Study On The Law Of Prescription Compatibility And Medicine Use For Collateral Disease Of Ancient Representative Physicians In The Treatment Of Stroke

Objective: To analyze the compatibility characteristics of ancient representative physicians’ stroke prescriptions and discuss the rule of medicine use for collateral disease based on collateral disease theory.Methods: Study selected 236 stroke prescriptions by representative physicians in Han and Tang Dynasties,Song,Jin and Yuan Dynasties,Ming Dynasty,and Qing Dynasty four periods,using the traditional philology research method,prescription metrology research method,and data mining research method,making use of ancient and modern consilia cloud platform to analyze the included prescriptions,including the number analysis of traditional Chinese medicine,four qi analysis,five flavor analysis,channel tropism analysis,efficacy analysis,high-frequency medicine analysis,high-frequency medicine cluster analysis,association analysis between two traditional Chinese medicines,complex network analysis between two traditional Chinese medicines,and statistical analysis of medicine use for collateral disease in stroke prescriptions.Results:(1)In terms of four qi,five flavors,and channel tropism,the medicines for treating stroke were mainly pungent and warm medicines,and their channel tropisms were lung and spleen channels in Han,Tang,Song,Jin and Yuan Dynasties.The medicines for treating stroke were mainly sweet and warm medicines,and their channel tropisms were spleen,heart,and kidney channels in Ming Dynasty.The medicines for treating stroke were mainly sweet and warm medicines,and their channel tropisms were lung and liver channels in Qing Dynasty.(2)In terms of the number of traditional Chinese medicine in a prescription,high-frequency medicine,and high-frequency efficacy,the average number of herbs per prescription was 14.34,and the high-frequency medicines included cinnamon,saponikovia,ephedra,licorice,radix aconiti carmichaeli,ligusticum wallichii,and the high-frequency efficacy was tonifying fire,helping yang,dispelling wind,and relieving pain in Han and Tang Dynasties.The average number of herbs per prescription was 12.64,and the high-frequency medicines included licorice,saponikovia,ligusticum wallichii,ginseng,scutellaria baicalensis,ginger,and the high-frequency efficacy was removing wind,reliving pain,reliving exterior syndrome,and dispelling cold in Song,Jin and Yuan Dynasties.The average number of herbs per prescription was 7.38,and the high-frequency medicines included licorice,prepared rehmannia root,ginseng,angelica sinensis,poria cocos,ginger,and the high-frequency efficacy was clearing heat,removing toxicity,invigorating spleen,replenishing qi in Ming Dynasty.The average number of herbs per prescription was 7.63,and the high-frequency medicines included ginseng,poria cocos,dendrobe,wolfberry fruit,pinellia ternata,angelica sinensis,and the high-frequency efficacy was engendering liquid,nourishing blood,lubricating the intestines,and moving the bowels in Qing Dynasty.(3)Cluster analysis showed that the cluster of 20 kinds of high-frequency medicines for stroke treatment in Han and Tang Dynasties could be divided into seven categories,and their frequently-used treatment methods put tonifying qi and blood,warming yang and dispelling cold first,combined with using pungent and warm medicines dispelling cold and dredging collaterals,dispelling wind and dredging collaterals,together with clearing heat and dredging collaterals,removing blood stasis and dredging collaterals,and removing dampness and dredging collaterals.The cluster of 20 kinds of high-frequency medicines for stroke treatment in Song,Jin and Yuan Dynasties could be divided into nine categories,and their frequently-used treatment methods put tonifying liver and kidney’s yin and blood,tonifying qi,warming yang,and dispelling cold first,followed by resolving phlegm and dredging collaterals,removing dampness and dredging collaterals,using pungent and warm medicines dispelling cold and dredging collaterals,dispelling wind and dredging collaterals,and clearing heat and dredging collaterals.The cluster of 20 kinds of high-frequency medicines for stroke treatment in Ming Dynasty could be divided into six categories,and their frequently-used treatment methods put nourishing qi and yin,nourishing liver and kidney first,combined with resolving phlegm,removing dampness,and dredging collaterals.The cluster of 22 kinds of high-frequency medicines for stroke treatment in Qing Dynasty could be divided into nine categories,and their frequently-used treatment methods put tonifying qi and blood,tonifying yin and yang first,combined with clearing heat,resolving phlegm,and dredging collaterals.(4)Association analysis showed that the core compatibility of medicine group was ligusticum wallichii-saponikoviaephedra-cinnamon-radix paeoniae alba-licorice in Han and Tang Dynasties.The core compatibility of medicine group was ligusticum wallichii-saponikovia-scutellaria baicalensis-ginseng-licorice in Song,Jin and Yuan Dynasties.The core compatibility of medicine group was ginseng-licorice-prepared rehmannia root-angelica sinensis in Ming Dynasty.The core compatibility of medicine group was pinellia ternata-poria cocos-ginseng-prepared rehmannia root-cistanche in Qing Dynasty.(5)Complex network analysis showed that the core prescription for stroke treatment in Han,Tang,Song,Jin and Yuan Dynasties was modified prescription of Xiaoxuming Decoction.The core prescription for stroke treatment in Ming Dynasty was modified prescription of Yougui Pills with Liujunzi Decoction.The core prescription for stroke treatment in Qing Dynasty was modified prescription of Banxia Baizhu Tianma Decoction with Dihuang Yinzi.(6)The discovery of collateral disease medicine in ancient stroke prescriptions showed that the high-frequency collateral disease medicines included ginseng,cassia twig,angelica sinensis,ephedra,asarum,radix ophiopogonis,rhizoma arisaematis,bamboo juice,antelope’s horn and musk.Conclusion: The treatment of stroke convalescence and sequelae periods can draw lessons from the treatment principle and method of both attack and complement in Ming and Qing Dynasties.The methods of strengthening includes nourishing qi,or nourishing blood,or nourishing yin,or warming yang,nourishing the deficiency of qi,blood,yin and yang in collaterals.Eliminating pathogens includes resolving phlegm and dredging collaterals,removing dampness and dredging collaterals,and removing blood stasis and dredging collaterals.And according to the differences between sthenia of pathogenic factors and asthenia of healthy qi,the proportion of attack and complement should be determined.In the acute stage of stroke,attention should be paid to the syndrome differentiation and treatment based on the theory of external wind.The principle and method of treatment can be imitated in Han and Tang Dynasties.The first choice is using Xiao Xuming Decoction to dispel wind,disperse pathogens,and dredge collaterals,which has an important reference value in the treatment of acute stage of stroke.