導語：新安王氏內科(ke)中風病(bing)案(an)證(zheng)候(hou)分析(xi)一文來(lai)源于網友上傳(chuan)，不代表本站(zhan)觀點，若需要(yao)原創文章可(ke)咨詢客服老師，歡(huan)迎(ying)參考。

摘要：目的基于數據挖掘探討新安王氏內科中風病的證治規律。方法依照“十二五”《中醫內科學》第３版中風病標準收集整理新安王氏醫學流派中有關中風的病案，總計錄入２５２例，建立王氏中風病醫案數據庫，并對其中的證候和藥物進行頻數分析、關聯(lian)規則挖掘(jue)，得到藥(yao)(yao)(yao)(yao)物(wu)頻次(ci)(ci)、證(zheng)(zheng)(zheng)(zheng)候頻次(ci)(ci)及兩者之(zhi)間的(de)關聯(lian)結果，以(yi)及各(ge)類證(zheng)(zheng)(zheng)(zheng)型(xing)與(yu)藥(yao)(yao)(yao)(yao)物(wu)的(de)關聯(lian)結果。結果所(suo)用藥(yao)(yao)(yao)(yao)物(wu)頻次(ci)(ci)前(qian)５味為(wei)(wei)豨薟草、當歸、遠志、黃芪、牡蠣(li)，證(zheng)(zheng)(zheng)(zheng)候頻次(ci)(ci)前(qian)５位為(wei)(wei)脈濡弦、舌強言蹇、麻木、頭暈、口舌歪斜，證(zheng)(zheng)(zheng)(zheng)型(xing)頻次(ci)(ci)前(qian)３位的(de)中風(feng)證(zheng)(zheng)(zheng)(zheng)型(xing)為(wei)(wei)風(feng)陽上擾證(zheng)(zheng)(zheng)(zheng)、肝(gan)腎(shen)(shen)虧虛(xu)證(zheng)(zheng)(zheng)(zheng)、氣虛(xu)血瘀證(zheng)(zheng)(zheng)(zheng)。結論(lun)新(xin)安王(wang)氏內科對于中風(feng)的(de)典型(xing)證(zheng)(zheng)(zheng)(zheng)候有與(yu)之(zhi)相應的(de)單味藥(yao)(yao)(yao)(yao)和藥(yao)(yao)(yao)(yao)對，并且中風(feng)各(ge)證(zheng)(zheng)(zheng)(zheng)型(xing)均有關聯(lian)藥(yao)(yao)(yao)(yao)物(wu)。證(zheng)(zheng)(zheng)(zheng)候與(yu)藥(yao)(yao)(yao)(yao)物(wu)之(zhi)間的(de)各(ge)種關聯(lian)體現(xian)了新(xin)安王(wang)氏流派以(yi)肝(gan)腎(shen)(shen)為(wei)(wei)本，培補(bu)肝(gan)腎(shen)(shen)、益氣活(huo)血通絡為(wei)(wei)核心的(de)獨(du)特用藥(yao)(yao)(yao)(yao)特色(se)。

關鍵詞：新安(an)王(wang)氏內科；中風(feng)病(bing)；證治規律；益氣活血通絡(luo)；Ａｐｒｉｏｒｉ算法

中(zhong)(zhong)風(feng)(feng)(feng)(feng)又名“卒中(zhong)(zhong)”，現(xian)代(dai)醫學歸之(zhi)于(yu)“腦卒中(zhong)(zhong)”的(de)(de)(de)范疇，由于(yu)其患病年(nian)輕化、病因病機(ji)復雜性(xing)，得到(dao)廣(guang)大臨床研(yan)究(jiu)人員的(de)(de)(de)關(guan)注。中(zhong)(zhong)風(feng)(feng)(feng)(feng)病有(you)廣(guang)義(yi)和(he)狹義(yi)之(zhi)分，本研(yan)究(jiu)則主(zhu)要探討狹義(yi)中(zhong)(zhong)風(feng)(feng)(feng)(feng)的(de)(de)(de)證(zheng)治(zhi)(zhi)規(gui)律(lv)，即《金匱要略(lve)》提(ti)到(dao)的(de)(de)(de)“夫風(feng)(feng)(feng)(feng)之(zhi)為病，當半身不(bu)(bu)遂，或但臂不(bu)(bu)遂者，此為痹。脈微而數，中(zhong)(zhong)風(feng)(feng)(feng)(feng)使(shi)然”，類似(si)于(yu)“肌(ji)膚不(bu)(bu)仁”“口吐(tu)涎(xian)”“僻不(bu)(bu)遂”“不(bu)(bu)識人”“舌即難(nan)言”等(deng)典型癥(zheng)候群已被整合(he)為中(zhong)(zhong)風(feng)(feng)(feng)(feng)病相關(guan)癥(zheng)候［１］。新安王(wang)(wang)氏(shi)(shi)內科在徽州(zhou)地區流傳久遠，在治(zhi)(zhi)療(liao)中(zhong)(zhong)風(feng)(feng)(feng)(feng)病上(shang)，獨(du)樹一幟，以培補肝腎(shen)為主(zhu)，兼以活血化瘀，息風(feng)(feng)(feng)(feng)通絡，豁(huo)痰開竅。本研(yan)究(jiu)搜集整理王(wang)(wang)氏(shi)(shi)名家(jia)第(di)四代(dai)王(wang)(wang)仲(zhong)奇，第(di)五代(dai)王(wang)(wang)任之(zhi)、王(wang)(wang)樂匋等(deng)中(zhong)(zhong)醫醫案處方(fang)共計(ji)２５２例(li)，運用數據挖掘手段，對(dui)證(zheng)候和(he)藥物組成進行關(guan)聯規(gui)則分析(xi)，探求(qiu)其治(zhi)(zhi)療(liao)中(zhong)(zhong)風(feng)(feng)(feng)(feng)病的(de)(de)(de)證(zheng)治(zhi)(zhi)規(gui)律(lv)。

