Article(id=1261262691084133001, tenantId=1146029695717560320, journalId=1146123166801305609, issueId=1261262687258985194, articleNumber=null, orderNo=null, doi=10.12404/j.issn.1671-1815.2404280, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=research-article, receivedDate=1717776000000, receivedDateStr=2024-06-08, revisedDate=1744041600000, revisedDateStr=2025-04-08, acceptedDate=null, acceptedDateStr=null, onlineDate=1778638058681, onlineDateStr=2026-05-13, pubDate=1752768000000, pubDateStr=2025-07-18, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1778638058681, onlineIssueDateStr=2026-05-13, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1778638058681, creator=13701087609, updateTime=1778638058681, updator=13701087609, issue=Issue{id=1261262687258985194, tenantId=1146029695717560320, journalId=1146123166801305609, year='2025', volume='25', issue='20', pageStart='8317', pageEnd='8759', issueExtLink='null', onlineDate='null', pubDate='null', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1778638057769, creator=13701087609, updateTime=1778753106634, updator=13701087609, preIssue=null, nextIssue=null, ext={EN=IssueExt(id=1261745237240722095, tenantId=1146029695717560320, journalId=1146123166801305609, issueId=1261262687258985194, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1261745237240722096, tenantId=1146029695717560320, journalId=1146123166801305609, issueId=1261262687258985194, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null}, startPage=8435, endPage=8444, ext={EN=ArticleExt(id=1261262692560528025, articleId=1261262691084133001, tenantId=1146029695717560320, journalId=1146123166801305609, language=EN, title=Application Characteristics of Expectorant in Traditional Chinese Medicine for Treating Ischemic Stroke Based on Clinical Data Mining, columnId=1156262732384031076, journalTitle=Science Technology and Engineering, columnName=Papers·Medicine, runingTitle=null, highlight=null, articleAbstract=

In order to explore the medication characteristics of expectorants in the Huatan prescriptions commonly used in treating ischemic stroke recently. “Huatan/Qutan/Ditan/Huotan/Daotan/Guntan/Banxia Baizhu Tianma Decoction/Xinglou Chengqi Decoction/Wendan Decoction/Erchen Decoction/Xiao xianxiong Decoction/Lingjiao Gouteng Decoction/Jieyu Dan” + “ischemic stroke/cerebral ischemia/cerebral infarction/cerebral embolism/cerebral thrombus” + “clinical” as the main topic on the China National Knowledge Network (from May 1, 1986 to April 1, 2024) was used to investigate the medication characteristics of expectorants, and selected literature meeting the criteria. Statistical analysis of the data was performed using Excel and IBM SPSS Modeler 18.0 software. The results show that Banxia and Tian nan-xing are the most frequently used expectorants in different stages of ischemic stroke, followed by Fuling, Shi chang-pu, Chenpi, and Gancao. The dosages of most expectorants are 10~15 g. In the analysis of Siqi and five flavors, Wen, Ping, Xin, Ku, and Gan have the highest frequency of occurrence in different stages of ischemic stroke. In the analysis of meridian tropism, the lung and spleen meridian have the highest frequency of occurrence. Most Huatan prescriptions are composed of 8~14 herbs in both the acute and rehabilitation stages, accounting for 82.51% and 78.05% of the total frequency, respectively. In the analysis of association rules, 25 traditional Chinese medicine combinations with strong correlation strength are obtained, and the most combinations of herbs are Huatan-Xifeng-Tongluo and Huatan-Huoxue-Qufeng. Most Huatan prescriptions are administered through the traditional decoction method and generally used in combination with Western medicine. It is concluded that the commonly used expectorants in Huatan prescriptions for treating ischemic stroke are mainly Banxia and Tian nan-xing, and the dosage ranges of most expectorants are 10~15 g. The number of herbs in Huatan prescriptions is mainly 8~14. The research results provide references and clinical data support for the application of expectorant Chinese medicine and Huatan prescriptions in the treatment of ischemic stroke and the development of research on treating ischemic stroke from the perspective of phlegm.

, correspAuthors=Ming-san MIAO, authorNote=null, correspAuthorsNote=null, copyrightStatement=null, copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, authorCompany=null, fund=null, authors=null, authorsList=Xun LI, Wei-peng JING, Xiao-yan FANG, Yan LI, Ming-san MIAO), CN=ArticleExt(id=1261262696842912452, articleId=1261262691084133001, tenantId=1146029695717560320, journalId=1146123166801305609, language=CN, title=基于临床数据挖掘化痰中药治疗缺血性脑卒中的应用特点, columnId=1156262732526637414, journalTitle=科学技术与工程, columnName=论文·医药、卫生, runingTitle=null, highlight=null, articleAbstract=

为探究近年来治疗缺血性脑卒中常用化痰方剂中化痰药的用药特点。以“化痰/祛痰/涤痰/豁痰/导痰/滚痰/半夏白术天麻汤/星蒌承气汤/温胆汤/二陈汤/小陷胸汤/羚角钩藤汤/解语丹”+ “缺血性中风/缺血性脑卒中/脑缺血/脑梗死/脑梗塞/脑栓塞/脑血栓” +“临床”为主题词在中国知网(1986年5月1日—2024年4月1日)中进行高级检索,筛选出符合标准的文献,采用Excel和IBM SPSS Modeler 18.0软件对数据进行统计分析。化痰方剂中以半夏和天南星为缺血性脑卒中不同时期中使用频率最高的两味化痰药,其次为茯苓、石菖蒲、陈皮和甘草等;大多数化痰药的高频使用剂量在均在10~15 g。在四气五味统计中,缺血性脑卒中不同时期化痰药均以温、平、辛、苦、甘出现频率最高;归经统计中,不同时期化痰药都以肺、脾经为主。在化痰方剂药味统计中,急性期和康复期均以由8~14味药组成的方剂最常见,约占各自总频数的82.51%和78.05%;关联规则分析中得到25个支持度较高的中药组合,以化痰熄风通络药和化痰活血祛风药等配伍较多;方剂基本都采用中药饮片汤剂煎煮服药方式,且多与西药联合应用。临床上治疗缺血性脑卒中的常用化痰方剂中化痰药以半夏和天南星为主,大部分化痰药物的使用剂量范围在10~15 g,常用化痰方剂味药数以8~14味为主,研究成果为化痰中药和化痰方剂在缺血性中风治疗中的应用和从痰论治缺血性中风研究发展提供一定的参考和临床数据支持。

, correspAuthors=苗明三, authorNote=null, correspAuthorsNote=
* 苗明三(1965—),男,汉族,河南新乡人,博士,教授,博士研究生导师。研究方向:中药学。E-mail:
, copyrightStatement=null, copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=O9TylRWd4I9T0PzHIqy8FQ==, magXml=bUpN/qIUCJBz6TReBF6xlg==, pdfUrl=null, pdf=4C5v60dovX3phn0t2yMZbQ==, pdfFileSize=3838562, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=KV6VQEDJwdlja10ifqltog==, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=MWPDzfq25HrPZzPUULFdug==, mapNumber=null, authorCompany=null, fund=null, authors=

李洵(1991—),男,汉族,河南许昌人,博士。研究方向:中药学。E-mail:

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李洵(1991—),男,汉族,河南许昌人,博士。研究方向:中药学。E-mail:

