科学院中医呼吸病防治研究所
  3.安徽大学
  4.安徽中医药大学第一附属医院
  5.安徽省教育厅重点实验室　中医药防治肺系重大疾病重点实验室
- 作者简介：
  
  Prof. LI Zegeng, Ph.D., Doctoral Supervisor, Chief Physician. the First Affiliated Hospital of Anhui University of Chinese Medicine, 117 Meishan Road, Hefei 230038. E-mail: li6609@126.com
- 基金信息：
  
  National Natural Science Foundation of China(U20A20398);Major Science and Technology Project of Anhui Province(201903a07020015);Key Laboratory of Disease and Pattern of Qi Deficiency, Department of Internal Medicine, State Administration of Traditional Chinese Medicine(国中药函〔2009〕95号)
- DOI：10.3969/j.issn.1006-2157.2022.06.008
  CLC： R256.14
- Received：08 November 2021，
  
  Published：30 June 2022
- 稿件说明：
移动端阅览
Qinjun YANG, Zhenhao HE, You SHI, et al. Xin’an doctors’ records of treating lung distention based on the "symptoms-patterns-medicines" model: A data mining study[J]. Journal of Beijing University of Traditional Chinese Medicine, 2022, 45(6): 594-602.
DOI：

Qinjun YANG, Zhenhao HE, You SHI, et al. Xin’an doctors’ records of treating lung distention based on the "symptoms-patterns-medicines" model: A data mining study[J]. Journal of Beijing University of Traditional Chinese Medicine, 2022, 45(6): 594-602. DOI： 10.3969/j.issn.1006-2157.2022.06.008.

摘要

目的

使用数据挖掘方法对新安医家治疗肺胀的医案从症状、证候、药物进行多维度研究，探讨其辨治肺胀的特色。

方法

收集整理新安医籍中有关肺胀治疗的医案，将各项信息规范化处理后，利用频数分析、拓扑学分析、Louvain聚类算法、因子分析等数学模型对症状、证候、方药进行分析、关联。

结果

共纳入361则医案，涉及272味药物，其中核心药物35味，包括茯苓、甘草、苦杏仁、薏苡仁、半夏、人参、白术、五味子等；补虚药(30.14%)使用最多，其次为化痰止咳平喘药(22.81%)。实证中痰湿蕴肺证(30.19%)最多，虚证中以肺气虚证(22.44%)、脾气虚证(21.05%)、肾气虚证(17.45%)为主。苦杏仁、茯苓、薏苡仁、半夏、化橘红等是痰湿蕴肺证的核心处方药物；茯苓、甘草、人参、白术、苦杏仁、陈皮等是肺气虚证的核心处方药物；茯苓、人参、甘草、白术、陈皮、半夏等是脾气虚证的核心处方药物；茯苓、山药、熟地黄、山萸肉、五味子等是肾气虚证的核心处方药物。共提取10个公因子；主要病位证素为肺、脾、肾，水湿、痰饮、瘀血是主要病理要素。

结论

肺胀属本虚标实之证，以肺、脾、肾亏虚为本，痰、瘀、热等病理因素为标。新安医家辨治肺胀喜用茯苓、薏苡仁、人参、白术；重视标本兼治，在祛痰、清肺、止咳、平喘治标的同时，常配伍补肺、健脾、益肾之品以治其本。

Abstract

Objective

To study the rules of symptoms

patterns

and medicines of medical records of lung distention treated by Xin’an doctors through data mining methods

and to explore the characteristics of Xin’an doctors in the treatment of lung distention.

Methods

Medical records related to the treatment of lung distention by Xin’an doctors were collected and sorted from the medical books of Xin’an. After the standardized processing of various information

mathematical models such as frequency analysis

topology analysis

Louvain clustering

and factor analysis were used to conduct data mining research on symptoms

patterns

and prescriptions.

Results

We included 361 medical records and counted 272 traditional Chinese medicines in total. Among them

35 were core medicines

including Poria

Radix Glycyrrhizae

Semen Armeniacae Amarum

Semen Coicis

Rhizoma Pinelliae

Radix Ginseng

Rhizoma Atractylodis Macrocephalae

and Fructus Schisandrae Chinensis. In the lung distention

clinical practice of Xin’an doctors

tonic medicines (30.14%) were used most

followed by expectorant cough suppressants and anti-asthmatic medicines (22.81%). The pattern of phlegm and dampness accumulating in the lung (30.19%) was the most commonly observed

and the patterns of deficiency were mainly lung qi deficiency (22.44%)

spleen qi deficiency (21.05%)

and kidney qi deficiency (17.45%). Semen Armeniacae Amarum

Poria

Semen Coicis

Rhizoma Pinelliae

and Exocarpium Citri Grandis were the core prescription medicines for the pattern of phlegm and dampness accumulating in the lung. Poria

