世界中医药

目的：运用数据挖掘技术，对《中华医典》医案部分的不寐医案进行挖掘分析，探究清代医家不寐诊治的遣方用药规律，为临床应用提供参考。方法：以《中华医典》医案部分为清代医家诊治不寐的数据来源，对其进行不寐诊治的医家著作、高频药物及其性味归经的频数统计；运用SPSS Modeler 18.0进行关联规则分析；运用SPSS 21.0对所筛选的高频药物进行聚类分析。结果：共收录122条医案，涉及医案著作32本，不寐诊治记载频数较高的清代医家为张聿青、邵兰荪、缪松心、叶天士、吴鞠通；122条医案中，涉及中药177味，中药使用总频次1 205次。经过筛选，得到50味不寐诊治的高频中药。对其进行统计分析可得，其药性多平、微寒；药味多甘、苦；归经以心经为主；通过关联规则分析可得，茯神、酸枣仁为常见两味药药对，茯神、酸枣仁、远志为常见三味药药组；通过聚类分析可得7个药物组合，如生脉散加减、阿胶鸡子黄汤合甘麦大枣汤加减、归脾汤加减、涤痰汤加减、天王补心丹加减、温胆汤合半夏秫米汤加减等。结论：清代医家诊治不寐注重虚实，虚证多选用补益气血，滋阴清热，养血安神之品，辨证多以心肾不交、心脾两虚多见；实证多见肝亢与痰热，故用药多配伍平肝潜阳、化痰理气之剂。

English Summary:

To analyze medication rule of physicians in the Qing Dynasty for insomnia based on data mining of Chinese Medical Records and thus to provide a reference for clinical practice.Methods:Medical records of some physicians in the Qing Dynasty on the treatment of insomnia in Chinese Medical Records were analyzed.To be specific，the related medical works，high-frequency medicinals，and the properties，flavor，and meridian tropism of the medicinals were clarified.SPSS Modeler18.0 was used for the association rules analysis and SPSS 21.0 for cluster analysis of selected high-frequency medicinals.Results:A total of 122 medical records were found，involving 32 books.Among them，the medical records of physicians Zhang Yuqing，Shao Lansun，Miao Songxin，Ye Tianshi，and Wu Jutong were the most.The 122 medical records involved 177 Chinese medicinals，with the total use frequency of 1 205.A total of 50 high-frequency medicinals were screened out.The statistical analysis showed that the majority were plain and slightly cold in property and sweet and bitter in taste with meridian tropism at the heart.The correlation analysis showed the combination of Poria cum Radix Pini and Semen Ziziphi Spinosae was the common medicinal pair in the medical records.As for the threesome，Poria cum Radix Pini，Semen Ziziphi Spinosae，and Radix Polygalae were used together frequently.Custer analysis yielded 7 medicinal combinations，such as modified Shengmai Powder，modified Ejiao Jizihuang Decotion and Ganmai Dazao Decoction，Guipi Decoction，modified Ditan Decoction，modified Tianwang Buxin Pills，and modified Wendan Decoction and Banxia Shumi Decoction.Conclusion:Physicians in Qing Dynasty focus on deficiency and excess in diagnosis and treatment of insomnia.For insomnia with deficiency，the medicinals with the functions of tonifying and replenishing qi and blood，nourishing yin and clearing heat，nourishing blood and tranquilizing the mind were used and the common symptoms were heart-kidney non-interaction and heart-spleen deficiency.As to insomnia with excess，medicinals with the effects of pacifying liver and subduing yang，and resolving phlegm and regulating qi were used and the liver hyperactivity and phlegm heat were more common in excessive insomnia.

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