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Shanghai Journal of Traditional Chinese Medicine, 2009, 43(11): 1-4., articleTitle=Discovery of classical prescription dose, refAbstract=null)], funds=[Fund(id=1261377096614556242, tenantId=1146029695717560320, journalId=1146123166801305609, articleId=1261262691084133001, awardId=201300310100, language=CN, fundingSource=河南省重大公益专项(201300310100), fundOrder=null, country=null), Fund(id=1261377096958489175, tenantId=1146029695717560320, journalId=1146123166801305609, articleId=1261262691084133001, awardId=221100310400, language=CN, fundingSource=河南省重大科技专项(221100310400), fundOrder=null, country=null), Fund(id=1261377098015453798, tenantId=1146029695717560320, journalId=1146123166801305609, articleId=1261262691084133001, awardId=国中医药人教函2022-6, language=CN, fundingSource=岐黄学者(国中医药人教函2022-6), fundOrder=null, country=null)], companyList=[AuthorCompany(id=1261377020433412135, tenantId=1146029695717560320, journalId=1146123166801305609, articleId=1261262691084133001, xref=1, ext=[AuthorCompanyExt(id=1261377020462772263, tenantId=1146029695717560320, journalId=1146123166801305609, articleId=1261262691084133001, companyId=1261377020433412135, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1 School of Pharmacy, Henan University of Chinese Medicine, Zhengzhou 450046, China), AuthorCompanyExt(id=1261377020483743785, tenantId=1146029695717560320, journalId=1146123166801305609, articleId=1261262691084133001, companyId=1261377020433412135, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1 河南中医药大学药学院, 郑州 450046)]), AuthorCompany(id=1261377020693458995, tenantId=1146029695717560320, journalId=1146123166801305609, articleId=1261262691084133001, xref=2, ext=[AuthorCompanyExt(id=1261377020987060280, tenantId=1146029695717560320, journalId=1146123166801305609, articleId=1261262691084133001, companyId=1261377020693458995, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=2 Collaborative Innovation Center of Research and Development on the Whole Industry Chain of Yu-Yao, Zhengzhou 450046, China), AuthorCompanyExt(id=1261377021008031803, tenantId=1146029695717560320, journalId=1146123166801305609, articleId=1261262691084133001, companyId=1261377020693458995, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=2 豫药全产业链研发河南省协同创新中心, 郑州 450046)])], figs=[ArticleFig(id=1261377075458486700, tenantId=1146029695717560320, journalId=1146123166801305609, articleId=1261262691084133001, language=EN, label=Fig.1, caption=Network display of association between high-frequency traditional Chinese medicine in the acute phase (frequency ≥ 90), figureFileSmall=pVzgaRAQQ/6GCUSsGXIhiw==, figureFileBig=qivv6+HJBvoFZ+Upj07uHw==, tableContent=null), ArticleFig(id=1261377076393816500, tenantId=1146029695717560320, journalId=1146123166801305609, articleId=1261262691084133001, language=CN, label=图1, caption=急性期高频中药网格化关联展示(频数 ≥ 90)

线条的粗细程度来表示不同中药之间关联度的强弱

, figureFileSmall=pVzgaRAQQ/6GCUSsGXIhiw==, figureFileBig=qivv6+HJBvoFZ+Upj07uHw==, tableContent=null), ArticleFig(id=1261377077572415934, tenantId=1146029695717560320, journalId=1146123166801305609, articleId=1261262691084133001, language=EN, label=Fig.2, caption=Network display of association between high-frequency traditional Chinese medicine in the rehabilitation phase (frequency ≥ 20), figureFileSmall=3EdtiITzErdED4rhqQ6wbA==, figureFileBig=/WPwHYkVx+pabRfzafhu3A==, tableContent=null), ArticleFig(id=1261377079677956548, tenantId=1146029695717560320, journalId=1146123166801305609, articleId=1261262691084133001, language=CN, label=图2, caption=康复期高频中药网格化关联展示(频数 ≥ 20)

线条的粗细程度来表示不同中药之间关联度的强弱

, figureFileSmall=3EdtiITzErdED4rhqQ6wbA==, figureFileBig=/WPwHYkVx+pabRfzafhu3A==, tableContent=null), ArticleFig(id=1261377080189661641, tenantId=1146029695717560320, journalId=1146123166801305609, articleId=1261262691084133001, language=EN, label=Table 1, caption=

Statistics of the frequency, dose range, and high-frequency dosage of expectorant (the frequency of this dosage ≥5) in commonly used Huatan prescriptions for acute ischemic stroke

, figureFileSmall=null, figureFileBig=null, tableContent=
药材 频次/次
(方剂占比/%)
剂量范围/g 高频剂量/g(频次/次) 药材 频次/次
(方剂占比/%)
剂量/g
半夏 292(69.03) 5~20 10(113)、15(72)、9(54)、12(40)、6(6)、8(6) 海藻 3(0.71) 10、10、20
天南星 230(54.37) 5~30 10(97)、6(71)、15(22)、12(19)、9(16) 苦杏仁 3(0.71) 10、12、12
茯苓 187(44.21) 5~30 15(83)、20(39)、10(31)、12(14)、30(12) 化橘红 3(0.71) 6、10、10
甘草 174(41.13) 3~20 6(90)、10(33)、5(19)、3(13)、15(10) 莱菔子 3(0.71) 10、10、10
石菖蒲 151(35.70) 3~30 10(75)、15(35)、20(7)、6(7)、9(6) 川贝母 2(0.47) 9、不明
陈皮 128(30.26) 5~20 10(66)、15(24)、12(22)、9(10) 牛蒡子 2(0.47) 15、15
枳实 74(17.49) 5~20 10(35)、15(17)、12(11)、9(7) 麝香 2(0.47) 0.15、0.5
瓜蒌 72(17.02) 10~30 30(25)、15(15)、12(12)、10(9) 苏合香 2(0.47) 2、2
竹茹 64(15.13) 6~20 10(37)、15(13) 桔梗 1(0.24) 12
天竺黄 54(12.77) 6~20 10(26)、6(8)、15(7)、12(6) 昆布 1(0.24) 12
橘红 54(12.77) 5~30 10(26)、12(13)、9(5) 紫苏子 1(0.24) 20
僵蚕 53(12.53) 6~20 10(35)、6(5) 桑白皮 1(0.24) 30
远志 48(11.35) 5~30 10(21)、15(11)、6(7) 细辛 1(0.24) 3
泽泻 22(5.20) 5~30 15(10)、10(5)、30(5) 射干 1(0.24) 12
白附子 21(4.96) 3~20 6(6)、5(5) 橘络 1(0.24) 10
生姜 12(2.84) 3~15 浙贝母 1(0.24) 不明
厚朴 11(2.60%) 5~15
芥子 10(2.36%) 3~15
竹沥 10(2.36%) 10~30 10(5)
桂枝 7(1.65%) 5~12
牡蛎 5(1.18%) 20~30
), ArticleFig(id=1261377081024328147, tenantId=1146029695717560320, journalId=1146123166801305609, articleId=1261262691084133001, language=CN, label=表1, caption=