Radix Glycyrrhizae

Radix Ginseng

Rhizoma Atractylodis Macrocephalae

Semen Armeniacae Amarum

and Pericarpium Citri Reticulatae were the core prescription medicines of the lung qi deficiency pattern. Poria

Radix Ginseng

Radix Glycyrrhizae

Rhizoma Atractylodis Macrocephalae

Pericarpium Citri Reticulatae

and Rhizoma Pinelliae were the core prescription medicines of the spleen qi deficiency pattern. Poria

Rhizoma Dioscoreae

Radix Rehmanniae Preparata

Fructus Corni

and Fructus Schisandrae Chinensis were the core prescription medicines of the kidney qi deficiency pattern. Furthermore

10 common factors were extracted by factor analysis. The disease’s main locations were the lung

spleen

and kidney. Water dampness

phlegm

and blood stasis were the main pathological factors.

Conclusion

Lung distention is a disease whose pathogenesis is the root deficiency with the branch in excess. The deficiency of the lung

spleen

and kidney are the root

while the pathological factors of phlegm

blood stasis

and heat are its branch. In Xin’an doctors’ clinical practice

they preferred to use Poria

Semen Coicis

Radix Ginseng

and Rhizoma Atractylodis Macrocephalae to treat lung distention. While eliminating phlegm

clearing the lung

relieving cough

and relieving asthma were used to correct the obvious and superficial pathological factors of lung distention

these were often combined with medicines for tonifying the lung and kidney as well as strengthening the spleen to benefit the root cause.

关键词

Keywords

references

中华医学会呼吸病学分会慢性阻塞性肺疾病学组．慢性阻塞性肺疾病诊治指南(2021年修订版) [J]. 中华结核和呼吸杂志， 2021 ， 44 ( 3 )： 170 － 205 .

王键，牛淑平，黄辉．新安医学的成就与贡献 [J]. 中华中医药杂志， 2013 ， 28 ( 1 )： 146 － 149 .

叶天士．临证指南医案 [M]. 苏礼，整理．北京：人民卫生出版社， 2006 ： 1 － 554 .

汪机．石山医案 [M]// 高尔鑫．汪石山医书大全．北京：中国中医药出版社， 2011 ： 57 － 115 .

孙一奎．孙文垣医案 [M]. 北京：中国医药科技出版社， 2012 ： 1 － 251 .

程文囿．程杏轩医案 [M]. 北京：中国医药科技出版社， 2018 ： 1 － 168 .

叶熙钧．东山别墅医案 [M]. 吴锦洪，审校 // 余瀛鳌，王乐匐，李济仁，等．新安医籍丛刊·医案医话类(三) . 合肥：安徽科技出版社， 1995 ： 1 － 65 .

程有功．冯塘医案 [M]. 汪文生，黄海海，整理．吴锦洪，审校 // 余瀛鳌，王乐匐，李济仁，等．新安医籍丛刊·医案医话类(三) . 合肥：安徽科技出版社， 1995 ： 1 － 56 .

吴楚．吴氏医验录 [M]. 李鸿涛，张明锐，贺长平，校注．北京：中国中医药出版社， 2011 ： 1 － 318 .

程从周．程茂先医案 [M]. 吴广铮，校点 // 余瀛鳌，王乐匐，李济仁，等．新安医籍丛刊·医案医话类(二) . 合肥：安徽科技出版社， 1993 ： 1 － 62 .

汪廷元．赤厓医案评注 [M]. 盛增秀，评注．北京：人民卫生出版社， 2014 ： 1 － 60 .

陈鸿猷．管见医案 [M]. 杨晓生，陈师农，点注 // 余瀛鳌，王乐匐，李济仁，等．新安医籍丛刊·医案医话类(三) . 合肥：安徽科技出版社， 1995 ： 1 － 27 .

余国珮．婺源余先生医案 [M]. 夏学传，汪沪双，点校 // 余瀛鳌，王乐匐，李济仁，等．新安医籍丛刊·医案医话类(三) . 合肥：安徽科技出版社， 1995 ： 1 － 49 .

洪桂．洪桂医案选 [M]. 洪必良，整理 // 余瀛鳌，王乐匐，李济仁，等．新安医籍丛刊·医案医话类(三) . 合肥：安徽科技出版社， 1995 ： 1 － 41 .

