基于数据挖掘分析绍派医家沈元良治疗失眠的用药规律

Analysis of the Medication Rules of Shaoxing School Physician SHEN Yuanliang in the Treatment of Insomnia Based on Data Mining

摘要:

目的：基于中医传承辅助平台（V3.5） 分析绍派医家沈元良治疗失眠的用药规律。方法：收集2022年1月1日至2025年11月30日沈元良教授于浙江中医药大学附属绍兴中医院门诊部诊治的失眠患者医案。将标准化处方数据录入中医传承计算平台（V3.5），进行用药频次、性味归经、功效统计及关联规则、聚类分析，挖掘其用药规律。结果：共纳入处方231张，涉及中药213味。高频药物有远志、茯神、酸枣仁、白术、党参、当归等；药性以温、平为主，其次为寒性；药味以甘、苦、辛为主；归经以脾、心为主，其次为肝、肺经。关联规则分析获得14个常用药对，药物组合关联规则11个，聚类分析提取出3类核心处方。结论：沈元良教授治疗失眠多从“心脾同治”入手，以养心安神为本，兼顾益气健脾、调气和血、疏肝解郁诸法，形成了补虚泻实、标本兼顾的辨治体系。

Abstract:

Abstract： Objective： To analyze the medication rules of Shaoxing school physician SHEN Yuanliang in the treatment of insomnia using the Traditional Chinese Medicine Inheritance Support System （TCMISS，V3.5）. Methods： Medical cases of insomnia patients diagnosed and treated by Professor SHEN Yuanliang at the Outpatient Department of Shaoxing TCM Hospital Affiliated to Zhejiang Chinese Medical University from January 1， 2022， to November 30， 2025， were collected. The standardized prescription data were entered into the TCMISS （V3.5） for statistics of medication frequency，properties，flavors，and meridian tropisms，efficacy analysis，association rule analysis，and cluster analysis， in order to explore the medication rules. Results： A total of 231 prescriptions were included， involving 213 distinct Chinese herbal medicines. The high-frequency herbal medicines included Polygalae Radix， Sclerotium Poriae Pararadicis， Ziziphi Spinosae Semen， Atractylodis Macrocephalae Rhizoma， Codonopsis Radix ， and Angelicae Sinensis Radix. The medicinal properties were primarily warm and neutral，followed by cold；the flavors were mainly sweet， bitter， and pungent； and the meridian tropisms were mainly the spleen and heart meridians， followed by the liver and lung meridians. Association rule analysis yielded 14 commonly used herbal pairs and 11 association rules for herbal combinations，and cluster analysis extracted 3 types of core prescriptions. Conclusion： Professor SHEN Yuanliang's treatment of insomnia has the primary actions of "simultaneous treatment of the heart and spleen， " taking nourishing the heart and calming the mind as the foundation， and also has the auxiliary effect on benefiting qi and strengthening the spleen，regulating qi and harmonizing blood，and soothing the liver and relieving depression， thus forming a syndrome differentiation and treatment system that combines replenishing deficiency and purgating excess，and treating both symptom and root cause simultaneously.