缺血性脑卒中急性期常用化痰方剂中化痰药物出现频次、剂量范围和高频剂量(该剂量在单味药中出现频次≥5)统计

, figureFileSmall=null, figureFileBig=null, tableContent=
药材 频次/次
(方剂占比/%)
剂量范围/g 高频剂量/g(频次/次) 药材 频次/次
(方剂占比/%)
剂量/g
半夏 292(69.03) 5~20 10(113)、15(72)、9(54)、12(40)、6(6)、8(6) 海藻 3(0.71) 10、10、20
天南星 230(54.37) 5~30 10(97)、6(71)、15(22)、12(19)、9(16) 苦杏仁 3(0.71) 10、12、12
茯苓 187(44.21) 5~30 15(83)、20(39)、10(31)、12(14)、30(12) 化橘红 3(0.71) 6、10、10
甘草 174(41.13) 3~20 6(90)、10(33)、5(19)、3(13)、15(10) 莱菔子 3(0.71) 10、10、10
石菖蒲 151(35.70) 3~30 10(75)、15(35)、20(7)、6(7)、9(6) 川贝母 2(0.47) 9、不明
陈皮 128(30.26) 5~20 10(66)、15(24)、12(22)、9(10) 牛蒡子 2(0.47) 15、15
枳实 74(17.49) 5~20 10(35)、15(17)、12(11)、9(7) 麝香 2(0.47) 0.15、0.5
瓜蒌 72(17.02) 10~30 30(25)、15(15)、12(12)、10(9) 苏合香 2(0.47) 2、2
竹茹 64(15.13) 6~20 10(37)、15(13) 桔梗 1(0.24) 12
天竺黄 54(12.77) 6~20 10(26)、6(8)、15(7)、12(6) 昆布 1(0.24) 12
橘红 54(12.77) 5~30 10(26)、12(13)、9(5) 紫苏子 1(0.24) 20
僵蚕 53(12.53) 6~20 10(35)、6(5) 桑白皮 1(0.24) 30
远志 48(11.35) 5~30 10(21)、15(11)、6(7) 细辛 1(0.24) 3
泽泻 22(5.20) 5~30 15(10)、10(5)、30(5) 射干 1(0.24) 12
白附子 21(4.96) 3~20 6(6)、5(5) 橘络 1(0.24) 10
生姜 12(2.84) 3~15 浙贝母 1(0.24) 不明
厚朴 11(2.60%) 5~15
芥子 10(2.36%) 3~15
竹沥 10(2.36%) 10~30 10(5)
桂枝 7(1.65%) 5~12
牡蛎 5(1.18%) 20~30
), ArticleFig(id=1261377084442685918, tenantId=1146029695717560320, journalId=1146123166801305609, articleId=1261262691084133001, language=EN, label=Table 2, caption=

Statistics of the frequency, dose range, and high-frequency dosage of expectorant (the frequency of this dosage ≥3) in commonly used Huatan prescriptions for convalescent ischemic stroke

, figureFileSmall=null, figureFileBig=null, tableContent=
药材 频次/次
(方剂占比/%)
剂量范围/g 高频剂量/g(频次/次) 药材 频次/次
(方剂占比/%)
剂量/g
半夏 44(53.66) 9~18 10(14)、12(10)、15(9)、9(8) 白附子 2(2.44) 5、10
天南星 32(39.02) 6~15 10(13)、6(8)、15(5)、12(4) 竹沥 2(2.44) 9、30
茯苓 30(36.59) 6~20 15(10)、12(6)、10(5)、20(4) 厚朴 2(2.44) 9、10
陈皮 25(30.49) 5~15 10(12)、15(3)、12(3) 泽泻 2(2.44) 25、不明
石菖蒲 25(30.49) 5~20 15(9)、10(8) 川贝母 1(1.22) 12
甘草 18(21.95) 3~15 6(12)、3(4) 桔梗 1(1.22) 4.5
天竺黄 11(13.41) 6~15 枇杷叶 1(1.22) 10
枳实 10(12.20) 6~15 10(4) 桂枝 1(1.22) 10
僵蚕 10(12.20) 5~20 10(5) 生姜 1(1.22) 6
竹茹 9(10.98) 6~15 10(4) 细辛 1(1.22) 3
瓜蒌 8(9.76) 10~30 橘皮 1(1.22) 10
远志 6(7.32) 6~12 莱菔子 1(1.22) 10
橘红 5(6.10) 9~20 麝香 1(1.22) 0.5
), ArticleFig(id=1261377085227020773, tenantId=1146029695717560320, journalId=1146123166801305609, articleId=1261262691084133001, language=CN, label=表2, caption=

缺血性脑卒中康复期常用化痰方剂中化痰药物出现频次、剂量范围和高频剂量(指该剂量在单味药中出现频次≥ 3)统计

, figureFileSmall=null, figureFileBig=null, tableContent=
药材 频次/次
(方剂占比/%)
剂量范围/g 高频剂量/g(频次/次) 药材 频次/次
(方剂占比/%)
剂量/g
半夏 44(53.66) 9~18 10(14)、12(10)、15(9)、9(8) 白附子 2(2.44) 5、10
天南星 32(39.02) 6~15 10(13)、6(8)、15(5)、12(4) 竹沥 2(2.44) 9、30
茯苓 30(36.59) 6~20 15(10)、12(6)、10(5)、20(4) 厚朴 2(2.44) 9、10
陈皮 25(30.49) 5~15 10(12)、15(3)、12(3) 泽泻 2(2.44) 25、不明
石菖蒲 25(30.49) 5~20 15(9)、10(8) 川贝母 1(1.22) 12
甘草 18(21.95) 3~15 6(12)、3(4) 桔梗 1(1.22) 4.5
天竺黄 11(13.41) 6~15 枇杷叶 1(1.22) 10
枳实 10(12.20) 6~15 10(4) 桂枝 1(1.22) 10
僵蚕 10(12.20) 5~20 10(5) 生姜 1(1.22) 6
竹茹 9(10.98) 6~15 10(4) 细辛 1(1.22) 3
瓜蒌 8(9.76) 10~30 橘皮 1(1.22) 10
远志 6(7.32) 6~12 莱菔子 1(1.22) 10
橘红 5(6.10) 9~20 麝香 1(1.22) 0.5
), ArticleFig(id=1261377088028815852, tenantId=1146029695717560320, journalId=1146123166801305609, articleId=1261262691084133001, language=EN, label=Table 3, caption=

Statistics of the frequency, dose range, and high-frequency dosage of expectorant (the frequency of this dosage ≥ 3) in commonly used Huatan prescriptions during the sequelae phase of ischemic stroke

, figureFileSmall=null, figureFileBig=null, tableContent=
药材 频次/次
(方剂占比/%)
剂量/g 高频剂量/g
(频次/次)
药材 频次/次(方剂占比/%) 剂量/g
天南星 10(76.92) 6~30 10(3)、6(3) 枳实 2(15.38) 10、10
半夏 9(69.23) 9~15 12(5) 远志 2(15.38) 6、不明
石菖蒲 6(46.15) 10~15 10(4) 甘草 2(15.38) 3、10
竹茹 3(23.08) 10、10、6 细辛 1(7.69) 3
茯苓 3(23.08) 6、10、15 厚朴 1(7.69) 9
僵蚕 3(23.08) 5、6、不明 麝香 1(7.69) 0.5
陈皮 2(15.38) 10、15
), ArticleFig(id=1261377088523743733, tenantId=1146029695717560320, journalId=1146123166801305609, articleId=1261262691084133001, language=CN, label=表3, caption=

缺血性脑卒中后遗症期常用化痰方剂中化痰药物出现频次、剂量范围和高频剂量(指该剂量在单味药中出现频次≥ 3)统计

, figureFileSmall=null, figureFileBig=null, tableContent=
药材 频次/次
(方剂占比/%)
剂量/g 高频剂量/g
(频次/次)
药材 频次/次(方剂占比/%) 剂量/g
天南星 10(76.92) 6~30 10(3)、6(3) 枳实 2(15.38) 10、10
半夏 9(69.23) 9~15 12(5) 远志 2(15.38) 6、不明
石菖蒲 6(46.15) 10~15 10(4) 甘草 2(15.38) 3、10
竹茹 3(23.08) 10、10、6 细辛 1(7.69) 3
茯苓 3(23.08) 6、10、15 厚朴 1(7.69) 9
僵蚕 3(23.08) 5、6、不明 麝香 1(7.69) 0.5
陈皮 2(15.38) 10、15
), ArticleFig(id=1261377089362604537, tenantId=1146029695717560320, journalId=1146123166801305609, articleId=1261262691084133001, language=EN, label=Table 4, caption=

Statistics on the distribution characteristics of the Siqi of expectorant in commonly used Huatan prescriptions for ischemic stroke at different stages

