探讨新安医家在消渴病治疗上的特色.认为消渴病的治疗应当用变通的方式,分期辨治,需以清热养阴生津为根本,加以补气健脾、滋补肾阴、温补肾阳等治法.新安医家对消渴病提出的病机认识和治法方药对后世影响深远,整理归纳这些治病思路与临证经验对于临床实践仍有重要的现实意义.

文章从四气五味、气味厚薄、主治功效、组方配伍4个方面对桔梗升降浮沉药性特征进行考证研究.气味方面,认为桔梗性平偏温、味辛苦,味辛具有升浮之性,兼苦味亦具有一定的沉降之性,性平偏温提示其在升降浮沉药性方面总体以升浮之性为主;气味厚薄方面认为桔梗性温气薄,具有升浮发泄之功;味辛、苦且厚亦具有发散通泄之性;功效配伍方面桔梗可宣发肺气、载药上行,有舟楫之功,作用于上焦胸胁、宽胸理气、定气安神.通过升宣肺气保持肺宣发肃降功能,通调水道致清气升而浊气降,通利三焦,有升降一身诸气之效.作用于中焦脾胃和下焦肠腑温中升阳,涩肠止泄,止肠鸣腹痛.通过综合考证认为桔梗不仅具有显著的升浮之性,其苦降沉泄之功同样不可忽略,其沉降之性寓于升清肺气的基础之上,升中有降,降寓于升.临床应用中若能谨守桔梗适应病证的病因病机并用之得法则既能上行又能下气,有升降诸气之功.

固本培元学说在两晋隋唐时期初见端倪,宋金元时期诸医家之学术主张为其奠定理论基础,经历代医家的临证探索,至明清时期渐趋成熟.新安固本培元流派是以汪机、孙一奎为主体的众多新安医家主张重视调补人体本元、培脾肾元气为治法的庞大医家群体,使固本培元学说得以完善并趋向成熟.总之,固本培元学说源远流长,历代医家各抒己见,有继承亦有创新,极大地丰富和发展了中医药理论体系.

吴楚是清代新安医学代表性医家和温补培元派医家,对于儿科疑难杂病的辨治具有独到经验.通过对其代表作《吴氏医验录》所载儿科疑难杂病验案进行探析,可知其治疗儿科杂病遵循"小儿易为虚实"之论,辨病时详察望诊,强调脏腑辨证,尤重脾肾.治疗上重视药性,善用甘温,临证组方用药灵活多变,巧用古方同时随证施治.治疗小儿慢惊风取法补虚治本,固护脾土;治疗小儿浮肿取法升清降浊,善用参芪;治疗小儿伤食取法消补兼施,治病求本.吴楚辨治儿科疑难杂病谨遵经旨,常救人于危急,总结归纳其儿科疑难杂病辨治经验,对当下中医儿科诊疗具有重要学术研究价值和实践指导意义.

Objective: Based on data mining, Wang Xun's medication rule in the treatment of dysentery was discussed. Methods: the traditional Chinese medicine used in the prescriptions for dysentery in Wang Xun's "Tzu hang Ji Sanyuan Puji Fang" was counted, the names of the drugs were standardized, and their properties, taste, efficacy and meridian tropism were investigated respectively. The database was established with the help of Microsoft Excel 2016, SPSS statistic 24.0 and SPSS modeler 18.0 computer software, and the frequency analysis and high-frequency drug association rules were carried out Analysis, cluster analysis. Results: 44 prescriptions of Wang Xun's dysentery were sorted out and 64 traditional Chinese medicines were used, of which 22 were high-frequency drugs (drugs with frequency ≥ 5％). The top ten drugs were Cheqianzi, Danggui, liquorice, Muxiang, white peony, Fructus aurantii, areca, Poria cocos, radish and rhubarb. The correlation analysis produced "Raphanus seed→Plantago asiatica, Bitter orange→liquorice, tangerine peel→Fructus aurantii, Fructus aurantii→Cheqianzi, areca There are 15 associations of 2 kinds of drugs, such as hammer, Cheqianzi, Fructus aurantii, Muxiang, and so on. Cluster analysis shows that there are 4 cluster formulas: Angelica, Cheqianzi, Raphani, Fructus aurantii, white peony, liquorice, areca, red peony, tangerine peel, rhubarb, Fructus aurantii, Magnolia officinalis and Coptis. Conclusion: the method of data mining is to study the rule of Wang's prescription in the treatment of dysentery, so as to summarize the characteristics of Wang's prescription in the treatment of dysentery, which has guiding significance for clinical treatment of dysentery.

目的:探讨基于数据挖掘的王勋治疗痢疾用药规律.方法:统计王勋《慈航集三元普济方》中治疗痢疾的处方中所使用的中药,将药物名称进行标准化处理,分别查处其药性、药味、功效及归经,借助Microsoft Excel 2016、SPSS Statistic 24.0、SPSS Modeler 18.0计算机软件建立数据库并进行用药频数分析、高频用药关联规则分析、聚类分析.结果:整理王勋治痢处方44首,使用中药64味,其中高频药物(使用频率≥5％的药物)22味,排名前十的药物为车前子、当归、甘草、木香、白芍、枳壳、槟榔、茯苓、莱菔子、大黄;关联分析共产生"莱菔子→车前子、枳实→甘草、陈皮→枳壳、枳壳→车前子、槟榔→车前子、枳实→木香"等15条2味药物关联,聚类分析得出当归、车前子、莱菔子、枳壳、白芍、甘草、槟榔、赤芍、陈皮;大黄、枳实、厚朴、黄连等4个聚类方.结论:数据挖掘的手段研究王氏治疗痢疾处方用药的规律,以此总结王氏治疗痢疾的用药特点,对临床治疗痢疾用药具有指导意义.