清代医家辨治咳嗽的用药规律*

作者：殷 浩1，臧凝子1,2，吕晓东1，庞立健2，李洪洋1，高萌蔓1

单位：1.辽宁中医药大学，辽宁 沈阳 110847； 2.辽宁中医药大学附属医院，辽宁 沈阳 110032

引用：引用：殷浩，臧凝子，吕晓东，庞立健，李洪洋，高萌蔓.清代医家辨治咳嗽的用药规律[J].中医药导报,2025,31(11):190-195.

DOI：10.13862/j.cn43-1446/r.2025.11.032

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摘要：目的：基于《中华医典》挖掘清代医家辨治咳嗽的用药规律，并进行总结分析，为临床治疗咳嗽提供新思路。方法：检索《中华医典》中清代医家治疗咳嗽的处方，运用Excel 2013软件建立清代医家治疗咳嗽数据库，进行药物频数统计分析，应用IBM Moldeler 18.0、RStudio软件对高频药物进行聚类分析及关联规则分析。结果：纳入方剂421首,涉及药物280味，药物出现总频数4 429次。在高频药物分析中，杏仁的频数最高，可视为治咳核心药物，其次为茯苓、冬瓜子、桑叶等。四气以寒、温性为主，五味以甘、苦、辛味为主，归经以肺、胃、脾、心经为主。共得到26条药物组合关联规则，聚类分析共得出5组核心药物、2首核心处方。结论：清代医家治疗咳嗽常从肺、脾、胃入手，关键组方为桑杏汤、败毒散，擅长以清肺润燥、疏风宣肺、化痰止咳、补阴益气、利水渗湿、解表清热等方法治咳。用药方面尤善用血肉之品滋肺肾之阴，虫类搜风通络，金石类、介类潜阳降逆。

关键词：咳嗽；用药规律；医案；清代；《中华医典》；数据挖掘

Abstract：

Objective: To explore and summarize the medication rules syndrome differentiation and treatment of cough by physicians of the Qing Dynasty based on China Medical Code through data mining, so as to provide new ideas for clinical treatment of cough. Methods: The prescriptions for treating cough by Qing Dynasty physicians were retrieved from China Medical Code. Excel 2013 was used to establish a database of these prescriptions, and frequency statistical analysis of drugs was performed. IBM SPSS Modeler 18.0 and RStudio software were employed for cluster analysis and association rule analysis of high-frequency drugs. Results: A total of 421 prescriptions were included, 280 drugs were involved, and the total frequency of drug occurrence was 4 429 times. Xingren (Armeniacae Semen) had the highest frequency and can be regarded as the core medicine for treating cough, followed by Fuling (Poria), Dongguazi (Benincasae Semen), Sangye (Mori Folium), etc. The four Qi are mainly cold and warm. The five flavors are mainly sweet, bitter and spicy. The meridians are mainly based on the lung, stomach, spleen, and heart meridians. A total of 26 drug combination association rules were obatined, and cluster analysis yielded 5 core drug groups and 2 core prescriptions. Conclusion: Physicians of the Qing Dynasty often treated cough starting from the lung, spleen, and stomach. The key prescriptions were Sangxing Decoction and Baidu Powder. They were skilled in treating cough through methods such as clearing lung-heat and moistening dryness, dispelling wind and promoting the lungs, resolving phlegm and relieving cough, nourishing Yin and replenishing Qi, promoting diuresis and excreting dampness, and relieving exterior syndrome and clearing heat. In terms of medication, they were particularly adept at using animal-derived drugs to nourish the Yin of the lung and kidney, insect drugs to dispel wind and unblock collaterals, and mineral and shell drugs to subdue Yang and descend counterflow.

Key words：cough; medication rules; medical cases; Qing Dynasty; China Medical Code; data mining

发布时间：2025-11-30

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