１資料與方法

１.１資料來源

搜集安徽(hui)中(zhong)醫(yi)(yi)(yi)(yi)藥(yao)大學圖書館庫(ku)藏(zang)《新安醫(yi)(yi)(yi)(yi)籍叢刊·醫(yi)(yi)(yi)(yi)案醫(yi)(yi)(yi)(yi)話類(lei)·第一冊·王仲奇醫(yi)(yi)(yi)(yi)案》《王任之醫(yi)(yi)(yi)(yi)案》《中(zhong)國現(xian)代(dai)百名(ming)中(zhong)醫(yi)(yi)(yi)(yi)臨(lin)床家叢書·王樂匋(tao)》，新安王氏醫(yi)(yi)(yi)(yi)學流派傳承工(gong)作室所存王氏醫(yi)(yi)(yi)(yi)家臨(lin)證(zheng)(zheng)(zheng)處(chu)方，將病(bing)名(ming)明確標為中(zhong)風(feng)病(bing)者總計２５２例病(bing)案整(zheng)理(li)歸檔，刪除(chu)不(bu)同醫(yi)(yi)(yi)(yi)案中(zhong)的相同處(chu)方。依照(zhao)處(chu)方中(zhong)證(zheng)(zheng)(zheng)候及(ji)藥(yao)物特點按照(zhao)肝(gan)腎虧虛(xu)證(zheng)(zheng)(zheng)、風(feng)陽上擾證(zheng)(zheng)(zheng)、氣虛(xu)血瘀(yu)證(zheng)(zheng)(zheng)、風(feng)痰(tan)入(ru)絡(luo)證(zheng)(zheng)(zheng)、陰(yin)虛(xu)風(feng)動證(zheng)(zheng)(zheng)５種(zhong)證(zheng)(zheng)(zheng)型整(zheng)理(li)成證(zheng)(zheng)(zheng)候和藥(yao)物數據庫(ku)，其中(zhong)痰(tan)熱瘀(yu)閉證(zheng)(zheng)(zheng)與痰(tan)蒙(meng)神竅證(zheng)(zheng)(zheng)由(you)于例數較(jiao)少則不(bu)做(zuo)討論。

１.２納入標準

①所(suo)選醫(yi)(yi)案確定(ding)為(wei)(wei)新安王(wang)氏內(nei)科(ke)處方；②所(suo)選醫(yi)(yi)案通過臨床(chuang)明確確診為(wei)(wei)中(zhong)風病；③所(suo)選醫(yi)(yi)案中(zhong)明確提出處方有效者(zhe)(zhe)；④藥(yao)物劑型統一為(wei)(wei)湯劑。滿足以上條(tiao)件者(zhe)(zhe)，依據全國中(zhong)醫(yi)(yi)藥(yao)行(xing)業高等教育“十(shi)二五”規(gui)劃教材《中(zhong)醫(yi)(yi)內(nei)科(ke)學》第３版中(zhong)風病證(zheng)型分類標準及醫(yi)(yi)案包含的基本證(zheng)型信息，對方藥(yao)及證(zheng)候信息進行(xing)整(zheng)理。

１.３排除標準

①醫(yi)案(an)記錄中(zhong)療(liao)效不明(ming)(ming)(ming)確；②藥(yao)(yao)物劑(ji)型(xing)不明(ming)(ming)(ming)確，或方藥(yao)(yao)不全(quan)；③所選醫(yi)案(an)中(zhong)明(ming)(ming)(ming)確提出處方無效；④合并(bing)其他(ta)治療(liao)方法，如外(wai)治、針灸、推拿等。

１.４數據規(gui)范化(hua)

①所錄處方(fang)中(zhong)(zhong)所載(zai)藥(yao)物統(tong)一(yi)按照(zhao)２０２０年(nian)版《中(zhong)(zhong)國藥(yao)典》［２］進行(xing)校正，如“元胡(hu)”“延(yan)(yan)胡(hu)”統(tong)一(yi)為“延(yan)(yan)胡(hu)索”，個例地方(fang)草藥(yao)則不予改動；②所錄處方(fang)中(zhong)(zhong)所載(zai)證候，統(tong)一(yi)按照(zhao)“十二五”教(jiao)材《中(zhong)(zhong)醫內(nei)科學》第(di)３版［３］及《中(zhong)(zhong)醫診(zhen)斷學》［４］予以修改，如“半(ban)身(shen)偏(pian)癱”“半(ban)身(shen)不遂(sui)(sui)”者統(tong)一(yi)為“半(ban)身(shen)不遂(sui)(sui)”。

