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基于潜在结构模型的古代痹证辨证及用药规律研究

[Study on syndrome differentiation of ancient arthralgia syndrome and drug use rules based on latent structure model].

作者信息

Qin L I, Huan L I, Song-Wei L I

机构信息

the First Affiliated Hospital of Henan University of Chinese Medicine Zhengzhou 450000, China.

出版信息

Zhongguo Zhong Yao Za Zhi. 2020 Oct;45(19):4784-4791. doi: 10.19540/j.cnki.cjcmm.20200726.501.

Abstract

In this study, the ancient doctors' concentrated prescriptions for arthralgia syndrome were collected and Lantern 3.2 software was used to construct and analyze the latent structure model of ancient arthralgia syndrome. A total of 10 syndrome types of ancient arthralgia syndrome were obtained, namely, cold-coagulation meridian syndrome(partial Yang deficiency), cold-dampness obstruction syndrome(cold weight), damp-heat obstruction syndrome, liver and kidney deficiency syndrome, essence deficiency syndrome, phlegm and blood stasis syndrome, spleen and stomach Qi deficiency syndrome, dampness evil accumulation syndrome, arthralgia meridian syndrome, cold-dampness binding lung syndrome, meridian obstruction syndrome, and wind-cold-dampness arthralgia syndrome(both wind-cold and dampness). This syndrome differentiation method further strengthened the thought on eight-class syndrome differentiation, and showed the characteristics of different syndrome differentiation types of the core drugs in the latent structure model, which was mainly reflected in paying attention to removing blood stasis and eliminating phlegm with use of pungent taste products having dispersing effect, emphasizing the effect of nourishing Yin and generating marrow to supplement congenital deficiency, invigorating spleen and replenishing Qi to regulate the spleen and stomach functions, nourishing vital energy and expelling evil. In addition, Python 3.7 software was used to mine the frequent item sets and association rules for the frequently used drugs for ancient arthralgia syndrome. The drug compatibility law is characterized by making good use of blood-nourishing drugs. Blood-activating drugs are often compatible with cold-dispelling drugs, liver and kidney tonifying drugs, and wind-dampness-dispelling drugs, following the compatibility principle of dispelling wind and dispelling cold as well as tonifying liver and kidney. The induction of syndrome differentiation types of ancient arthralgia syndrome and the discussion on the characteristics of drug use and compatibility law provide a new way for clinical syndrome differentiation and treatment, with certain reference value for the research and development of new Chinese patent medicines.

摘要

本研究收集古代医家治疗痹证的经方,运用Lantern 3.2软件构建并分析古代痹证潜在结构模型。共得出古代痹证的10种证型,即寒凝血瘀证(偏阳虚)、寒湿阻络证(寒重)、湿热阻络证、肝肾亏虚证、肾精亏虚证、痰瘀阻络证、脾胃气虚证、湿邪蕴积证、经络痹阻证、寒湿束肺证、风寒湿痹证(风寒湿并重)。这种辨证方法进一步强化了八纲辨证思想,展现了潜在结构模型中不同辨证类型核心药物的特点,主要体现在注重运用具有发散作用的辛味药活血化瘀、祛痰散结,强调滋阴生髓以补先天不足,健脾益气以调节脾胃功能,扶正祛邪。此外,运用Python 3.7软件挖掘古代痹证常用药物的频繁项集和关联规则。药物配伍规律的特点是善用养血药物。活血药物常与散寒药物、补益肝肾药物、祛风除湿药物配伍,并遵循祛风散寒、补益肝肾的配伍原则。古代痹证辨证类型的归纳以及用药特点和配伍规律的探讨为临床辨证论治提供了新途径,对中成药新药研发具有一定的参考价值。

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