CAJ | 학술논문

目的：探讨名医王行宽辨治胸痹心痛的规律。方法收集王老门诊胸痹心痛医案267份,规范其中出现的中医术语,建立Excel数据库,运用Weka3.6软件,对证候、证素、病机、治法、药味等进行描述性统计,采用 Apriori 算法对主要病机→治法进行关联规则分析。结果证候包括胸闷(痛)、心悸、气短、舌淡(黯)红等；证素辨证以肝、心为主,尚有血瘀、痰、气郁、热等；病机关键为肝心失调,包括肝木失疏、心络瘀阻等；治疗原则为肝心同治,治“肝”以疏肝木为主,治“心”包括通络、化痰瘀、宁心、益气营等；主要病机→治法的关联置信度均≥0.50,其中肝心失调→肝心并治为0.71,具有较高的置信度；用药讲究通补兼施,“通”予丹参、薤白、三七、柴胡等,“补”予白参、麦冬、白芍、茯神、炙远志等。结论“心痛治肝、肝心同治、通补兼施”乃王老临床辨治胸痹心痛的学术思想和临床经验。
목적：탐토명의왕행관변치흉비심통적규률。방법수집왕로문진흉비심통의안267빈,규범기중출현적중의술어,건립Excel수거고,운용Weka3.6연건,대증후、증소、병궤、치법、약미등진행묘술성통계,채용 Apriori 산법대주요병궤→치법진행관련규칙분석。결과증후포괄흉민(통)、심계、기단、설담(암)홍등；증소변증이간、심위주,상유혈어、담、기욱、열등；병궤관건위간심실조,포괄간목실소、심락어조등；치료원칙위간심동치,치“간”이소간목위주,치“심”포괄통락、화담어、저심、익기영등；주요병궤→치법적관련치신도균≥0.50,기중간심실조→간심병치위0.71,구유교고적치신도；용약강구통보겸시,“통”여단삼、해백、삼칠、시호등,“보”여백삼、맥동、백작、복신、자원지등。결론“심통치간、간심동치、통보겸시”내왕로림상변치흉비심통적학술사상화림상경험。
Objective To explore Wang Xingkuan’s rules of syndrome and treatment of chest blocking and heartache (Xiongbixintong).Methods Collection of professor Wang Xingkuan’s 267 consilia of patients with Xiongbixintong for outpatients. Chinese medicine terminology was regulated and Excelldatabase was established. Symptom, syndrome element, pathogenesis and treatment were statistically described by using Weka3.6 software, and Apriori algorithm was adopted for the main pathogenesis→treatment analysis of association rules.Results Symptoms include:chest pain, heart palpitations, shortness of breath, pale tongue (dark) red, etc. Syndrome elements include:in liver, and heart, and blood stasis, phlegm, qi stagnation, etc. The key pathogenesis is liver-heart imbalance, including stagnation of liver qi, heart and blood stasis, deficiency of heart qi-ying, disturbing heart-mind, etc. The principle of treatment is liver-heart Tongzhi, so the treatment is of“liver” with Shu gan-mu;treatment of“heart” contains freeing channels, eliminating phlegm and blood stasis, quiet the heart, replenishing qi-ying, etc. The main pathogenesis related credibility→treatment was higher than 0.50;with high reliability, the liver-heart imbalance→liver-heart Tongzhi was 0.71. Medication includes catharsis and tonic,“catharsis” to salvia, allium macrostemon, pseudo-ginseng, bupleurum, etc;“tonic” to white ginseng, ophiopogon japonicus, radix paeoniae alba, poria with hostwood, polygala tenuifolia, etc. Conclusion “Xintongzhigan, liver-heart Tongzhi, catharsis and tonic” is Wang Xingkuan’s thoughts and experience in treating Xiongbixintong.