, figureFileSmall=null, figureFileBig=null, tableContent=
急性期 康复期 后遗症期
药性 频次/
频率/
%
药性 频次/
频率/
%
药性 频次/
频率/
%
753 44.11 145 58.00 32 71.11
419 24.55 60 24.00 8 17.78
207 12.13 23 9.20 微寒 5 11.11
165 9.67 微寒 21 8.40
微寒 148 8.67 微温 1 0.40
微温 15 0.88
), ArticleFig(id=1261377090155328003, tenantId=1146029695717560320, journalId=1146123166801305609, articleId=1261262691084133001, language=CN, label=表4, caption=

缺血性脑卒中不同时期常用化痰方剂中化痰药四气分布特点统计

, figureFileSmall=null, figureFileBig=null, tableContent=
急性期 康复期 后遗症期
药性 频次/
频率/
%
药性 频次/
频率/
%
药性 频次/
频率/
%
753 44.11 145 58.00 32 71.11
419 24.55 60 24.00 8 17.78
207 12.13 23 9.20 微寒 5 11.11
165 9.67 微寒 21 8.40
微寒 148 8.67 微温 1 0.40
微温 15 0.88
), ArticleFig(id=1261377092223119887, tenantId=1146029695717560320, journalId=1146123166801305609, articleId=1261262691084133001, language=EN, label=Table 5, caption=

Statistics on the distribution characteristics of the five flavors of expectorant in commonly used Huatan prescriptions for ischemic stroke at different stages

, figureFileSmall=null, figureFileBig=null, tableContent=
急性期 康复期 后遗症期
药性 频次/
频率/
%
药性 频次/
频率/
%
药性 频次/
频率/
%
897 31.73 168 40.00 37 48.68
714 25.26 109 25.95 23 30.26
600 21.22 83 19.76 8 10.53
209 7.39 32 7.62 3 3.95
微辛 208 7.36 10 2.38 3 3.95
74 2.62 10 2.38 2 2.63
微苦 63 2.23 微苦 8 1.90
62 2.19
), ArticleFig(id=1261377092692881943, tenantId=1146029695717560320, journalId=1146123166801305609, articleId=1261262691084133001, language=CN, label=表5, caption=

缺血性脑卒中不同时期常用化痰方剂所涉及化痰药物五味分布特点统计

, figureFileSmall=null, figureFileBig=null, tableContent=
急性期 康复期 后遗症期
药性 频次/
频率/
%
药性 频次/
频率/
%
药性 频次/
频率/
%
897 31.73 168 40.00 37 48.68
714 25.26 109 25.95 23 30.26
600 21.22 83 19.76 8 10.53
209 7.39 32 7.62 3 3.95
微辛 208 7.36 10 2.38 3 3.95
74 2.62 10 2.38 2 2.63
微苦 63 2.23 微苦 8 1.90
62 2.19
), ArticleFig(id=1261377092999066140, tenantId=1146029695717560320, journalId=1146123166801305609, articleId=1261262691084133001, language=EN, label=Table 6, caption=

Statistics on the distribution characteristics of the meridian tropism of expectorant in commonly used Huatan prescriptions for ischemic stroke at different stages

, figureFileSmall=null, figureFileBig=null, tableContent=
急性期 康复期 后遗症期
归经 频次/
频率/
%
归经 频次/
频率/
%
归经 频次/
频率/
%
肺经 1 398 27.82 肺经 201 26.14 肺经 36 27.07
脾经 1 193 23.74 脾经 172 22.37 脾经 30 22.56
心经 704 14.01 心经 149 19.38 肝经 22 16.54
肝经 664 13.21 肝经 101 13.13 心经 18 13.53
胃经 664 13.21 胃经 89 11.57 胃经 17 12.78
肾经 245 4.88 肾经 37 4.81 肾经 6 4.51
大肠经 81 1.61 大肠经 10 1.30 胆经 3 2.26
胆经 69 1.37 胆经 9 1.17 大肠经 1 0.75
膀胱经 7 0.14 膀胱经 1 0.13
), ArticleFig(id=1261377093561102887, tenantId=1146029695717560320, journalId=1146123166801305609, articleId=1261262691084133001, language=CN, label=表6, caption=

缺血性脑卒中不同时期常用化痰方剂所涉及化痰药物药性归经分布特点统计

, figureFileSmall=null, figureFileBig=null, tableContent=
急性期 康复期 后遗症期
归经 频次/
频率/
%
归经 频次/
频率/
%
归经 频次/
频率/
%
肺经 1 398 27.82 肺经 201 26.14 肺经 36 27.07
脾经 1 193 23.74 脾经 172 22.37 脾经 30 22.56
心经 704 14.01 心经 149 19.38 肝经 22 16.54
肝经 664 13.21 肝经 101 13.13 心经 18 13.53
胃经 664 13.21 胃经 89 11.57 胃经 17 12.78
肾经 245 4.88 肾经 37 4.81 肾经 6 4.51
大肠经 81 1.61 大肠经 10 1.30 胆经 3 2.26
胆经 69 1.37 胆经 9 1.17 大肠经 1 0.75
膀胱经 7 0.14 膀胱经 1 0.13
), ArticleFig(id=1261377093863092783, tenantId=1146029695717560320, journalId=1146123166801305609, articleId=1261262691084133001, language=EN, label=Table 7, caption=

Statistics on the number of commonly used Huatan prescriptions in three periods of ischemic stroke

, figureFileSmall=null, figureFileBig=null, tableContent=
急性期 康复期 后遗症期
方剂药
味数
出现频
次/次
方剂占
比/%
方剂药
味数
出现频
次/次
方剂占
比/%
方剂药
味数
出现频
次/次
方剂占
比/%
4 5 1.18 5 1 1.22 4 1 7.69
5 5 1.18 6 6 7.32 8 3 23.08
6 11 2.60 7 5 6.10 9 1 7.69
7 15 3.55 8 9 10.98 10 1 7.69
8 33 7.80 9 7 8.54 11 2 15.38
9 45 10.64 10 7 8.54 12 2 15.38
10 63 14.89 11 6 7.32 13 2 15.38
11 58 13.71 12 13 15.85 14 1 7.69
12 53 12.53 13 13 15.85
13 53 12.53 14 9 10.98
14 44 10.40 15 3 3.66
15 12 2.84 16 2 2.44
16 10 2.36 18 1 1.22
17 9 2.13
18 2 0.47
19 4 0.95
20 1 0.24
), ArticleFig(id=1261377094211220021, tenantId=1146029695717560320, journalId=1146123166801305609, articleId=1261262691084133001, language=CN, label=表7, caption=

缺血性脑卒中3个时期常用化痰方剂的药味数量使用频次、频率统计

, figureFileSmall=null, figureFileBig=null, tableContent=
急性期 康复期 后遗症期
方剂药
味数
出现频
次/次
方剂占
比/%
方剂药
味数
出现频
次/次
方剂占
比/%
方剂药
味数
出现频
次/次
方剂占
比/%
4 5 1.18 5 1 1.22 4 1 7.69
5 5 1.18 6 6 7.32 8 3 23.08
6 11 2.60 7 5 6.10 9 1 7.69
7 15 3.55 8 9 10.98 10 1 7.69
8 33 7.80 9 7 8.54 11 2 15.38
9 45 10.64 10 7 8.54 12 2 15.38
10 63 14.89 11 6 7.32 13 2 15.38
11 58 13.71 12 13 15.85 14 1 7.69
12 53 12.53 13 13 15.85
13 53 12.53 14 9 10.98
14 44 10.40 15 3 3.66
15 12 2.84 16 2 2.44
16 10 2.36 18 1 1.22
17 9 2.13
18 2 0.47
19 4 0.95
20 1 0.24
), ArticleFig(id=1261377094509015615, tenantId=1146029695717560320, journalId=1146123166801305609, articleId=1261262691084133001, language=EN, label=Table 8, caption=

