陈宏道　丁一帆　谢师旅　冷文飞　蒋晓凤

【摘要】目的：分析《類证治裁》治疗风湿病用药规律，为临床提供参考。方法：查阅《类证治裁》收录治疗风湿病的方剂，采用Microsoft Excel 2019、SPSS 26和SPSS Modeler 18对中药的频次、频率、类别、四气五味、归经、聚类和关联规则进行分析。结果：共纳入方剂119首，涉及药物158味，用药总频次1002次，其中频率大于10%的高频药物有甘草、当归、茯苓、川芎、白术等;补虚药、解表药和活血化瘀药为常用中药类别;中药四气以温为主，五味以辛、苦、甘为主，归经以肝、脾、肺、肾经为主;将高频药物聚类分析可聚为5类;常用药对为甘草-白术、甘草-生姜、川芎-羌活等。结论：《类证治裁》中治疗风湿病以补虚药为主，配以解表药、活血化瘀药、祛风湿药等治疗风湿病，对临床有指导意义。

【关键词】类证治裁;风湿病;用药规律;数据挖掘

【中图分类号】R22 【文献标志码】 A【文章编号】1007-8517（2021）23-0008-05

Study on the Law of Drug Use in Treating Rheumatism Based on the Data Mining of Leizheng Zhicai

CHEN Hongdao¹DING Yifan¹XIE Shilü¹LENG Wenfei²JIANG Xiaofeng^2*

1.Hunan University of Chinese Medicine，Changsha 410208，China;

2.Traditional Chinese Medicine Hospital Dianjiang，Chongqing 408399，China

Abstract：Objective To analyze the medication rule of treating rheumatism in “Leizheng Zhicai” and provide reference for clinical practice. Methods Looking up the prescriptions for treating rheumatism listed in “Leizheng Zhicai”， the frequency， frequency， category， four qi and five flavors， meridian tropism， clustering and association rules of traditional Chinese medicine were analyzed by using Microsoft Excel 2019， SPSS 26 and SPSS Modeler 18. Results A total of 119 prescriptions were included， involving 158 drugs， with a total frequency of 1002 times， among which the high-frequency drugs with a frequency greater than 10% were Glycyrrhiza uralensis， Angelica sinensis， Poria cocos， Ligusticum Chuanxiong and Atractylodes macrocephala， etc. Deficiency-tonifying drugs， exterior-relieving drugs and blood-activating and blood-stasis-removing drugs are commonly used traditional Chinese medicine categories. The four qi of traditional Chinese medicine are mainly warm， the five flavors are mainly pungent， bitter and sweet， and the meridians are mainly liver， spleen， lung and kidney. High-frequency drugs can be clustered into five categories by cluster analysis. The common drug pairs are Glycyrrhiza uralensis Fisch-Atractylodes macrocephala Koidz， Glycyrrhiza uralensis Fisch-Ginger， Ligusticum Chuanxiong-Notopterygium Rhizoma， etc. Conclusion In “Leizheng Zhicai”， the main treatment for rheumatism is deficiency-tonifying drugs， combined with drugs for relieving exterior syndrome， promoting blood circulation and removing blood stasis， and rheumatism， which has guiding significance for clinical practice.

Key words：Leizheng Zhicai; Arthralgia Syndrome; Medication Rule; Data Mining

风湿病是人体正气不足或脏腑功能失调，风寒湿等外邪趁虚侵袭，造成经脉气血不通不荣，出现以肢体关节肌肉疼痛、麻木、重着、肿胀、屈伸不利，甚则关节变形，或累及脏腑为特征的一类疾病^[1]。风湿病的病名是在1986年卫生部主持的中医证候规范学术会议上确定的，它包括中医传统的痹证、痹病、风湿和因风寒湿等邪引起的肢体、关节病变。《类证治裁》是由清代林佩琴集百家之言所著，該书既体现理论和临床，又体现继承和创新，其对各种“痹”做了鉴别，并列举有效处方，条理清晰，切合实用，注重补助真元，调畅气血脉络。在《类证治裁》卷之五的痹证论治、痛风历节风论治、鹤膝风论治和卷之六的肩背手臂痛论治、腰脊腿足痛论治等篇章充分体现了林佩琴治疗风湿病的临床经验^[2]。……