１.５數據挖掘

通過Ｅｘｃｅｌ２０１０軟件對(dui)２５２例病(bing)案整(zheng)理歸(gui)檔的(de)數(shu)據庫進行(xing)頻次與頻率分析，ＩＢＭＳＰＳＳＭｏｄｅｌｅｒ１４.２中Ａｐｒｉｏｒｉ算法對(dui)處(chu)方中藥物?證候之間配伍關(guan)聯規則關(guan)系進行(xing)挖(wa)掘。

２結果

２.１藥物頻次

２５２例新(xin)安王氏內科治療中(zhong)風中(zhong)最常用的前１０位(wei)藥物為豨薟草、當歸、遠(yuan)志、黃芪、牡(mu)蠣、地(di)龍、石(shi)斛(hu)、紅花、雞(ji)血藤、茯神，根據其特(te)點而推導出治法主(zhu)要為活血化瘀(yu)、補氣(qi)養血、潛(qian)陽育陰，具體見(jian)表１。

２.２證候頻次

２５２例醫(yi)案中頻次最高(gao)的前１０位證(zheng)候為脈濡弦、舌強(qiang)言(yan)蹇、半(ban)身不(bu)遂(sui)、麻木、頭(tou)暈、口舌歪斜、舌質(zhi)(zhi)紅，苔薄黃、舌質(zhi)(zhi)暗淡(dan)，有齒痕，苔白膩、舌質(zhi)(zhi)淡(dan)紅、目眩，具體見表２。項(xiang)，后項(xiang)為證(zheng)候項(xiang)）。表３證(zheng)候與(yu)藥(yao)物單(dan)項(xiang)關聯分(fen)析（支(zhi)持(chi)度≥１０％，置信度≥

２.３證候與藥(yao)物單項關聯(lian)分(fen)析

具體(ti)見表３（前項為藥物(wu)項，后項為證候(hou)項）。

２.４證候與藥(yao)物(wu)二項關聯分析(xi)

具體(ti)見表(biao)４（前項(xiang)為(wei)藥(yao)物(wu)項(xiang)，后項(xiang)為(wei)證候項(xiang)）。

２.５證型頻次

２５２例(li)醫案中風陽上擾證(zheng)、肝(gan)腎虧(kui)虛證(zheng)、氣虛血(xue)瘀證(zheng)為最常見的中風證(zheng)型，其頻率分(fen)別達到２５.７９％、２４.６０％、２４.６０％，痰熱(re)瘀閉證(zheng)、痰蒙神竅(qiao)證(zheng)由于例(li)數過少則不作討論，具體(ti)見表５。

２.６證型與藥物關(guan)聯分析

通過(guo)關聯規則挖掘得(de)到(dao)證(zheng)(zheng)型與藥物或藥對之間(jian)的(de)關系，例(li)如肝腎虧虛型，常(chang)(chang)用(yong)藥物為熟地(di)黃(huang)、巴戟天、肉蓯蓉、鎖陽(yang)(yang)、牛膝、續斷、沙苑子(zi)、枸(gou)杞子(zi)等；風(feng)陽(yang)(yang)上擾證(zheng)(zheng)則常(chang)(chang)用(yong)鉤藤、地(di)龍、牡蠣、珍(zhen)珠(zhu)母、夏枯草、白(bai)蒺(ji)藜、桑寄生、天麻、野料豆(dou)等；氣虛血瘀(yu)證(zheng)(zheng)主要使(shi)用(yong)鹿銜草、葛根、黃(huang)芪、當(dang)歸、雞血藤、紅花、豨薟草、地(di)龍、秦艽等；風(feng)痰(tan)入(ru)絡證(zheng)(zheng)則多使(shi)用(yong)郁金(jin)、遠(yuan)志、茯苓、石菖(chang)蒲、鹿銜草、天麻、郁金(jin)、膽南星、茯神等；陰虛風(feng)動(dong)證(zheng)(zheng)者常(chang)(chang)用(yong)石決(jue)明、白(bai)蒺(ji)藜、白(bai)芍、茯神、石斛的(de)等，見表６（后項為證(zheng)(zheng)型項，前項為藥物項）。

