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基于601诊次医案的朱仁康治疗变态反应性皮肤病用药规律研究

Zhu Renkang's experience on treatmenting allergic skin diseases based on 601 cases

摘要目的:分析名医朱仁康治疗变态反应性皮肤病的临床用药规律。方法:收集古今医案云平台(V 1.4)中朱仁康治疗变态反应性皮肤病的有效验案,检索中国期刊全文数据库(CNKI)、中文科技期刊数据库(重庆维普)、中国学术期刊数据库(万方数据)建库至2019年11月20日相关期刊文献,以及蔡瑞康教授于1976-1977年跟诊时整理的朱仁康亲诊验案资料,提取各验案中药处方数据,利用古今医案云平台(V 1.4)对所获处方的数据进行规范化处理,构建结构化医案数据库,再以平台的分析挖掘模块及SPSS 22.0软件,对纳入医案中的中药、中药属性、中药功效数据进行频次统计,对用药进行聚类分析。结果:共纳入有效验案463个,共计601诊次。分析发现朱老治疗变态反应性皮肤病的高频药物为生地黄(217次)、甘草(198次)、赤芍(198次)、荆芥(148次)、牡丹皮(137次)等;药性以寒性(852次)、温性(679次)为主;药味以苦味(1 336次)、甘味(1 304次)、辛味(1 134次)为主;常用具清热解毒(389次)、利水渗湿(225次)、散瘀止痛(219次)、清热凉血(218次)功效的中药。结论:朱老治疗变态反应性皮肤病多从卫气营血论治,治疗以清热解毒为主,辅以利水渗湿、散瘀止痛、清热凉血,遣方用药善用经方加减,祛邪与扶正并用,用药灵活。

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abstractsObjective:To analyze the clinical medication rule of Zhu Renkang in the treatment of allergic dermatosis. Methods:The effective cases of Zhu Renkang in the treatment of allergic dermatosis were collected from "ancient and modern medical records cloud platform (V 1.4)". The CNKI, Chongqing VIP and Wanfang Data, the relevant journal literatures were searched from November 20, 2019, and the data of Zhu Renkang's records compiled by Professor Cai Ruikang during his follow-up visit from 1976 to 1977. The data of traditional Chinese medicine prescriptions, standardized by the "Ancient and modern medical records cloud platform (V1.4)" , were extracted to construct a medical record database. And then we used platform and SPSS 22.0 software to carry out frequency statistics of traditional Chinese medicine, traditional Chinese medicine properties and Chinese Medicine effects, and carry out cluster analysis on medication. Results:A total of 463 cases of allergic dermatosis treated by Zhu Renkang were included in this study with 601 individual visit. It was found that the high frequency symptoms of allergic dermatosis were pruritus (494 times), papules (321 times), red skin lesions (236 times) and macula (210 times). The common medicines used for allergic dermatosis included Rehmannia radix (217 times), Glycyrrhizae radix et rhizoma (198 times), Paeoniae radix rubra (198 times), Schizonepetae herba (148 times), Moutan cortex (137 times). The main attributes of common medicines were cold (852 times), warm (679 times), bitter (1 336 times), sweet (1 304 times) and spicy (1 134 times). The effects of commonly used Chinese medicines are clearing away heat and detoxification (389 times), clearing dampness (225 times), dispersing blood stasis and relieving pain (219 times) and clearing away heat and cooling blood (218 times). Conclusion:The treatment of allergic dermatosis by Zhu Renkang is mostly based on Wei Qi Ying Xue, mainly on clearing away heat and detoxification, supplemented by clearing dampness, dispersing blood stasis and relieving pain, clearing away heat and cooling blood. The dispatching prescription is mainly and modified based on classic formular with effects of dispel pathogens and strengthen the body.

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