目的:基于中医传承计算平台分析高上林教授辨治 2型糖尿病的用药规律.方法:采集高上林教授门诊治疗 2型糖尿病的病案,运用中医传承计算平台构建医案数据库,基于该软件的集成规则分析、复杂系统熵聚类分析等数据挖掘方法,对高上林教授门诊治疗 2 型糖尿病的用药规律进行总结.结果:整理出处方 383 条,共包含药物 83 味,其中药性以寒、温为主,药味以甘、苦、辛为主,归经主要入肺经、脾经、肾经.山药、黄芪、牡丹皮、泽泻、山茱萸、姜半夏、茯苓、白芍、麦冬为核心组方,其中山药、黄芪、牡丹皮、山茱萸、柴胡为最主要的五味药.结论:高上林教授指出糖尿病发病因饮食、情志等因素导致脏腑气机枢机不利,早期病位多在肝胃,饮食不节,湿浊内生,肝胆气机失和,胃失降浊,脾失健运,郁久化热,湿热内阻中焦,滞气机之升降,故而发病,此期高老多以小柴胡汤化裁调和少阳枢机气.若糖尿病迁延日久,脾虚日甚,气血化生不足,脏腑虚衰,损及阴阳,阴损及阳而致气阴两虚,此期高老多以黄芪六味地黄汤化裁调和阴阳气血.临证时以和为主,一则以调和脏腑气机、阴阳为其治疗之根本;一则强调顾护胃气、重视后天之本.处方用药以补为主,同时顾护脾气,升降同治、气血同养、阴阳相和、五脏同调,临床上取得了较好疗效,为2型糖尿病的中医诊疗提供了一条崭新的思路.
Objective:To analyze the medication rules of Professor GAO Shanglin in the differentiation and treatment of type 2 diabetes mellitus based on the Traditional Chinese Medicine Inheritance Computing Platform.Methods:The medical records of Professor GAO Shanglin's outpatient treatment of type 2 diabetes mellitus were collected,and the medical record database was constructed using the Traditional Chinese Medicine Inheritance Computing Platform.Based on the data mining methods such as integration rule analysis and complex system entropy cluster analysis,the medication rules of Professor GAO Shanglin's outpatient treatment of type 2 diabetes mellitus were summarized.Results:A total of 383 prescriptions were sorted out,including 83 drug flavors,including cold and warm properties,sweet,bitter and spicy drugs,and the meridians mainly enter the lung,spleen,kidney.Shanyao(Rhizoma Dioscoreae),Huangqi(Radix Astragali),Mudanpi(Cortex Moutan),Zexie(Rhizoma Alismatis),Shanzhuyu(Fructus Corni),Jiangbanxia(Rhizoma Pinelliae),Fuling(Poria),Baishao(Radix Paeoniae Alba),Maidong(Radix Ophiopogonis)as the core prescription,Shanyao,Huangqi,Mudanpi,Shanzhuyu and Chaihu(Radix Bupleuri)are the five main medicines.Conclusion:Professor GAO Shanglin pointed out that the onset of diabetes mellitus is caused by diet,emotion and other factors that lead to unfavourable internal organs and Qi(气).Early stage of diabetes mellitus is mostly located in the liver and stomach,dietary irregularities,internal dampness and turbidity,liver and gallbladder Qi disharmony,gastric loss of subduing turbidities,loss of healthy transport of the spleen,and the accumulation of long-lasting heat.In this period,the high old man mostly uses the Xiao Chaihu decoction(小柴胡汤)to adjust and harmonise the Shaoyang(少阳)pivotal Qi.If the diabetes is prolonged for a long time,the spleen is very weak,the gas and blood are not enough,the internal organs are weakened,the loss of Yin(阴)and Yang(阳),Yin damage and Yang and cause Qi and Yin deficiency,this period of the old man to use the Huangqi Liuwei Dihuang decoction(黄芪六味地黄汤)to adjust Yin and Yang,Qi and blood.When the evidence and the main,one to reconcile the internal organs and Qi,Yin and Yang for its treatment of the fundamental;one stresses the care of the stomach Qi,the importance of the nature of the latter.The prescription is based on tonic,at the same time,care for the spleen,lift and lower the same treatment,Qi and blood with the same nutrition,Yin and Yang and the five viscera with the same adjustment,clinically achieved a better therapeutic effect,for the Chinese medicine of type 2 diabetes mellitus diagnosis and treatment put forward a brand-new idea.