杨必安 陈嘉琪 韩雨欣 曹丽娟

摘要 目的：基于明清医家文献，明确不孕不育症中医常用中药及其四气、五味和归经，为临床实践提供经验。方法：用关键词对中国基本古籍库进行检索，根据纳入和排除标准筛选合格文献。建立明清种子方数据库并对原始文献进行规范化处理，整理和分析明清种子方治疗类别、剂型、药物组成、四气、五味和归经，应用软件进行统计分析，得到明清治疗不孕不育症的用药规律。结果：本研究共纳入明清种子方剂235首，明清治疗不孕不育症文献中，1）常见剂型为丸剂;2）治疗类别主要为不孕;3）出现频率最高的方剂为五子衍宗丸;4）使用的药物主要是补虚药，其次为清热药和活血化瘀药;5）使用药物的四气主要为温，五味主要为甘，归经主要为肾、脾、肝;6）常用药对为白芍、当归;药物组合为白芍、当归、川芎、熟地黄。结论：明清医家治疗不孕不育以丸药为主，治方思路针对肾、脾、肝以甘温补虚为主流，同时也兼以清热药和活血化瘀药。此研究为现代临床治疗不孕不育提供了参考。

关键词 不孕不育;文献;用药规律;明清;五子衍宗丸;关联规则;数据挖掘

Abstract Objective：Based on the literature of doctors in Ming and Qing Dynasties，it is clear that the commonly used Chinese medicinals for infertility and its four qi，five flavors and return channels are used to provide experience for clinical practice.Methods：We used keywords to search the basic ancient books database in China，and screened qualified documents according to the inclusion and exclusion criteria.We established the Ming and Qing seed prescription database and standardized the original documents，sorted out and analyzed the Ming and Qing seed prescription treatment categories，dosage forms，drug composition，four qi，five flavors and return channels，applied software to perform statistical analysis，and obtained rule of medication for infertility in Ming and Qing dynasty.Results：This study included 235 seed prescriptions in Ming and Qing dynasties. 1）Common dosage form is pill. 2）The main treatment category was infertility. 3） The prescription with the highest frequency is Wuzi Yanzong pill. 4） The main drugs used were tonifying deficiency drugs，followed by heat-clearing drugs and Blood-activating and stasis-removing drugs. 5） The four qi of the medicines are mainly warm，the five flavors are mainly sweet，and the meridian tropism is mainly kidney，spleen and liver. 6）The commonly used medicine pairs are：Radix Paeoniae Alba，Radix Angelicae Sinensis; Rhizoma Ligustici Chuanxiong，and Radix Rehmanniae Preparata.Conclusion：In the Ming and Qing dynasties，the treatment of infertility is based on pills，and the main ideas of the prescriptions are for the kidney，spleen and liver，with the mainstay of sweetness，warming and invigorating deficiency，as well as heat-clearing medicine and blood-activating medicine.This research provides a reference for modern clinical treatment of infertility.

Keywords Infertility; Literature; Law of medication; Ming and Qing dynasties; Wuzi Yanzong Pills; Association rules; Data mining

中圖分类号：R229;R271.14;R256.56文献标识码：Adoi：10.3969/j.issn.1673-7202.2021.22.025

女性无避孕性生活至少12个月而未怀孕，称为不孕症，在男性称为不育症。不孕症分原发性不孕和继发性不孕两大类，既往从未有过妊娠史，无避孕而从未妊娠者为原发不孕;既有过妊娠史，而后无避孕连续12个月未孕者，称为继发不孕[1]。不孕不育症在世界范围内有8 000万至1.1亿患者，影响到8%～12%的育龄夫妇[2]。……