３討論

從藥(yao)(yao)(yao)物(wu)使(shi)(shi)(shi)用頻(pin)次(ci)可(ke)(ke)見，王(wang)氏(shi)在(zai)治(zhi)(zhi)療中(zhong)(zhong)(zhong)風(feng)(feng)(feng)時認(ren)(ren)為(wei)(wei)(wei)中(zhong)(zhong)(zhong)風(feng)(feng)(feng)以(yi)肝(gan)(gan)(gan)(gan)(gan)腎不(bu)(bu)(bu)足為(wei)(wei)(wei)本(ben)［５］，因而(er)所用藥(yao)(yao)(yao)物(wu)中(zhong)(zhong)(zhong)歸肝(gan)(gan)(gan)(gan)(gan)、腎經(jing)(jing)(jing)(jing)者(zhe)居(ju)多，如地(di)(di)(di)(di)黃(huang)、豨(xi)(xi)薟(lian)草(cao)(cao)(cao)、牛膝(xi)、巴(ba)戟(ji)天、桑(sang)寄(ji)生(sheng)、肉(rou)蓯蓉(rong)、鎖(suo)陽(yang)(yang)(yang)、續斷(duan)(duan)等(deng)，皆有滋補(bu)(bu)(bu)(bu)(bu)肝(gan)(gan)(gan)(gan)(gan)腎之(zhi)(zhi)(zhi)(zhi)效。若陰(yin)(yin)(yin)虧者(zhe)甚則佐以(yi)白芍、枸(gou)杞子(zi)、女貞子(zi)斂陰(yin)(yin)(yin)；血(xue)(xue)(xue)(xue)(xue)虧者(zhe)則加當歸身(shen)、雞(ji)血(xue)(xue)(xue)(xue)(xue)藤(teng)(teng)等(deng)，和絡(luo)(luo)(luo)(luo)(luo)(luo)養血(xue)(xue)(xue)(xue)(xue)［６］。用藥(yao)(yao)(yao)頻(pin)次(ci)排名第一的(de)是豨(xi)(xi)薟(lian)草(cao)(cao)(cao)，在(zai)２５２例處(chu)方(fang)中(zhong)(zhong)(zhong)總計(ji)使(shi)(shi)(shi)用了１０９次(ci)，豨(xi)(xi)薟(lian)草(cao)(cao)(cao)性(xing)苦寒，入(ru)(ru)肝(gan)(gan)(gan)(gan)(gan)腎之(zhi)(zhi)(zhi)(zhi)經(jing)(jing)(jing)(jing)，常(chang)(chang)用于(yu)祛(qu)風(feng)(feng)(feng)除濕、強筋壯骨(gu)；王(wang)氏(shi)常(chang)(chang)用其治(zhi)(zhi)療中(zhong)(zhong)(zhong)風(feng)(feng)(feng)，一取其通(tong)(tong)經(jing)(jing)(jing)(jing)活(huo)(huo)(huo)絡(luo)(luo)(luo)(luo)(luo)(luo)之(zhi)(zhi)(zhi)(zhi)意，凡中(zhong)(zhong)(zhong)風(feng)(feng)(feng)患(huan)(huan)者(zhe)，無論內外因，皆有經(jing)(jing)(jing)(jing)脈閉阻之(zhi)(zhi)(zhi)(zhi)嫌(xian)，二(er)取蒸制后，其性(xing)轉溫，更可(ke)(ke)與(yu)(yu)(yu)(yu)(yu)黃(huang)芪、當歸、紅花(hua)(hua)雞(ji)血(xue)(xue)(xue)(xue)(xue)藤(teng)(teng)等(deng)藥(yao)(yao)(yao)調補(bu)(bu)(bu)(bu)(bu)氣(qi)(qi)(qi)血(xue)(xue)(xue)(xue)(xue)、活(huo)(huo)(huo)血(xue)(xue)(xue)(xue)(xue)通(tong)(tong)絡(luo)(luo)(luo)(luo)(luo)(luo)，猶擅(shan)治(zhi)(zhi)療氣(qi)(qi)(qi)虛(xu)(xu)血(xue)(xue)(xue)(xue)(xue)瘀(yu)證(zheng)(zheng)(zheng)(zheng)之(zhi)(zhi)(zhi)(zhi)中(zhong)(zhong)(zhong)風(feng)(feng)(feng)［７］。中(zhong)(zhong)(zhong)風(feng)(feng)(feng)病病理因素復雜，風(feng)(feng)(feng)、火、痰、瘀(yu)、虛(xu)(xu)或單(dan)(dan)(dan)一為(wei)(wei)(wei)患(huan)(huan)，或合而(er)為(wei)(wei)(wei)病。王(wang)氏(shi)在(zai)培補(bu)(bu)(bu)(bu)(bu)肝(gan)(gan)(gan)(gan)(gan)腎的(de)基礎上(shang)，分中(zhong)(zhong)(zhong)經(jing)(jing)(jing)(jing)絡(luo)(luo)(luo)(luo)(luo)(luo)、中(zhong)(zhong)(zhong)臟腑，四診合參，隨(sui)證(zheng)(zheng)(zheng)(zheng)治(zhi)(zhi)之(zhi)(zhi)(zhi)(zhi)。