摘要
目的基于中医传承辅助系统(V2.5)软件,探析门氏杂医流派代表性传承人门九章教授治疗食管神经功能紊乱的处方用药规律。方法收集2017年11月—2022年11月期间就诊于山西中医药大学附属医院国医堂门九章教授门诊的食管神经功能紊乱患者220例,录入“中医传承辅助系统(V2.5)”,利用该软件的集成规则分析、改进的互信息法、复杂系统熵聚类、无监督的熵层次聚类、四气五味归经数据分析等方法,分析挖掘门九章教授治疗食管神经功能紊乱的用药规律。结果对筛选出的245个处方(包含联合方组)进行数据分析,发现食管神经功能紊乱患者的好发年龄区间有年轻化趋势,弦、细、弱、沉脉为食管神经功能紊乱之核心脉象,以淡、暗为基调之舌象比重较大,绝大多数患者均伴见消化系统症状,且多集中在胃脘不适、消化差、呃逆、胃痛、腹胀、反酸、大便不成形等胃肠道症状,并兼见口苦、眠差、疲乏等症状。门九章教授在治疗本病时,最常使用的药物为炙甘草、党参、姜半夏、炒白术、大枣、茯苓、干姜、黄芩,从中大致能看出理中汤、小儿异功散、六君子汤及半夏泻心汤的雏形,并发现参与联合方组较多的方剂为香砂六君子汤、半夏泻心汤、理中汤、门氏护胃散、小柴胡汤、四逆汤。结论门氏杂病流派治疗食管神经功能紊乱时以脾胃为本,活用经方,治验甚众,其临床经验值得在临床推广应用。
Objective To explore the prescription rule of Professor Menjiuzhang,the representative successor of Men′s miscellaneous disease academic school,in the treatment of esophageal nerve dysfunction based on Traditional Chinese medicine inheritance support system(TCMISS,V2.5).Methods A total of 220 patients with esophageal nerve dysfunction by Professor Men in the Affiliated Hospital of Shanxi University of Chinese Medicine from November 2017 to November 2022 were collected,and the data were inputted into the TCMISS(v2.5).With the integrated rule analysis,improved mutual information method,complex system entropy clustering,unsupervised entropy-based hierarchical clustering,data analysis of four properties,five flavors of herbs and meridian tropism,this paper analyzed and excavated the prescription rule of Professor Men in the treatment of esophageal nerve dysfunction.Results By the analysis of the selected 245 prescriptions(including the combined prescriptions),it was found that esophageal nerve dysfunction mostly occurred in young people,and the wiry,thready,weak and deep pulses were the core of esophageal nerve dysfunction.The proportion of tongue with light and dark manifestations was large,and the vast majority of patients were accompanied by digestive system symptoms,mainly epigastric discomfort,poor digestion,hiccup,stomachache,abdominal distension,acid regurgitation,defecation and other gastrointestinal symptoms,with bitter mouth,poor sleep,fatigue and other symptoms.While treating this disease by Professor Men,the most commonly used herbal medicines were processed Radix et Rhizoma Glycyrrhizae Praeparata Cum Melle,Radix Codonopsis,ginger-processed Pinellia Tuber,fried Rhizoma Atractylodis Macrocephalae,Fructus Jujubae,Poria,Rhizoma Zingiberis and Radix Scutellariae,from which Lizhong Decoction,Xiaoer Yigong Powder,Liujunzi Decoction and Banxia Xiexin Decoction were prepared.It was also found that the most common prescriptions for combination were Xiangsha Liujunzi Decoction,Banxia Xiexin Decoction,Lizhong Decoction,Menshi Huwei Powder,Xiaochaihu Decoction and Sini Decoction.Conclusion Men′s miscellaneous disease academic school treated esophageal nerve dysfunction based on the spleen and stomach,and used classical prescriptions in a flexible way,with rich experience,which was worthy of clinical application.
作者
梁继丹
弓鹏
芦亦旻
李孝波
LIANG Ji-dan;GONG Peng;LU Yi-min;LI Xiao-bo(Shanxi University of Chinese Medicine,Jinzhong Shanxi 030619)
出处
《世界中西医结合杂志》
2024年第3期472-480,494,共10页
World Journal of Integrated Traditional and Western Medicine
基金
门氏中医功能态诊疗体系建设研究(2023ZYYA030)
山西中医药大学中医临床基础学科基金。
关键词
门氏杂病流派
食管神经功能紊乱
癔球症
用药规律
门九章
Men's miscellaneous disease academic school
Esophageal nerve dysfunction
Globus hysteria
Prescription rule
Men Jiuzhang
