摘要
目的:研究挖掘蔡小荪教授关于子宫腺肌症的治疗思想及用药经验。方法:从符合子宫腺肌症诊断标准的病例中,使用中医传承辅助平台对蔡小荪教授临证医案中的标准处方的组成药物进行数据挖掘分析。结果:对蔡小荪教授148个中药处方进行分析,子宫肌腺症患者的辨证多为宿瘀内结证;中药处方涉及中药122味,四气五味以温性、甘味较多。归经以肝经药物最多,心经与脾经药物分布相近。用药频次最多的是茯苓,其次是生地黄、淫羊藿、赤芍、桂枝、牡丹皮,其中茯苓、淫羊藿的用量多为12g;生地黄、赤芍的用量多为10g;桂枝用量多为3g。药物组合规律分析及网络展示结果显示,蔡小荪教授治疗子宫腺肌症最常用的药物组合是桂枝、茯苓、牡丹皮、赤芍、生地黄、淫羊藿。通过聚类算法,得到5组药物核心组合,进一步得到4首新处方。结论:蔡小荪教授治疗子宫腺肌症认为"血瘀"是其病理本质,多辨证为宿瘀内结证。在治疗上注重顾护脾胃,善用通法,用药具有阴阳兼顾、攻补兼施、统筹全局的思维。
Objective:Researching into Professor CAI Xiaosun’s ideology and medicating experiences to cure adenomyosis.Methods:Using Traditional Chinese Medicine(TCM)inheritance platform system to analyze the data of drug contents of standard prescriptions of Professor CAI’s authorized medical cases,which fitted the standard diagnosis of adenomyosis.Results:Byanalyzing Professor CAI’s 148 TCM prescriptions,the most common syndrome differentiation was abiding stasis binding internally syndrome.The TCM prescription included 122 Chinese herbs,most of whose four Qi and five flavors were mostly warm and sweet.Liver meridian herbs were the most,while less were heart and spleen meridians herbs with similar frequencies.The most frequently used herb was Poria,then Radix Rehmanniae,Herba Epimedii,Redpeony root,Cassia twig,Cortex moutan,trending down by frequencies.For drug dosage in one single prescription,Poria,Herba Epimedii dosages were mostly 12 grams,Radix Rehmanniae,Red peony root dosages were mostly 10 grams,Cassia twig dosages were mostly 3 grams.By analyzing herbal drugs’combination rules and exhibiting in web,Professor CAI’s prescriptions to cure adenomyosis often include drug combination of Cassia twig,Poria,Cortex moutan,Red peony root,Radix Rehmanniae,Herba Epimedii.5 herbal drug combinations were derived using clustering method,then 4 novel prescriptions were obtained.Conclusion:Pofessor CAI Xiaosun deems"blood stasis"as pathological nature of adenomyosis in the process of curing this disease,with the most common syndrome differentiation of abiding stasis binding internally syndrome.Spleen and stomach caring are mostly used in curing,with good application of dredging method,and with the ideology of Ying-Yang equity,reinforcement and elimination combination and overall planning.
作者
陈琼
金毓莉
杭远远
CHEN Qiong;JIN Yuli;HANG Yuanyuan(Department of Traditional Chinese Medicine,the First People’s Hospital of Shanghai City,Shanghai 200080,China)
出处
《四川中医》
2020年第11期12-16,共5页
Journal of Sichuan of Traditional Chinese Medicine
基金
上海市卫生健康委员会资助项目-肾化瘀周期法治疗腹腔镜术后轻中度子宫内膜异位症合并不孕的临床研究(编号:2018LQ013)
“海派中医”蔡氏妇科流派专科(编号:ZY(2018-2020)-CCCX-1015)
上海市松江区科学技术攻关项目-蔡氏养血化瘀方联合中药离子导入治疗原发性痛经的临床研究(编号:18sjkjgg29)。
关键词
子宫腺肌症
蔡小荪
中医传承辅助平台
用药规律
Adenomyosis
Caixiaosun
Traditional Chinese medicine inheritance platform
Medication and prescription rules
