Abstract:

Objective　To explore the potential rules of Cortex Lycii in 6 783 prescriptions of Yin deficiency syndrome, so as to provide the theoretical basis and reference for clinical application and pharmacological research of Cortex Lycii. Methods　The cases involved in this study were provided by Fujian Provincial People's Hospital. A total of 6 783 prescriptions of Yin deficiency syndrome containing Cortex Lycii from 2018 to 2020 were collected. and input into the traditional Chinese Medicine (TCM) inheritance calculation platform to establish the database. The frequencies of symptom types, main TCM diseases, and main diseases were counted. The overall drugs, the core medicinal materials and their combination rules in the treatment of Yin deficiency syndrome were statistically analyzed under different support degrees when the confidence was 0.9. Finally, the core medicinal materials and their combination rules of Cortex Lycii in high-frequency applied syndrome types were further statistically analyzed by the Apriori association rule algorithm. Results　The Yin deficiency syndrome mainly treated was highly concentrated in the liver and kidney. There were 5 kinds of diseases with frequency ≥200, among which the top three with the highest frequencies were Xiaoke disease, white astringent disease, and gall disease. There were 741 kinds of diseases, the top three with the highest frequencies were type 2 diabetes mellitus, xerophthalmia, and conjunctivitis. Baishao, Radix Rehmanniae, and Huangqi were the top three with the highest compatibility frequency in the prescription of Yin deficiency syndrome. Its core combinations were Cortex Lycii - Baishao, Cortex Lycii – Radix Rehmanniae, and Cortex Lycii - Huangqi. The core compatible herbs in the Qi and Yin deficiency syndrome mainly included Huangqi, Zhimu, Baishao, Poria Cocos, and Chuanxiong. The core combinations were Cortex Lycii - Huangqi - Zhimu, Cortex Lycii - Poria Cocos, Cortex Lycii - Zhimu, Huangqi - Zhimu, Cortex Lycii - Baishao, Cortex Lycii - Huangqi, Cortex Lycii - Chuanxiong. Among which, Cortex Lycii – Chuanxiong and Huangqi - Zhimu had special synergistic significance in the Qi and Yin deficiency syndrome. In the liver Yin deficiency syndrome, the core compatible herbs were Baishao, Radix Scrophulariae, and Radix Rehmanniae (with a support degree up to 60%). Its core combinations were Cortex Lycii – Baishao - Radix Scrophulariae, Cortex Lycii - Baishao - Radix Rehmanniae, Baishao - Radix Scrophulariae, Cortex Lycii – Baishao, Cortex Lycii - Radix Rehmanniae, Cortex Lycii - Radix Scrophulariae, and Baishao - Radix Rehmanniae. In the kidney Yin deficiency syndrome, there were four core compatible herbs, namely Baishao, Maidong, Radix Rehmanniae, and Radix scrophulariae (with a support degree up to 40%). The core combinations were Cortex Lycii – Baishao, Cortex Lycii - Radix Rehmanniae, Cortex Lycii – Maidong, and Cortex Lycii - Radix Scrophulariae. Among which, Radix Rehmanniae - Maidong and Radix Rehmanniae - Radix Scrophulariae were often used in pairs and compatible with Cortex Lycii (with a support degree up to 40%). Conclusion　Based on a large number of clinical prescriptions, this analysis of actual use of Cortex Lycii in the Yin deficiency syndrome shows the prescription law of Cortex Lycii in the treatment of Yin deficiency syndrome and the core combination law of Yin deficiency syndrome of different viscera for the first time, which can provide ideas and basis for modern clinical application and modern pharmacological research of Cortex Lycii.

Key words:

Cortex Lycii, TCM heritage computing platform, Data mining, Clinical analysis, Prescription rules

摘要：

目的　分析6 783例阴虚证处方中地骨皮的用药规律，为地骨皮的临床应用与药理学研究提供理论基础与参考。方法　本研究病例由福建中医药大学附属人民医院提供。收集2018年至2020年处方中使用地骨皮的所有病例，剔除与阴虚证完全无关的病例，最终纳入6 783例。通过中医传承计算平台，构建地骨皮相关数据库，统计主治证候、主治中医疾病、主治西医疾病频次，分析总体药物使用情况，分析置信度为0.9时，不同支持度下地骨皮治疗阴虚证配伍的核心药材及其组合规律。随后采用基于Apriori关联规则算法进一步挖掘地骨皮高频次应用的证候类型中配伍的核心药材及其组合规律。结果　在6 783例阴虚证处方中，地骨皮主治的阴虚证高度集中在肝、肾等脏腑的阴虚证；主治中医疾病类型共121种，使用频次≥200的有5种疾病，其中频次最高的3种疾病分别为消渴病、白涩病、瘿病；主治西医疾病741种，2型糖尿病、干眼症、结膜炎位列处方频次前3。地骨皮在阴虚证处方中配伍频次最高的前3味药为白芍、生地黄、黄芪，其核心组合为地骨皮-白芍、地骨皮-生地黄、地骨皮-黄芪。气阴两虚证中，核心配伍药物主要有黄芪、知母、白芍、茯苓、川芎，其配伍组合为地骨皮-黄芪-知母、地骨皮-茯苓、地骨皮-知母、黄芪-知母、地骨皮-白芍、地骨皮-黄芪、地骨皮-川芎，且地骨皮-川芎与黄芪-知母组合在气阴两虚证中具有特殊协同意义。肝阴虚证中，核心配伍药材有3味药，即白芍、玄参、生地黄（支持度高达60%），其配伍组合为地骨皮-白芍-玄参、地骨皮-白芍-生地黄、白芍-玄参、地骨皮-白芍、地骨皮-生地黄、地骨皮-玄参、白芍-生地黄。肾阴虚证中，核心配伍药材有4味药，即白芍、麦冬、生地黄、玄参（支持度高达40%），其核心组合为地骨皮-白芍、地骨皮-生地黄、地骨皮-麦冬、地骨皮-玄参，其中生地黄-麦冬、生地黄-玄参常成对使用与地骨皮配伍（支持度为40%）。结论　本次基于大样本临床处方分析地骨皮在阴虚证中的实际使用情况，首次呈现了地骨皮治疗阴虚证的组方规律及不同脏腑阴虚证的核心组合规律，可为地骨皮的现代临床应用和现代药理学研究提供思路和依据。

关键词:

地骨皮, 中医传承计算平台, 数据挖掘, 临床分析, 组方规律