Association rules analysis of high-frequency traditional Chinese medicine(Frequency of use during acute phase ≥ 90 and rehabilitation phase ≥ 20)

, figureFileSmall=null, figureFileBig=null, tableContent=
中药组合(急性期) 支持度/% 置信度/% 提升度 中药组合(康复期) 支持度/% 置信度/% 提升度
半夏→天麻 53.08 88.04 1.17 川芎→当归 54.17 86.54 1.43
半夏→茯苓 51.92 92.96 1.23 半夏→南星 45.83 84.09 1.30
半夏→甘草 45.00 85.90 1.14 当归→赤芍 44.79 83.72 1.55
天麻→白术 43.08 83.48 1.57 川芎→赤芍 44.79 81.40 1.35
半夏→白术 43.08 92.86 1.23 川芎→黄芪 42.71 80.49 1.33
天麻→白术,半夏 40.00 87.98 1.66 半夏→茯苓 41.67 87.50 1.36
半夏→白术,天麻 35.96 97.86 1.30 半夏→陈皮 39.58 94.74 1.47
天麻→白术,茯苓 33.46 85.06 1.60 桃仁→红花 37.50 86.11 2.43
半夏→白术,茯苓 33.46 92.53 1.23 当归→红花 37.50 80.56 1.49
白术→茯苓,天麻 32.50 87.57 2.03 川芎→红花 37.50 80.56 1.33
半夏→茯苓,天麻 32.50 97.63 1.30 川芎→赤芍,当归 37.50 88.89 1.47
当归→赤芍,川芎 36.46 91.43 1.69
), ArticleFig(id=1261377094706147908, tenantId=1146029695717560320, journalId=1146123166801305609, articleId=1261262691084133001, language=CN, label=表8, caption=

高频中药关联规则分析(急性期使用频数≥90,康复期使用频数≥20)

, figureFileSmall=null, figureFileBig=null, tableContent=
中药组合(急性期) 支持度/% 置信度/% 提升度 中药组合(康复期) 支持度/% 置信度/% 提升度
半夏→天麻 53.08 88.04 1.17 川芎→当归 54.17 86.54 1.43
半夏→茯苓 51.92 92.96 1.23 半夏→南星 45.83 84.09 1.30
半夏→甘草 45.00 85.90 1.14 当归→赤芍 44.79 83.72 1.55
天麻→白术 43.08 83.48 1.57 川芎→赤芍 44.79 81.40 1.35
半夏→白术 43.08 92.86 1.23 川芎→黄芪 42.71 80.49 1.33
天麻→白术,半夏 40.00 87.98 1.66 半夏→茯苓 41.67 87.50 1.36
半夏→白术,天麻 35.96 97.86 1.30 半夏→陈皮 39.58 94.74 1.47
天麻→白术,茯苓 33.46 85.06 1.60 桃仁→红花 37.50 86.11 2.43
半夏→白术,茯苓 33.46 92.53 1.23 当归→红花 37.50 80.56 1.49
白术→茯苓,天麻 32.50 87.57 2.03 川芎→红花 37.50 80.56 1.33
半夏→茯苓,天麻 32.50 97.63 1.30 川芎→赤芍,当归 37.50 88.89 1.47
当归→赤芍,川芎 36.46 91.43 1.69
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基于临床数据挖掘化痰中药治疗缺血性脑卒中的应用特点
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李洵 1, 2 , 井卫朋 1, 2 , 方晓艳 1, 2 , 李艳 1, 2 , 苗明三 1, 2, *
科学技术与工程 | 论文·医药、卫生 2025,25(20): 8435-8444
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科学技术与工程 | 论文·医药、卫生 2025, 25(20): 8435-8444
基于临床数据挖掘化痰中药治疗缺血性脑卒中的应用特点
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李洵1, 2 , 井卫朋1, 2, 方晓艳1, 2, 李艳1, 2, 苗明三1, 2, *
作者信息
  • 1 河南中医药大学药学院, 郑州 450046
  • 2 豫药全产业链研发河南省协同创新中心, 郑州 450046
  • 李洵(1991—),男,汉族,河南许昌人,博士。研究方向:中药学。E-mail:

通讯作者:

* 苗明三(1965—),男,汉族,河南新乡人,博士,教授,博士研究生导师。研究方向:中药学。E-mail:
Application Characteristics of Expectorant in Traditional Chinese Medicine for Treating Ischemic Stroke Based on Clinical Data Mining
Xun LI1, 2 , Wei-peng JING1, 2, Xiao-yan FANG1, 2, Yan LI1, 2, Ming-san MIAO1, 2, *
Affiliations
  • 1 School of Pharmacy, Henan University of Chinese Medicine, Zhengzhou 450046, China
  • 2 Collaborative Innovation Center of Research and Development on the Whole Industry Chain of Yu-Yao, Zhengzhou 450046, China
出版时间: 2025-07-18 doi: 10.12404/j.issn.1671-1815.2404280
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为探究近年来治疗缺血性脑卒中常用化痰方剂中化痰药的用药特点。以“化痰/祛痰/涤痰/豁痰/导痰/滚痰/半夏白术天麻汤/星蒌承气汤/温胆汤/二陈汤/小陷胸汤/羚角钩藤汤/解语丹”+ “缺血性中风/缺血性脑卒中/脑缺血/脑梗死/脑梗塞/脑栓塞/脑血栓” +“临床”为主题词在中国知网(1986年5月1日—2024年4月1日)中进行高级检索,筛选出符合标准的文献,采用Excel和IBM SPSS Modeler 18.0软件对数据进行统计分析。化痰方剂中以半夏和天南星为缺血性脑卒中不同时期中使用频率最高的两味化痰药,其次为茯苓、石菖蒲、陈皮和甘草等;大多数化痰药的高频使用剂量在均在10~15 g。在四气五味统计中,缺血性脑卒中不同时期化痰药均以温、平、辛、苦、甘出现频率最高;归经统计中,不同时期化痰药都以肺、脾经为主。在化痰方剂药味统计中,急性期和康复期均以由8~14味药组成的方剂最常见,约占各自总频数的82.51%和78.05%;关联规则分析中得到25个支持度较高的中药组合,以化痰熄风通络药和化痰活血祛风药等配伍较多;方剂基本都采用中药饮片汤剂煎煮服药方式,且多与西药联合应用。临床上治疗缺血性脑卒中的常用化痰方剂中化痰药以半夏和天南星为主,大部分化痰药物的使用剂量范围在10~15 g,常用化痰方剂味药数以8~14味为主,研究成果为化痰中药和化痰方剂在缺血性中风治疗中的应用和从痰论治缺血性中风研究发展提供一定的参考和临床数据支持。

临床数据挖掘  /  缺血性中风  /  化痰方剂  /  药味数量  /  化痰药  /  使用频率  /  剂量范围  /  药性归经

In order to explore the medication characteristics of expectorants in the Huatan prescriptions commonly used in treating ischemic stroke recently. “Huatan/Qutan/Ditan/Huotan/Daotan/Guntan/Banxia Baizhu Tianma Decoction/Xinglou Chengqi Decoction/Wendan Decoction/Erchen Decoction/Xiao xianxiong Decoction/Lingjiao Gouteng Decoction/Jieyu Dan” + “ischemic stroke/cerebral ischemia/cerebral infarction/cerebral embolism/cerebral thrombus” + “clinical” as the main topic on the China National Knowledge Network (from May 1, 1986 to April 1, 2024) was used to investigate the medication characteristics of expectorants, and selected literature meeting the criteria. Statistical analysis of the data was performed using Excel and IBM SPSS Modeler 18.0 software. The results show that Banxia and Tian nan-xing are the most frequently used expectorants in different stages of ischemic stroke, followed by Fuling, Shi chang-pu, Chenpi, and Gancao. The dosages of most expectorants are 10~15 g. In the analysis of Siqi and five flavors, Wen, Ping, Xin, Ku, and Gan have the highest frequency of occurrence in different stages of ischemic stroke. In the analysis of meridian tropism, the lung and spleen meridian have the highest frequency of occurrence. Most Huatan prescriptions are composed of 8~14 herbs in both the acute and rehabilitation stages, accounting for 82.51% and 78.05% of the total frequency, respectively. In the analysis of association rules, 25 traditional Chinese medicine combinations with strong correlation strength are obtained, and the most combinations of herbs are Huatan-Xifeng-Tongluo and Huatan-Huoxue-Qufeng. Most Huatan prescriptions are administered through the traditional decoction method and generally used in combination with Western medicine. It is concluded that the commonly used expectorants in Huatan prescriptions for treating ischemic stroke are mainly Banxia and Tian nan-xing, and the dosage ranges of most expectorants are 10~15 g. The number of herbs in Huatan prescriptions is mainly 8~14. The research results provide references and clinical data support for the application of expectorant Chinese medicine and Huatan prescriptions in the treatment of ischemic stroke and the development of research on treating ischemic stroke from the perspective of phlegm.