若邪在(zai)于(yu)絡(luo)(luo)(luo)(luo)(luo)(luo)表，則病較(jiao)輕，可(ke)(ke)出現肌(ji)膚麻(ma)木(mu)不(bu)(bu)(bu)仁，麻(ma)木(mu)則與(yu)(yu)(yu)(yu)(yu)葛(ge)根單(dan)(dan)(dan)項(xiang)(xiang)關(guan)(guan)聯(lian)(lian)(lian)(lian)，與(yu)(yu)(yu)(yu)(yu)鹿(lu)銜(xian)草(cao)(cao)(cao)、地(di)(di)(di)(di)龍(long)二(er)項(xiang)(xiang)關(guan)(guan)聯(lian)(lian)(lian)(lian)，葛(ge)根辛甘活(huo)(huo)(huo)散，可(ke)(ke)活(huo)(huo)(huo)通(tong)(tong)氣(qi)(qi)(qi)血(xue)(xue)(xue)(xue)(xue)，尤其可(ke)(ke)升散陽(yang)(yang)(yang)明(ming)之(zhi)(zhi)(zhi)(zhi)陽(yang)(yang)(yang)氣(qi)(qi)(qi)，走(zou)指端細微之(zhi)(zhi)(zhi)(zhi)脈絡(luo)(luo)(luo)(luo)(luo)(luo)，鼓氣(qi)(qi)(qi)血(xue)(xue)(xue)(xue)(xue)入(ru)(ru)之(zhi)(zhi)(zhi)(zhi)；鹿(lu)銜(xian)草(cao)(cao)(cao)可(ke)(ke)補(bu)(bu)(bu)(bu)(bu)精填(tian)(tian)髓(sui)，地(di)(di)(di)(di)龍(long)可(ke)(ke)通(tong)(tong)絡(luo)(luo)(luo)(luo)(luo)(luo)，兩者(zhe)一通(tong)(tong)一補(bu)(bu)(bu)(bu)(bu)，共奏奇效，由(you)此可(ke)(ke)知，王(wang)氏(shi)認(ren)(ren)為(wei)(wei)(wei)麻(ma)木(mu)多為(wei)(wei)(wei)中(zhong)(zhong)(zhong)風(feng)(feng)(feng)初期之(zhi)(zhi)(zhi)(zhi)癥，多由(you)肝(gan)(gan)(gan)(gan)(gan)木(mu)不(bu)(bu)(bu)養，肝(gan)(gan)(gan)(gan)(gan)筋不(bu)(bu)(bu)柔所致。若邪入(ru)(ru)于(yu)經(jing)(jing)(jing)(jing)絡(luo)(luo)(luo)(luo)(luo)(luo)深處(chu)，則出現肢體行動困難，半(ban)身(shen)不(bu)(bu)(bu)遂(sui)等(deng)證(zheng)(zheng)(zheng)(zheng)候，半(ban)身(shen)不(bu)(bu)(bu)遂(sui)與(yu)(yu)(yu)(yu)(yu)紅花(hua)(hua)單(dan)(dan)(dan)項(xiang)(xiang)關(guan)(guan)聯(lian)(lian)(lian)(lian)，與(yu)(yu)(yu)(yu)(yu)秦(qin)艽、地(di)(di)(di)(di)龍(long)二(er)項(xiang)(xiang)關(guan)(guan)聯(lian)(lian)(lian)(lian)，半(ban)身(shen)不(bu)(bu)(bu)遂(sui)者(zhe)經(jing)(jing)(jing)(jing)絡(luo)(luo)(luo)(luo)(luo)(luo)血(xue)(xue)(xue)(xue)(xue)脈不(bu)(bu)(bu)通(tong)(tong)，紅花(hua)(hua)可(ke)(ke)活(huo)(huo)(huo)血(xue)(xue)(xue)(xue)(xue)化瘀(yu)，亦可(ke)(ke)通(tong)(tong)經(jing)(jing)(jing)(jing)疏絡(luo)(luo)(luo)(luo)(luo)(luo)；秦(qin)艽可(ke)(ke)治(zhi)(zhi)諸(zhu)風(feng)(feng)(feng)，入(ru)(ru)厥陰(yin)(yin)(yin)肝(gan)(gan)(gan)(gan)(gan)經(jing)(jing)(jing)(jing)，地(di)(di)(di)(di)龍(long)息(xi)(xi)風(feng)(feng)(feng)通(tong)(tong)絡(luo)(luo)(luo)(luo)(luo)(luo)，兩者(zhe)合之(zhi)(zhi)(zhi)(zhi)可(ke)(ke)息(xi)(xi)風(feng)(feng)(feng)舒經(jing)(jing)(jing)(jing)活(huo)(huo)(huo)絡(luo)(luo)(luo)(luo)(luo)(luo)，故王(wang)氏(shi)認(ren)(ren)為(wei)(wei)(wei)中(zhong)(zhong)(zhong)經(jing)(jing)(jing)(jing)絡(luo)(luo)(luo)(luo)(luo)(luo)者(zhe)，多有血(xue)(xue)(xue)(xue)(xue)脈閉阻之(zhi)(zhi)(zhi)(zhi)嫌(xian)，氣(qi)(qi)(qi)血(xue)(xue)(xue)(xue)(xue)被阻，則肢體失養，應活(huo)(huo)(huo)血(xue)(xue)(xue)(xue)(xue)通(tong)(tong)經(jing)(jing)(jing)(jing)，息(xi)(xi)風(feng)(feng)(feng)活(huo)(huo)(huo)絡(luo)(luo)(luo)(luo)(luo)(luo)。中(zhong)(zhong)(zhong)臟腑，則病情較(jiao)重，會(hui)出現猝(cu)然(ran)昏撲，神志(zhi)不(bu)(bu)(bu)清，舌(she)強言蹇、口舌(she)歪(wai)(wai)斜等(deng)證(zheng)(zheng)(zheng)(zheng)候，舌(she)強言蹇與(yu)(yu)(yu)(yu)(yu)白附(fu)子(zi)單(dan)(dan)(dan)項(xiang)(xiang)關(guan)(guan)聯(lian)(lian)(lian)(lian)，與(yu)(yu)(yu)(yu)(yu)遠志(zhi)、豨(xi)(xi)薟(lian)草(cao)(cao)(cao)二(er)項(xiang)(xiang)關(guan)(guan)聯(lian)(lian)(lian)(lian)，白附(fu)子(zi)主中(zhong)(zhong)(zhong)風(feng)(feng)(feng)失音，可(ke)(ke)祛(qu)風(feng)(feng)(feng)止痙(jing)豁痰，猶擅(shan)治(zhi)(zhi)療風(feng)(feng)(feng)痰入(ru)(ru)絡(luo)(luo)(luo)(luo)(luo)(luo)；遠志(zhi)寧心(xin)靜(jing)氣(qi)(qi)(qi)，心(xin)開(kai)竅于(yu)舌(she)，豨(xi)(xi)簽(qian)草(cao)(cao)(cao)通(tong)(tong)絡(luo)(luo)(luo)(luo)(luo)(luo)活(huo)(huo)(huo)血(xue)(xue)(xue)(xue)(xue)，二(er)藥(yao)(yao)(yao)合用可(ke)(ke)通(tong)(tong)舌(she)竅。