唐茂修．舟山医案 [M]. 吴守远，整理 // 余瀛鳌，王乐匐，李济仁，等．新安医籍丛刊·医案医话类(三) . 合肥：安徽科技出版社， 1995 ： 1 － 29 .

程敬通．程敬通医案 [M]. 程曦，江倬，雷吉亭，述评．北京：人民军医出版社， 2012 ： 1 － 64 .

王仲奇．王仲奇医案 [M]// 余瀛鳌，王乐匐，李济仁，等．新安医学丛刊·医案医话类(一) . 合肥：安徽科学技术出版社， 1992 ： 1 － 440 .

叶天士．徐批叶天士晚年方案真本 [M]. 徐灵胎，评批 // 余瀛鳌，王乐匐，李济仁，等．新安医籍丛刊·医案医话类(三) . 合肥：安徽科技出版社， 1995 ： 1 － 113 .

叶天士．未刻本叶氏医案 [M]. 吴守远，审校 // 余瀛鳌，王乐匐，李济仁，等．新安医籍丛刊·医案医话类(三) . 合肥：安徽科技出版社， 1995 ： 1 － 139 .

叶天士．评点叶案存真类编 [M]. 叶万青，辑．周学海，评．吴广铮，审校 // 余瀛鳌，王乐匐，李济仁，等．新安医籍丛刊·医案医话类(三) . 合肥：安徽科技出版社， 1995 ： 1 － 145 .

江瓘．名医类案 [M]. 苏礼，整理．北京：人民卫生出版社， 2005 ： 1 － 546 .

吴楚．宝命真诠 [J]. 郭晓冬，林大勇，张丽艳，等，校注．北京：中国中医药出版社， 2015 ： 1 － 371 .

王意庵．意庵医案 [M]. 张金鼎，曹鸿云，校注．南京：江苏科学技术出版社， 1986 ： 1 － 54 .

世界中医药学会联合会．国际中医临床实践指南　慢性阻塞性肺疾病 [J]. 世界中医药， 2020 ， 15 ( 7 )： 1084 － 1092 .

国家卫生健康委员会，国家中医药管理局 . 中医临床诊疗术语　第二部分：证候(修订版)：GB/T 16751.1—2021 [S/OL].( 2020－11－16 )[ 2021－03－25 ]. http：//yzs.satcm.gov.cn/zhengcewenjian/2020－11－23/18461.html .

TANG Y , LI M , WANG JX , et al . CytoNCA: A cytoscape plugin for centrality analysis and evaluation of protein interaction networks [J]. Biosystems , 2015 ， 127 ： 67 － 72 .

BLONDEL VD , GUILLAUME JL , LAMBIOTTE R , et al . Fast unfolding of communities in large networks [J/OL]. Journal of Statistical Mechanics: Theory and Experiment , 2008 ( 10 ): P10008 [ 2020－08－21 ]. https：//iopscience.iop.org/article/10.1088/1742－5468/2008/10/P10008 https：//iopscience.iop.org/article/10.1088/1742－5468/2008/10/P10008 .

贾东风，任长安． SPSS统计软件中的因子分析法在医学科研中的应用 [J]. 办公自动化杂志， 2009 ， 150 ( 2 )： 53 － 55 .

骆方，刘红云，黄崑． SPSS数据统计与分析 [M]. 北京：清华大学出版社， 2011 ： 147 － 152 .

李济仁．新安名医及学术源流考 [M]. 北京：中国医药科技出版社， 2014 ： 5 － 8 .

王玮，吴海斌，王琦，等．益气化痰祛瘀方治疗COPD稳定期临床疗效观察 [J]. 北京中医药大学学报， 2015 ， 38 ( 11 )： 777 － 780 .

王键．新安医学流派研究 [M]. 北京：人民卫生出版社， 2016 ： 468 .

高振，董竞成．由四诊合参到中医精准辨证论治 [J]. 中华中医药杂志， 2019 ， 34 ( 1 )： 13 － 17 .

黄辛迪，丁长松，梁昊，等．基于药性理论的中医辨证论治模型构建研究 [J]. 北京中医药大学学报， 2019 ， 42 ( 6 )： 455 － 459 .

杨勤军，吴迪，王心恒，等．基于关联规则的新安“王氏内科”代表医家论治咳嗽的药－症规律 [J]. 世界科学技术—中医药现代化， 2018 ， 20 ( 9 )： 1699 － 1704 .

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