clinical data mining  /  ischemic stroke  /  Huatan prescriptions  /  number of medications  /  expectorants  /  usage frequency  /  dose range  /  drug properties
李洵, 井卫朋, 方晓艳, 李艳, 苗明三. 基于临床数据挖掘化痰中药治疗缺血性脑卒中的应用特点. 科学技术与工程, 2025 , 25 (20) : 8435 -8444 . DOI: 10.12404/j.issn.1671-1815.2404280
Xun LI, Wei-peng JING, Xiao-yan FANG, Yan LI, Ming-san MIAO. Application Characteristics of Expectorant in Traditional Chinese Medicine for Treating Ischemic Stroke Based on Clinical Data Mining[J]. Science Technology and Engineering, 2025 , 25 (20) : 8435 -8444 . DOI: 10.12404/j.issn.1671-1815.2404280
脑血管病是中国常见病,以其高致残率、高死亡率和高复发率的特点严重危害人类的健康与生活质量,目前脑血管病是中国成年人致残和致死的第一位原因,并给患者带来巨大的经济负担[1]。其中,缺血性脑血管病患病率(即缺血性脑卒中)约占脑血管病总数的80%[2]
缺血性脑卒中指由各种原因所致的局部脑组织区域血液供应障碍,导致脑组织缺血缺氧性病变坏死,进而产生临床上对应的神经功能缺失表现[3-4]。目前对于缺血性脑卒中的治疗方法仍相对有限,由于脑缺血区域的病理损伤是逐渐加重发展的,所以超早期溶栓以恢复血液供应是国际公认的最为有效的治疗措施,但该方法对溶血系统影响较大,适用人群面较窄,并且有着严格的治疗时间窗。而中医药以其多途径、多靶点、多通路和用药毒副作用低的特点,这几十年来在脑缺血的治疗中一直受到广泛的重视、认可和应用[5-8]
脑缺血属于中医中风范畴。中风的基本病机为“本虚标实”,其中,“本虚”包括气血不足或肝肾阴虚,而“标实”主要指风、火、痰、瘀。实际上风、火、虚皆可生痰[9],且风、火都是无形走窜之邪气,不能留滞,在中风发病中只起到“动摇”的辅助作用,而与风、火相比,痰是有形之邪。中风的起病,多是由风、火挟动痰邪,阻滞经脉,蒙蔽清窍导致,所以有“中风无痰不病”之说[9]。此外,痰、瘀都是人体津血的病理产物,痰来自津,瘀来自血,“津血同源”,痰和瘀存在病理相关性,两者能够相互转化而致病。综上可知,痰在中风病机中的重要地位。
临床上应用化痰法治疗中风已是中医界的共识,化痰治法根据辨证可分为化痰通腑、化痰益气、化痰熄风、化痰通络、化痰祛湿、化痰开窍、化痰活血、化痰解毒等[10-11],但目前关注从痰论治中风的文献多数较为陈旧[12-15],且相关文献一般聚焦于中医病机探讨、本草古籍整理与名医用药经验分析[16-20],并未全面总结已发表临床数据中化痰方剂在缺血性脑卒中的应用特点、药味组成、使用频率、剂量范围和应用形式等内容。因此,有必要对近几十年来治疗缺血性脑卒中常用化痰方剂中化痰药的种类、使用频率、剂量范围、药性特点以及化痰方剂药味数量、高频中药关联规则和应用形式进行统计分析,以期为化痰方剂和化痰药的临床应用提供一定的参考。
以“中国知网(CNKI)”为数据库,分别以“化痰/祛痰/涤痰/豁痰/导痰/滚痰/半夏白术天麻汤/星蒌承气汤/温胆汤/二陈汤/小陷胸汤/羚角钩藤汤/解语丹” + “缺血性中风/缺血性脑卒中/脑缺血/脑梗死/脑梗塞/脑栓塞/脑血栓” + “临床”为主题词进行检索,选取时间为1986年5月1日—2024年4月1日,共检索到学术期刊文献44 997篇。
①纳入文献均来自临床观察数据;②文献明确表明对缺血性脑卒中临床治疗效果良好;③口服给药方式;④纳入文献均为化痰方剂联合西药常规治疗;⑤只统计基本方,随证加减药物不纳入统计。
①排除网络药理学、Meta及综述相关文献;②排除医案、经验和心得体会;③排除短暂性脑缺血;④排除治疗脑缺血并发症的文献;⑤排除预防性用药;⑥排除化痰方剂合用其他中医方剂、中药制剂或针灸康复治疗的文献;⑦排除重复计算的文献;⑧排除缺血性脑卒中未明确分期的文献;⑨排除化痰方剂药味数量未写明的文献;⑩排除疑似单用化痰方剂治疗的文献(剔除原因见讨论部分)。最终从44 997篇文献中筛选出符合标准的文献592篇。
①将文献分为缺血性脑卒中急性期(发病2周以内)、康复期(2周~6个月)和后遗症期(6个月以上);②化痰包含在其功效主治里的中药均录入;③记录方剂中每味化痰药及其不同炮制品的使用剂量;④统计方剂包括古方、自拟方和中成药,方剂名称相同但药物组成不同的计为不同方剂;⑤将方中化痰药名称、药性分类根据《中国药典(2020年版)》[21]和《中药学》[22]进行统一规范化处理,如将僵虫统一为僵蚕,将胆星、制胆星统一为胆南星;⑥一味化痰药有多个性味归经等的分别进行统计,炮制方法或者入药部位对中药药性有影响的另统计,如天南星性温,胆南星性凉,两者在药性四气中分开统计,同理瓜蒌、瓜蒌皮、瓜蒌子在药性归经中分开统计;⑦当化痰方剂同时应用于脑缺血不同分期时,在每个单独分期中该方剂都纳入统计;⑧颗粒剂、胶囊等不同中成药剂型但中药组成相同的算作同一方剂,并记录其换算成生药的剂量。
在符合标准的592篇文献中,从急性期开始服药的文献为520篇,一共记载方剂423个,涉及化痰药37味。恢复期用药的文献96篇,一共记载方剂82个,涉及化痰药26味。后遗症期用药的文献12篇,一共记载方剂13个,涉及化痰药13味。
将上述符合标准的中药方剂录入2007版Excel表格建立数据库并进行统计分析,采用IBM SPSS Modeler 18.0软件中Apriori算法建模进行关联规则分析,挖掘化痰方剂中的核心药物组合。
纳入符合急性期使用标准的化痰方剂423首,共涉及化痰药37味,累计用药频数为1 707次。将急性期化痰药按出现频数从高到低排序,如表1所示,使用频次最高的前6位药及其剂量范围分别为:半夏(292次,方剂占比69.03%),剂量范围5~20 g;天南星(230次,方剂占比54.37%),剂量范围5~30 g;茯苓(187次,方剂占比44.21%),剂量范围5~30 g;甘草(174次,方剂占比41.13%),剂量范围3~20 g;石菖蒲(151次,方剂占比35.70%),剂量范围3~30 g;陈皮(128次,方剂占比30.26%),剂量范围5~20 g。同时记录急性期单味化痰药中高频剂量的使用情况,如表1所示。
急性期化痰药不同炮制品或不同用药部位出现的频数和剂量范围也纳入统计,结果表明:半夏出现总频数为292次,其中写明为法半夏的119次,剂量范围6~20 g;清半夏27次,剂量范围9~15 g;姜半夏21次,剂量范围5~15 g;半夏曲和生半夏各1次,剂量均为10 g。天南星出现总频数为230次,其中写明为胆南星的207次,剂量范围5~30 g;其余制天南星出现频数为23次,剂量范围6~15 g。甘草出现总频数为174次,其中写明为炙甘草的62次,甘草112次,两者剂量均为3~20 g。瓜蒌出现总频数为72次,其中写明为瓜蒌皮的6次,剂量范围10~15 g;瓜蒌子出现3次剂量均为15 g。竹沥出现总频数为10次,其中姜竹沥出现1次,剂量为9 g。