口舌(she)歪(wai)(wai)斜與(yu)(yu)(yu)(yu)(yu)紅花(hua)(hua)單(dan)(dan)(dan)項(xiang)(xiang)關(guan)(guan)聯(lian)(lian)(lian)(lian)，與(yu)(yu)(yu)(yu)(yu)紅花(hua)(hua)、葛(ge)根二(er)項(xiang)(xiang)關(guan)(guan)聯(lian)(lian)(lian)(lian)，葛(ge)根走(zou)太陰(yin)(yin)(yin)肺經(jing)(jing)(jing)(jing)，太陰(yin)(yin)(yin)之(zhi)(zhi)(zhi)(zhi)經(jing)(jing)(jing)(jing)散于(yu)舌(she)下，連于(yu)舌(she)本(ben)，紅花(hua)(hua)循經(jing)(jing)(jing)(jing)活(huo)(huo)(huo)血(xue)(xue)(xue)(xue)(xue)化瘀(yu)以(yi)通(tong)(tong)絡(luo)(luo)(luo)(luo)(luo)(luo)牽正。頭暈者(zhe)，虛(xu)(xu)實皆有，頭暈與(yu)(yu)(yu)(yu)(yu)女貞子(zi)單(dan)(dan)(dan)項(xiang)(xiang)相關(guan)(guan)聯(lian)(lian)(lian)(lian)，女貞子(zi)可(ke)(ke)補(bu)(bu)(bu)(bu)(bu)益(yi)肝(gan)(gan)(gan)(gan)(gan)腎，治(zhi)(zhi)肝(gan)(gan)(gan)(gan)(gan)腎陰(yin)(yin)(yin)虛(xu)(xu)之(zhi)(zhi)(zhi)(zhi)頭暈；與(yu)(yu)(yu)(yu)(yu)菊(ju)花(hua)(hua)、牡(mu)(mu)(mu)蠣二(er)項(xiang)(xiang)關(guan)(guan)聯(lian)(lian)(lian)(lian)，菊(ju)花(hua)(hua)平(ping)肝(gan)(gan)(gan)(gan)(gan)清熱、清利(li)頭目(mu)，牡(mu)(mu)(mu)蠣重鎮潛陽(yang)(yang)(yang)，善(shan)治(zhi)(zhi)肝(gan)(gan)(gan)(gan)(gan)陽(yang)(yang)(yang)上(shang)亢證(zheng)(zheng)(zheng)(zheng)之(zhi)(zhi)(zhi)(zhi)頭暈。目(mu)眩(xuan)與(yu)(yu)(yu)(yu)(yu)石(shi)(shi)決明(ming)單(dan)(dan)(dan)項(xiang)(xiang)相關(guan)(guan)聯(lian)(lian)(lian)(lian)，與(yu)(yu)(yu)(yu)(yu)石(shi)(shi)決明(ming)、牡(mu)(mu)(mu)蠣二(er)項(xiang)(xiang)關(guan)(guan)聯(lian)(lian)(lian)(lian)，兩者(zhe)皆是重鎮浮越之(zhi)(zhi)(zhi)(zhi)陽(yang)(yang)(yang)。乏力者(zhe)多為(wei)(wei)(wei)虛(xu)(xu)證(zheng)(zheng)(zheng)(zheng)，與(yu)(yu)(yu)(yu)(yu)續斷(duan)(duan)單(dan)(dan)(dan)項(xiang)(xiang)關(guan)(guan)聯(lian)(lian)(lian)(lian)，與(yu)(yu)(yu)(yu)(yu)巴(ba)戟(ji)天、牛膝(xi)二(er)項(xiang)(xiang)關(guan)(guan)聯(lian)(lian)(lian)(lian)，續斷(duan)(duan)可(ke)(ke)補(bu)(bu)(bu)(bu)(bu)益(yi)肝(gan)(gan)(gan)(gan)(gan)腎，巴(ba)戟(ji)天溫補(bu)(bu)(bu)(bu)(bu)腎陽(yang)(yang)(yang)，牛膝(xi)填(tian)(tian)骨(gu)益(yi)髓(sui)。行動不(bu)(bu)(bu)便與(yu)(yu)(yu)(yu)(yu)鎖(suo)陽(yang)(yang)(yang)單(dan)(dan)(dan)項(xiang)(xiang)關(guan)(guan)聯(lian)(lian)(lian)(lian)，與(yu)(yu)(yu)(yu)(yu)續斷(duan)(duan)、鎖(suo)陽(yang)(yang)(yang)二(er)項(xiang)(xiang)關(guan)(guan)聯(lian)(lian)(lian)(lian)，二(er)藥(yao)(yao)(yao)共起補(bu)(bu)(bu)(bu)(bu)腎固髓(sui)、養陰(yin)(yin)(yin)補(bu)(bu)(bu)(bu)(bu)肝(gan)(gan)(gan)(gan)(gan)之(zhi)(zhi)(zhi)(zhi)效［８］。