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《张简斋医案》中内伤杂病的治法特征与用药特点研究
引用本文:叶亮,尚尔鑫,侯俊,张工彧,林朴. 《张简斋医案》中内伤杂病的治法特征与用药特点研究[J]. 南京中医药大学学报, 2019, 35(6): 724-727
作者姓名:叶亮  尚尔鑫  侯俊  张工彧  林朴
作者单位:1.南京中医药大学科学技术处,江苏 南京 210023
摘    要:目的 探讨《张简斋医案》中内伤杂病的治法特征与用药特点。方法 先把《张简斋医案》中有关内伤杂病治法的描述进行归纳简化,然后采用关联规则结合二项式检验的方法对治法进行数据挖掘研究,并进行统计学检验。采用Apriori关联规则的数据挖掘研究方法挖掘《张简斋医案》中治疗内伤杂病的高频药物,然后提炼其用药特点。结果 通过对张氏医案中内伤杂病相关的治法进行归纳与组合,得到疏、和、清、托4种最常用的治法,并各有其所对应的特征性药物。发现使用频率较高的药物有甘草、白芍、半夏、茯神等,使用频率较高的药对和药组也基本上以此4味药的组合为主。结论 张氏治疗内伤杂病4种最常用的治法中,疏法包含有外解表、内利湿、中理气和胃的作用,体现了张氏疏通的用意;和法除调和之意外,重点强调了安神的作用;清法主要包含了清肺化痰与宁心的功效;托则强调了通过内补以达到外宣的作用。张氏用药整体比较平和,以脾胃、心肝诸脏腑的调理为主。4大法中有3法涉及到茯神这一味药,体现了张氏临证重调心神的用药特点。 

关 键 词:张简斋   用药特点   治法特征   数据挖掘

Study on Therapy Characteristics and Medication Feature in Zhang Jian-zhai's Case Records
YE Liang,SHANG Er-xin,HOU Jun,ZHANG Gong-yu,LIN Pu. Study on Therapy Characteristics and Medication Feature in Zhang Jian-zhai's Case Records[J]. Journal of Nanjing University of Traditional Chinese Medicine(Natural Science), 2019, 35(6): 724-727
Authors:YE Liang  SHANG Er-xin  HOU Jun  ZHANG Gong-yu  LIN Pu
Affiliation:1.Science and Technology Office, Nanjing University of Chinese Medicine, Nanjing, 210023, China2.Jiangsu Collaborative Innovation Center of Chinese Medicine Resources Industrialization, Nanjing University of Chinese Medicine, Nanjing, 210023, China3.Traditional Chinese Medicine Cultural Heritage Research Centre for Jinling Medical School, Nanjing, 210001, China4.Institute of Literature in Chinese Medicine, Nanjing University of Chinese Medicine, Nanjing, 210023, China
Abstract:OBJECTIVE To discuss Zhang Jian-zhai's therapy characteristics and medication feature in the treatment of miscellaneous disease due to internal injury based on Zhang Jian-zhai's Case Records. METHODS The clauses of therapy for internal diseases in Zhang Jian-zhai's Case Records was summarized. Then APRIORI association rules and binomial test were applied to conduct data mining, analysis on those therapeutic methods so as to disclose Zhang's medication feature. RESULTS On the summary of the therapy recorded in Zhang Jian-zhai's Case Records, it has been found that there were four most commonly applied therapeutic methods, that is, dredging, harmonizing, clearing and strengthening, which applied Chinese medicine with relevant properties. It also showed us the most commonly prescribed Chinese medicine, like gan cao (glycyrrhiza uralensis), bai shao (paeoniae alba), ban xia (pinelliae tuber) and fu shen (sclerotium poriae pararadicis). As for the highly used couplet medicinals and formulae, they were mainly prescribed based on the combination of these four herbs. CONCLUSION In terms of the four commonly applied therapeutic methods to treat miscellaneous disease due to internal injury, dredging method was to release the exterior pathogen, dispel the inner dampness, rectify qi and harmonize stomach so as to resolve the obstruction. Harmonizing method highlighted the role of calming mind in addition to reconciling yin and yang. Clearing method was to clear lung heat, dissolve phlegm and calm heart. Strengthening method was to diffuse the exterior by nourishing the interior. On the whole, Mr Zhang's medication feature tended to be mild, which aimed at regulating zang-fu organs. Furthermore, fu shen was applied in three of the four therapeutic methods, which implicated Zhang's clinical thinking of emphasizing the regulation of heart spirit. 
Keywords:Zhang Jian-zhai   medication feature   therapy characteristics   data mining
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