纳入符合恢复期使用标准的化痰方剂82首,涉及化痰药26味,累计用药频数为250次。将恢复期化痰药按出现频数从高到低排序,如表2所示,使用频次最高的前6位药及其剂量范围分别为:半夏(44次,方剂占比53.66%),剂量范围9~18 g;天南星(32次,方剂占比39.02%),剂量范围6~15 g;茯苓(30次,方剂占比36.59%),剂量范围6~20 g;陈皮(25次,方剂占比30.49%),剂量范围5~15 g;石菖蒲(25次,30.49%),剂量范围5~20 g;甘草(18次,方剂占比21.95%),剂量范围3~15 g。同时,记录恢复期单味化痰药中高频剂量的使用情况,如表2所示。
此外,恢复期化痰药不同炮制品出现的频数和剂量范围也纳入统计,结果如下:半夏出现总频数为44次,其中写明为法半夏的16次,剂量范围9~15 g;清半夏的3次,剂量范围10~15 g;姜半夏出现2次均为10 g。天南星出现总频数为32次,其中写明为胆南星的29次,剂量范围6~15 g;其余制天南星出现频数为3次,剂量范围6~10 g。甘草出现总频数为18次,其中写明为炙甘草的5次,剂量范围3~15 g;剩余甘草出现频数13次,剂量范围3~10 g。
纳入符合后遗症期使用标准的化痰方剂13首,涉及化痰药13味,累计用药频数为45次。将后遗症期化痰药按出现频数从高到低排序,如表3所示,使用频次最高的前3位药及其剂量范围分别为天南星(10次,方剂占比22.22%),剂量范围6~30 g;半夏(9次,方剂占比20.00%),剂量范围9~15 g;石菖蒲(6次,方剂占比13.33%),剂量范围10~15 g,如表3所示。
统计后遗症期化痰药不同炮制品出现的频数和剂量范围,具体如下:天南星出现总频数为10次,其中,写明为胆南星的9次,剂量范围6~30 g;制天南星仅出现1次,为15 g。半夏出现总频数为9次,其中写明为法半夏的5次,剂量范围10~15 g;清半夏仅1次,为15 g。甘草出现总频数为2次,其中炙甘草出现1次,为3 g。
表4所示,急性期化痰药的四气涉及温、平、凉、寒等,无性热药物,四气出现频率以温44.11%、平24.55%、凉12.13%为主;康复期化痰药的四气涉及温、平、寒等,无性热和性凉药物,四气出现频率以温58.00%、平24.00%为主;后遗症期化痰药的四气仅涉及温、平、微寒。
急性期化痰药的五味均有涉及,五味出现频率以辛31.73%、苦25.26%、甘21.22%为主;康复期化痰药的五味均涉及,五味出现频率以辛40.00%、苦25.95%、甘19.76%为主;后遗症期化痰药的五味也均有涉及,五味出现频率以辛48.68%、苦30.26%、甘10.53%为主,如表5所示。
急性期化痰药的归经出现频率以肺经27.82%、脾经23.74%、心经14.01%、肝经13.21%、胃经13.21%为主,无药物归三焦经、小肠经和心包经;康复期化痰药的归经出现频率以肺经26.14%、脾经22.37%、心经19.38%、肝经13.13%、胃经11.57%为主,无药物归三焦经、小肠经和心包经;后遗症期化痰药的归经出现频率以肺经27.07%、脾经22.56%、肝经16.54%、心经13.53%、胃经12.78%为主,无药物归膀胱经、三焦经、小肠经和心包经,如表6所示。
在急性期使用的423首化痰方剂中,药味分布在4~20味,出现频率较高的药味数分别是10味(方剂占比14.89%)、11味(方剂占比13.71%)、12(方剂占比12.53%)、13味(方剂占比12.53%)、9味(方剂占比10.64%)和14味(方剂占比10.40%);在康复期使用的82首化痰方剂中,药味分布在5~18味,出现频率较高的药味数分别是12味(方剂占比15.85%)、13味(方剂占比15.85%)、8味(方剂占比10.98%)和14味(方剂占比10.98%);在后遗症期使用的13首化痰方剂中,药味分布在4~14味,出现频率较高的药味数分别是8味(方剂占比23.08%)、11味(方剂占比15.38%)、12味(15.38%)和13味(方剂占比15.38%),如表7所示。
采用IBM SPSS Modeler 18.0统计软件对化痰方剂中高频药物(急性期使用频数≥90,康复期使用频数≥20)进行关联规则分析,使用Apriori建模并进一步挖掘不同中药间的配伍关系,设置急性期支持度为32%,康复期支持度为36%,两期置信度均为80%,最大前项数均为5,提升度均 ≥ 1等条件挖掘出急性期和康复期化痰方剂中的潜在药物组合,得到急性期核心药物组合12组和康复期核心药物组合13组,统计结果如表8所示,两个时期高频药物关联“网格化展示”如图1图2所示。
在符合标准的592篇文献中,有570篇采取传统中药饮片汤剂煎煮服药方式,占总文献数的96.28%;有12篇文献采用颗粒剂冲泡的方式服用,占总文献数的2.03%;有9篇文献采用胶囊口服方式,占总文献数的1.52%;另有1篇文献采用丸剂口服方式,仅占总文献数的0.17%。
中风病机中讲到的痰,广义上指中风前后停积于脏腑经络之间各种各样的痰证,且痰作为其他病因转化而成的一种病理结果,反过来又可成为中风的致病因素。此外,狭义上痰也指中风后经呼吸道咳出的有形之痰。因此,痰既是中风的病因病机,又是中风时的症状表现[23]
痰邪与中风的密切关系早在《黄帝内经》中已有记录,《内经》称中风为“薄厥”“偏枯”“仆击”“大厥”等,如《素问·通评虚实论篇》载:“仆击、偏枯,肥贵人则高梁之疾也”,指出中风与嗜食高粱等肥甘厚味所滋生的痰邪有关[24]。元朝朱震亨继承并发扬了这个观点,他认为“痰生热,热生风”“中风大率主血虚有痰,治痰为先”,更有“痰一化,窍自开,络自通,风自灭”之说,明确指出风、火皆因痰而生,并随痰而祛[9]。此外,气虚、气滞、血虚、血瘀和寒热失常,均是形成痰饮的重要因素[23]。可见风、火、气、血、虚、瘀皆与痰相关,痰是中风的首要病因之一。
当代医家均强调痰浊在中风病机里的重要作用,早在20世纪80年代,王永炎等[25]针对中风病提出了化痰通腑疗法,他认为缺血性脑卒中急性期的病人,其病机虽有本虚,但是更侧重标实,标实以痰浊、瘀血为主。近年来,学者们在遵循中医辩证原则的条件下,试图对中医辩证标准进行客观具体的量化,通过对缺血性脑卒中的证候分型进行科学规范的研究。结果表明,痰证是缺血性脑卒中的主要证候之一,并且痰证候始终贯穿缺血性中风的3个阶段,包括急性期、恢复期和后遗症期[26-33]
由此可见,痰在中风病机中的重要地位,但现存有关从痰论治中风的文献多关注于古籍挖掘、个案或名医用药经验报道[16-20],并未有文献对目前临床已发表数据中有关治疗缺血性中风的化痰药或化痰方剂进行全面的总结与分析。因此,基于知网中数量众多的应用化痰方剂治疗缺血性脑卒中的临床报道数据,对此次所搜集到符合标准的文献中的化痰方剂及其化痰药进行统计和分析。