由(you)證(zheng)(zheng)(zheng)(zheng)型(xing)與(yu)(yu)(yu)(yu)(yu)藥(yao)(yao)(yao)物(wu)的(de)關(guan)(guan)聯(lian)(lian)(lian)(lian)結果可(ke)(ke)知，肝(gan)(gan)(gan)(gan)(gan)腎虧虛(xu)(xu)型(xing)常(chang)(chang)用藥(yao)(yao)(yao)物(wu)為(wei)(wei)(wei)熟(shu)(shu)地(di)(di)(di)(di)黃(huang)、巴(ba)戟(ji)天、肉(rou)蓯蓉(rong)、鎖(suo)陽(yang)(yang)(yang)、牛膝(xi)、續斷(duan)(duan)、沙苑(yuan)子(zi)、枸(gou)杞子(zi)，有地(di)(di)(di)(di)黃(huang)飲子(zi)之(zhi)(zhi)(zhi)(zhi)意，熟(shu)(shu)地(di)(di)(di)(di)補(bu)(bu)(bu)(bu)(bu)腎填(tian)(tian)髓(sui)、滋水涵木(mu)，肉(rou)蓯蓉(rong)甘溫潤陰(yin)(yin)(yin)，鎖(suo)陽(yang)(yang)(yang)補(bu)(bu)(bu)(bu)(bu)陰(yin)(yin)(yin)固髓(sui)，牛膝(xi)引妄風(feng)(feng)(feng)妄血(xue)(xue)(xue)(xue)(xue)下行，續斷(duan)(duan)、沙苑(yuan)子(zi)固腎益(yi)精，枸(gou)杞子(zi)陰(yin)(yin)(yin)陽(yang)(yang)(yang)同補(bu)(bu)(bu)(bu)(bu)；風(feng)(feng)(feng)陽(yang)(yang)(yang)上(shang)擾證(zheng)(zheng)(zheng)(zheng)常(chang)(chang)用鉤藤(teng)(teng)、地(di)(di)(di)(di)龍(long)、牡(mu)(mu)(mu)蠣、珍珠母、夏枯草(cao)(cao)(cao)、白蒺藜(li)、桑(sang)寄(ji)生(sheng)、天麻(ma)、野料(liao)豆(dou)等(deng)［９］，以(yi)平(ping)肝(gan)(gan)(gan)(gan)(gan)潛陽(yang)(yang)(yang)、清熱息(xi)(xi)風(feng)(feng)(feng)，加以(yi)活(huo)(huo)(huo)血(xue)(xue)(xue)(xue)(xue)通(tong)(tong)絡(luo)(luo)(luo)(luo)(luo)(luo)；氣(qi)(qi)(qi)虛(xu)(xu)血(xue)(xue)(xue)(xue)(xue)瘀(yu)證(zheng)(zheng)(zheng)(zheng)主要(yao)使(shi)(shi)(shi)用鹿(lu)銜(xian)草(cao)(cao)(cao)、葛(ge)根、黃(huang)芪、當歸、雞(ji)血(xue)(xue)(xue)(xue)(xue)藤(teng)(teng)、紅花(hua)(hua)、豨(xi)(xi)薟(lian)草(cao)(cao)(cao)、地(di)(di)(di)(di)龍(long)、秦(qin)艽等(deng)，鹿(lu)銜(xian)草(cao)(cao)(cao)補(bu)(bu)(bu)(bu)(bu)精填(tian)(tian)髓(sui)，豨(xi)(xi)簽(qian)草(cao)(cao)(cao)蒸者(zhe)可(ke)(ke)通(tong)(tong)絡(luo)(luo)(luo)(luo)(luo)(luo)活(huo)(huo)(huo)血(xue)(xue)(xue)(xue)(xue)，葛(ge)根作循經(jing)(jing)(jing)(jing)之(zhi)(zhi)(zhi)(zhi)用，黃(huang)芪、紅花(hua)(hua)、雞(ji)血(xue)(xue)(xue)(xue)(xue)藤(teng)(teng)、紅花(hua)(hua)、地(di)(di)(di)(di)龍(long)等(deng)藥(yao)(yao)(yao)補(bu)(bu)(bu)(bu)(bu)氣(qi)(qi)(qi)血(xue)(xue)(xue)(xue)(xue)、通(tong)(tong)經(jing)(jing)(jing)(jing)絡(luo)(luo)(luo)(luo)(luo)(luo)、化瘀(yu)滯，補(bu)(bu)(bu)(bu)(bu)中(zhong)(zhong)(zhong)有行，補(bu)(bu)(bu)(bu)(bu)而(er)不(bu)(bu)(bu)滯，血(xue)(xue)(xue)(xue)(xue)和絡(luo)(luo)(luo)(luo)(luo)(luo)通(tong)(tong)；風(feng)(feng)(feng)痰入(ru)(ru)絡(luo)(luo)(luo)(luo)(luo)(luo)證(zheng)(zheng)(zheng)(zheng)多使(shi)(shi)(shi)用郁金、遠志(zhi)、茯(fu)苓(ling)、石(shi)(shi)菖蒲、鹿(lu)銜(xian)草(cao)(cao)(cao)、天麻(ma)、膽南(nan)星、茯(fu)神，茯(fu)苓(ling)利(li)水滲濕，且引氣(qi)(qi)(qi)血(xue)(xue)(xue)(xue)(xue)下行，菖蒲芳(fang)香開(kai)竅豁痰，天麻(ma)息(xi)(xi)風(feng)(feng)(feng)豁痰，膽南(nan)星清火化痰，郁金行氣(qi)(qi)(qi)開(kai)郁助諸(zhu)藥(yao)(yao)(yao)化痰濁，遠志(zhi)、茯(fu)神安五臟；陰(yin)(yin)(yin)虛(xu)(xu)風(feng)(feng)(feng)動證(zheng)(zheng)(zheng)(zheng)常(chang)(chang)用石(shi)(shi)決明(ming)、白蒺藜(li)、白芍、茯(fu)神、石(shi)(shi)斛，陰(yin)(yin)(yin)虛(xu)(xu)者(zhe)，以(yi)石(shi)(shi)斛益(yi)胃養陰(yin)(yin)(yin)，白芍柔肝(gan)(gan)(gan)(gan)(gan)斂陰(yin)(yin)(yin)；風(feng)(feng)(feng)動者(zhe)，白蒺藜(li)平(ping)肝(gan)(gan)(gan)(gan)(gan)疏肝(gan)(gan)(gan)(gan)(gan)，石(shi)(shi)決明(ming)潛陽(yang)(yang)(yang)抑肝(gan)(gan)(gan)(gan)(gan)，以(yi)定肝(gan)(gan)(gan)(gan)(gan)風(feng)(feng)(feng)［１０］。

