基于复杂网络探析国医大师郭诚杰治疗原发性痛经医案病-症-证-药关联规律*
作者：焦小玉1，王 渊1,2，姚 乐1，吴 驰1，李彬锋3
单位：1.陕西中医药大学针灸推拿学院，陕西 咸阳 712046； 2.陕西省针药结合重点实验室，陕西 咸阳 712046； 3.陕西中医药大学附属医院，陕西 咸阳 712000
引用：引用：焦小玉，王渊，姚乐，吴驰，李彬锋.基于复杂网络探析国医大师郭诚杰治疗原发性痛经医案病-症-证-药关联规律[J].中医药导报,2025,31(7):150-157.
DOI：10.13862/j.cn43-1446/r.2025.07.026
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摘要：
目的：基于复杂网络研究国医大师郭诚杰治疗原发性痛经（PD）的用药规律及处方思路，探索其病-症-证-药关联关系。方法：收集2011年6月至2016年9月郭诚杰诊治PD的临床医案。运用Microsoft Excel 2021对患者的一般资料、症状体征、舌质、舌苔、脉象、中药处方等信息提取与整理，建立标准化、规范化的医案数据库。利用频数统计、关联规则分析、聚类分析、因子分析和复杂网络分析等方法发掘隐含在医案中的诊疗信息。结果：共纳入病例103例，筛选处方258份，涉及185味中药，用药总频数为3 054。就诊者年龄多分布在20~49岁，病例共涉及153种症状体征、10种舌质、舌苔和脉象。高频药物包括当归、香附、川芎、延胡索、黄芪等，药性以温、寒、平为主，药味以甘、苦、辛居多，归经以肝经、脾经为主，功效以补虚、活血化瘀、理气类为主。关联规则分析得出高频药物组合模式20组，因子分析共提取出9个常用中药组合，药物聚类分为5类潜在药物群，通过k-core层次分析法筛选出当归、香附、川芎、黄芪、生地黄、延胡索等57个核心药物。结论：郭诚杰治疗PD提倡“病-症-证”结合法，首重肝脾，贵在治血，以“疏肝郁、通胞络、调冲任、补气血”为治疗原则，标本兼治，用药甘温并济，苦寒佐助，忌用大寒大热之品的特点，核心组方数量丰富，遣方多变，用药精专。
关键词：原发性痛经；复杂网络；用药规律；关联分析；国医大师；郭诚杰
Abstract：
Objective:
To study the medication rules and prescription strategies of traditional Chinese
medicine (TCM) master GUO Chengjie in the treatment of primary dysmenorrhea (PD) based on complex
networks, and to explore the association between disease, symptom, syndrome,
and medicine. Methods: The clinical cases of PD treated by GUO Chengjie from June
2011 to September 2016 were collected. Microsoft Excel 2021 was used to extract
and sort out information such as patients' general data, symptoms and signs,
tongue texture, tongue coating, pulse conditions, and herbal prescriptions,
thereby establishing a standardized medical case database. Methods including
frequency statistics, association rule analysis, cluster analysis, factor
analysis, and complex network analysis were applied to explore the implicit
diagnostic and therapeutic information in the medical cases. Results: A total
of 103 cases were included, with 258 prescriptions screened, involving 185
kinds of Chinese herbs, and the total frequency of medication was 3,054. The
ages of the patients were mostly distributed between 20 to 49 years old. The
cases involved 153 symptoms and signs, 10 types of tongue texture, tongue
coating, and pulse conditions. High-frequency herbs included Danggui (Angelicae
Sinensis Radix), Xiangfu (Cyperi Rhizoma), Chuanxiong (Chuanxiong Rhizoma),
Yanhusuo (Corydalis Rhizoma), Huangqi (Astragali Radix), etc. The medicinal
properties were mainly warm, cold, and neutral. The flavors were mostly sweet,
bitter, and pungent. The meridians tropism were mainly the liver meridian and
spleen meridian, and the effects were mainly tonifying deficiency, promoting
blood circulation to remove blood stasis, and regulating Qi. The association
rule analysis yielded 20 groups of high-frequency herb combinations, factor
analysis extracted 9 common herbal combinations, cluster analysis divided the
herbs into 5 potential drug groups, and 57 core herbs such as Danggui
(Angelicae Sinensis Radix), Xiangfu (Cyperi Rhizoma), Chuanxiong (Chuanxiong
Rhizoma), Huangqi (Astragali Radix), Shengdihuang (Rehmanniae Radix Exsiccata
seu Recens), and Yanhusuo (Corydalis Rhizoma) were screened out through k-core
hierarchical analysis. Conclusion: GUO Chengjie advocates the
"disease-symptom-syndrome" integration method in the treatment of PD,
with primary focus on the liver and spleen and emphasis on regulating blood. He
takes "soothing liver depression, dredging collaterals, regulating Chong
and Ren, tonifying Qi and blood" as the treatment principle, and treats
both the symptoms and the root causes. His medication features the combination
of sweet-warm herbs, assistance of bitter-cold herbs, and avoidance of
extremely cold or hot herbs. The core prescriptions are abundant, with flexible
formulation and precise medication.
Key words：primary dysmenorrhea; complex network; medication rule; association analysis; National TCM Master; GUO Chengjie
发布时间：2026-01-06
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