从前文统计结果来看,半夏和天南星为缺血性脑卒中3个时期中使用频率最高的两味化痰药,其次为茯苓、甘草、陈皮、石菖蒲等;中医有“传方传药不传量”之说,临床中药的使用剂量对于疗效至关重要,通过对比各个时期化痰药的剂量范围和高频剂量使用情况,能看出不同时期大多数化痰药的高频使用剂量均在10~15 g。此外,从天南星和半夏不同炮制品的使用频率和剂量范围来看,胆南星使用频次占到天南星总频次的绝大部分,且胆南星的使用剂量范围普遍比制天南星剂量范围更大;而法半夏在写明半夏具体炮制方式的文献中出现次数最多。
表4~表6所示,缺血性脑卒中所用化痰药在3个时期的高频性味和归经分布特点较为一致。具体从四气使用特点来看,3个时期化痰药均以温、平出现频率最高,其次为凉、寒或微寒。从五味使用特点来看,3个时期化痰药都以辛、苦、甘最常见。最后,从归经特点来看,3个时期化痰药都以肺、脾经为主,其次为心、肝、胃、肾经。
中医讲“急病单病用精方,慢病合病用围方”[34-35]。围方一般指药味较多、单味药剂量偏小的处方,精方一般指药味较少、单味药用量较大的处方,但目前精方和围方的用药味数和剂量范围并无明确的划分标准。
据统计《伤寒杂病论》经方平均单剂药味数为4.18味[36],如果以3个时期化痰方剂使用药味≤ 5为划分标准分析此次数据,那么所得出的使用频率过小而意义不大,如表7所示。《重剂起沉疴》一书中指出,8味药以内的方剂,《伤寒杂病论》占94.7%,《金匮要略》占92.7%,《肘后备急方》占82.2%,《普济本事方》占72.2%,《世医得效方》占76.3%,《医学衷中参西录》占86.2%。因此,如果以≤8味为划分标准,那么3个时期 ≤ 8 味的化痰方剂使用频率分别为:16.31%、25.61%和30.77%;相反,≥ 8味的化痰方剂在这3个时期的使用频率均占大多数,出现这种情况的部分原因可能为现代社会面对缺血性脑卒中此类危急重症时处理方法选择更多,中药汤剂仅作为联合辅助治疗的缘故。
此外,从3个时期化痰方剂高频药味数的分布情况来看,急性期由8~14味药组成的化痰方剂最为常见,约占急性期化痰方总频数的82.51%;康复期也由8~14味药组成的化痰方剂最为常见,约占康复期化痰方总频数的78.05%;而后遗症期不同药味出现频数较为平均,如表7所示。
由前文高频中药关联规则分析结果可见,支持度相对较高的急性期中药组合为:半夏→天麻、半夏→茯苓、半夏→甘草、天麻→白术、半夏→白术、天麻→白术-半夏等;支持度相对较高的康复期中药组合为:川芎→当归、半夏→南星、当归→赤芍、川芎→赤芍、川芎→黄芪、半夏→茯苓、半夏→陈皮等;该结果与化痰药使用频率统计结果相对一致。从高支持度的中药组合配伍关系来看,急性期治法以化痰熄风通络、化痰渗湿健脾、化痰益气燥湿等较为常见,康复期治法以化痰活血祛风、化痰补血活血、化痰清热活血、化痰益气活血、化痰渗湿健脾、化痰理气燥湿等多见。
在前期搜集和筛选资料过程中,发现疑似单用化痰方剂治疗缺血性脑卒中的文献仅为8篇,由于这些文献未明确记录给予化痰方剂治疗同时有无西医基础治疗,是否为单独使用化痰方剂治疗尚存疑,并且从报道时间上看,这些文献多为20年前的报道,因此该8篇疑似单用文献在数据分析中予以排除。在纳入统计分析的592篇文献中,均为西药基础治疗的同时联合中药作为辅助治疗。从治疗效果来看,与单纯西药组相比,联合治疗组都展示出显著的改善作用,表明中药联合治疗是一种有效的补充替代手段。最后,在应用形式上化痰方剂仍以传统中药饮片汤剂煎煮服药的方式最为多见。
(1)化痰方剂中以半夏和天南星为缺血性脑卒中不同时期使用频率最高的两味化痰药,其次为茯苓、石菖蒲、陈皮和甘草等;中医不传之秘在于剂量,这也是本次数据挖掘将剂量范围和高频剂量纳入统计的原因,从剂量范围来看,3个时期大多数化痰药的高频使用剂量在均在10~15 g;从半夏和天南星不同炮制品的应用来看,法半夏和胆南星是常见的炮制方式。在四气五味和归经统计中,缺血性脑卒中不同时期化痰药以温、平、辛、苦、甘和肺、脾经出现频率最高。从化痰方剂用药味数的使用频率看,急性期和康复期均以由8~14味药组成的方剂最常见,约占各自总频数的82.51%和78.05%。从化痰方剂中高支持度中药组合关系上看,急性期以化痰熄风通络药、化痰渗湿健脾药、化痰益气燥湿药等配伍较为常见,康复期以化痰活血祛风药、化痰补血活血药、化痰清热活血药、化痰益气活血药等配伍较为多见。最后应用形式上,化痰方剂仍以传统中药饮片汤剂煎煮服药方式为主,占比达96.28%。
(2)基于知网数据库中报道的大量临床资料,本研究首次全面系统的对治疗缺血性脑卒中常用化痰方剂的药味数量、高频药物关联配伍特点、应用形式以及化痰方剂中化痰药的种类、使用频率、使用剂量和药性归经进行统计分析,希望为化痰药和化痰方剂在缺血性中风治疗中的应用提供适当的临床数据支持,并为从痰论治缺血性中风进一步研究发展提供一些可参考的理论依据。
  • 河南省重大公益专项(201300310100)
  • 河南省重大科技专项(221100310400)
  • 岐黄学者(国中医药人教函2022-6)
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2025年第25卷第20期
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doi: 10.12404/j.issn.1671-1815.2404280
  • 接收时间:2024-06-08
  • 首发时间:2026-05-13
  • 出版时间:2025-07-18
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  • 收稿日期:2024-06-08
  • 修回日期:2025-04-08
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河南省重大公益专项(201300310100)
河南省重大科技专项(221100310400)
岐黄学者(国中医药人教函2022-6)
作者信息
    1 河南中医药大学药学院, 郑州 450046
    2 豫药全产业链研发河南省协同创新中心, 郑州 450046

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* 苗明三(1965—),男,汉族,河南新乡人,博士,教授,博士研究生导师。研究方向:中药学。E-mail:
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2种不同金属材料的力学参数

Family
属数
Number of
genus
种数
Number of
species
占总种数比例
Percentage of
total species (%)

Genus
种数
Number of
species
占总种数比例
Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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