４結論

本研究(jiu)通(tong)過Ａｐｒｉｏｒｉ算法對新安(an)王(wang)氏(shi)治(zhi)療中(zhong)風(feng)(feng)病的證(zheng)治(zhi)規(gui)律(lv)進(jin)行探討，從頻次、證(zheng)候與藥(yao)物(wu)(wu)單項關(guan)聯(lian)、證(zheng)候與藥(yao)物(wu)(wu)二項關(guan)聯(lian)、證(zheng)型與藥(yao)物(wu)(wu)組(zu)合關(guan)聯(lian)等(deng)多個(ge)角度(du)(du)分析，一定程度(du)(du)上能夠反映新安(an)王(wang)氏(shi)治(zhi)療中(zhong)風(feng)(feng)病的特色。新安(an)王(wang)氏(shi)治(zhi)療中(zhong)風(feng)(feng)病以(yi)培(pei)補肝腎(shen)、益氣(qi)活血通(tong)絡為核心，臨(lin)證(zheng)予以(yi)加(jia)減，風(feng)(feng)痰(tan)(tan)上涌予以(yi)豁痰(tan)(tan)祛風(feng)(feng)，肝陽上亢者(zhe)(zhe)(zhe)予以(yi)平肝潛陽，肝腎(shen)虧虛(xu)者(zhe)(zhe)(zhe)予以(yi)補益肝腎(shen)，陰(yin)虛(xu)風(feng)(feng)動者(zhe)(zhe)(zhe)予以(yi)育陰(yin)息風(feng)(feng)，氣(qi)虛(xu)血瘀者(zhe)(zhe)(zhe)予以(yi)補氣(qi)活血，所用之藥(yao)中(zhong)正平和(he)，不(bu)偏不(bu)倚，實為佳(jia)法。上述結果(guo)可傳承新安(an)王(wang)氏(shi)內科經驗(yan)，從而(er)用于指導(dao)臨(lin)床。

作者(zhe)：石小雨 郭錦晨 朱(zhu)喜(xi)英 朱(zhu)茂萍 潘壘(lei) 高(gao)兵 劉龍民 單(dan)位(wei)：上海中(zhong)醫(yi)藥大(da)(da)學(xue)附屬(shu)普陀(tuo)醫(yi)院 新安醫(yi)學(xue)教育部重點實(shi)驗室 安徽中(zhong)醫(yi)藥大(da)(da)學(xue)