王颖 杨凯 史利卿 董尚娟 马建岭 季坤 王丽云 温绍惠

〔摘要〕 目的 基于古今医案云平台挖掘史利卿教授治疗慢性咳嗽湿热郁肺（湿热咳嗽）的用药规律，以期为湿热咳嗽的治疗提供临床思路。方法 以2015年9月至2020年2月北京中医药大学东方医院呼吸热病科史利卿教授门诊湿热咳嗽案例为数据来源，建立数据库并规范术语;通过古今医案云平台WEB端对中药使用频数、屬性进行统计分析，对高频用药进行关联分析得出常用药物组合，进行聚类分析和复杂网络分析得出核心处方。结果 本研究共纳入病案307份，涉及129味中药，累计用药频数为4 871次，高频用药有黄芩、薏苡仁、蜜麻黄、蜜紫菀、黄连、清半夏、豆蔻等;药性以寒、温居多，药味以辛、苦居多，主要归肺、脾、胃经，药物功效以清热燥湿为主;常用药物组合有豆蔻-清半夏-薏苡仁-黄连-黄芩、蜜麻黄-厚朴-前胡、蜜紫菀-蜜款冬花-清半夏;核心处方为三仁汤合祛风宣肺方加减。结论 史利卿教授治疗湿热咳嗽以祛风宣肺、清热利湿为法，注重肺脾同调、寒温并用、宣降共施。

〔关键词〕 湿热咳嗽;湿热郁肺;数据挖掘;史利卿;用药规律;祛风宣肺;清热利湿

〔中图分类号〕R256.11       〔文献标志码〕A       〔文章编号〕doi：10.3969/j.issn.1674-070X.2021.05.015

Study on the Medication Rules of Professor Shi Liqing in Treating Chronic Cough with Damp-heat Limit Lung Syndrome Based on Ancient and Modern Medical Cases Cloud Platform

WANG Ying1， YANG Kai2， SHI Liqing3*， DONG Shangjuan3*， MA Jianling3， JI Kun3， WANG Liyun3， WEN Shaohui3

（1. Zhejiang Provincial Hospital of Chinese Medicine， Hangzhou， Zhejiang 310018， China; 2. Beijing University of Chinese Medicine， Beijing 100029， China; 3. Dongfang Hospital， Beijing University of Chinese Medicine， Beijing 100078， China）

〔Abstract〕 Objective To explore the medication rule of professor Shi Liqing in the treatment of chronic cough with dampness-heat limit lung syndrome based on the ancient and modern medical records cloud platform， so as to provide clinical ideas for the treatment of dampness-heat cough. Methods Based on the outpatient dampness-heat cough case of professor Shi Liqing from the department of respiratory febrile diseases， Dongfang Hospital， Beijing University of Traditional Chinese Medicine from September 2015 to February 2020， the database was established and the terminology was standardized. The frequency and attributes of traditional Chinese medicine were statistically analyzed through the ancient and modern medical records cloud platform Web， and the common drug combinations were obtained by correlation analysis， and the core prescription was obtained by cluster analysis and complex network analysis. Results A total of 307 medical records were included in this study， involving 129 kinds of traditional Chinese medicine， and the cumulative frequency of drug use was 4 871 times. The high-frequency drugs were Huangqin （Scutellariae Radix）， Yiyiren （Coicis Semen）， Mimahuang （Ephedrae Herba）， Miziwan （Asteris Radix Et Rhizoma）， Huanglian （Coptidis Rhizoma）， Qingbanxia （Pinelliae Rhizoma Praeparatum Cum Alumine）， Doukou （Amomi Fructus Rotundus）， etc. Most of which property belonged to warm and cold， most of which flavor belonged to pungent and bitter， most of which meridian belonged to lung， spleen and stomach meridians. The main efficacy of the medicine was clearing away heat and drying dampness. The commonly used drug combinations are Doukou （Amomi Fructus Rotundus）-Qingbanxia （Pinelliae Rhizoma Praeparatum Cum Alumine）-Yiyiren （Coicis Semen）-Huanglian （Coptidis Rhizoma）-Huangqin （Scutellariae Radix）， Mimahuang （Ephedrae Herba）-Houpo （Magnoliae Officinalis Cortex）-Qianhu （Peucedani Radix）， Miziwan （Asteris Radix Et Rhizoma）-Mikucindonghua （Farfarae Flos）-Qingbanxia （Pinelliae Rhizoma Praeparatum Cum Alumine）. The core prescription was modified Sanren Decoction with Qufeng Xuanfei Decoction. Conclusion Professor Shi Liqing's treatment of chronic cough with dampness-heat limit lung is based on the method of dispelling wind and dispersing lung， clearing heat and removing dampness， and paying attention to the coordination of lung and spleen. In terms of medication， cold medicine and warm medicine are used together， and lung dispersing medicine and lung lowering medicine are used together.

〔Keywords〕 chronic cough with syndrome of damp-heat; dampness-heat limit lung; data mining; Shi Liqing; medication rules; expelling wind and dispersing lung; clearing heat and promoting dampness

慢性咳嗽通常是指以咳嗽为主要或唯一临床表现，持续时间大于8周，X线胸片无明显异常的临床常见病症[1]。据统计，慢性咳嗽在全球普通人群中的患病率为9.6%，占国内呼吸专科门诊量10%～38%，但由于病因复杂，误诊、误治现象普遍，且单用西药治疗临床疗效常不令人满意，严重影响了患者的生活质量和心理健康，同时带来了经济负担[2]。……