近20年中药治疗慢性阻塞性肺疾病稳定期组方用药规律文献研究
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摘要
目的总结中医药治疗慢性阻塞性肺疾病(COPD)稳定期的用药配伍及组方规律。方法检索中国知网、万方数据库、维普期刊数据库1998年1月1日至2018年8月31日关于中医药复方治疗COPD稳定期的临床研究文献,提取纳入文献中方剂及药物信息,分别统计药物使用及性味归经分布情况,对高频药物进行二项、三项关联分析及聚类分析。结果共纳入文献109篇,筛选方剂109首,涉及药物161味,药物类别15种。用药频次≥10次的中药共计35味,其中使用频次前3位的分别为黄芪(76),甘草(60),白术(56);药物类别出现频次前3位的分别为补益药(46),化痰止咳平喘药(21),清热药(19)。用药频次≥5的中药共计48味,其药性频次前3位分别为温(15)、平(11)、微温(9),药味分别为甘(25)、辛(23)、苦(18),归经分别为肺(26)、脾(24)、肝(17)。用药频次≥10次的35味药物中二项关联共12对,三项关联共9组,聚为7类时聚类效果较好。结论 COPD稳定期的治疗药物以辛温、归肺脾经者为多,组方思路以补肺健脾益肾、化痰止咳平喘、化瘀通络为主。
Objective To summarize the compatibility and prescription rules of traditional Chinese medicine in the treatment of chronic obstructive pulmonary disease( COPD) at stable stage. Methods The clinical research literatures on the stable stage of COPD with Chinese medicine compound treatment from January 1,1998 to August 31,2018 were retrieved from Chinese National Knowledge Infrastructure( CNKI),Wanfang Database and VIP Journal Database. The prescriptions and drug information in the included literature were extracted. Drug use,and the distribution of nature,flavor,and channel tropism were counted,and high-frequency drugs were analyzed by binomial and tertiary correlation analysis and cluster analysis. Results A total of 109 papers were included in the literature,and109 prescriptions were screened,involving 161 drugs and 15 drug classes. There are a total of 35 kinds Chinese medicines with a frequency ≥10 times,of which the top 3 frequencies were Huang qi [Radix Astragali seu Hedysari( 76) ],Gancao [Radix Glycyrrhizae( 60) ],and Baizhu [Rhizoma Atractylodis Macrocephalae( 56) ]. The top 3 drug categories were replenishing and invigorating drugs( 46),dissipating phlegm,reliving cough and anti-asthmatic drugs( 21),heat-clearing drugs( 19). There are a total of 48 kinds Chinese medicine with a frequency of ≥5,and the top 3 drug natures were warm( 15),neutral( 11),and slight warm( 9),and the top 3 flavors were sweet( 25),pungent( 23),and bitter( 18). The channel tropism was the lung( 26),spleen( 24),and liver( 17). Among the35 drugs with frequency ≥10 times,there were 12 pairs of two associations,and the three associations totaled 9 groups. When clustered into 7 categories,the clustering effect was better. Conclusion The treatment drug of COPD in stable stage was characterized by pungent and warm in nature and channel tropism of the lung and spleen.The prescriptions ideas are mainly to invigorate the lung,spleen and kidney,dissipate phlegm,relive cough and antiasthmatic and resolve the stasis and unblock the collaterals.
Objective To summarize the compatibility and prescription rules of traditional Chinese medicine in the treatment of chronic obstructive pulmonary disease( COPD) at stable stage. Methods The clinical research literatures on the stable stage of COPD with Chinese medicine compound treatment from January 1,1998 to August 31,2018 were retrieved from Chinese National Knowledge Infrastructure( CNKI),Wanfang Database and VIP Journal Database. The prescriptions and drug information in the included literature were extracted. Drug use,and the distribution of nature,flavor,and channel tropism were counted,and high-frequency drugs were analyzed by binomial and tertiary correlation analysis and cluster analysis. Results A total of 109 papers were included in the literature,and109 prescriptions were screened,involving 161 drugs and 15 drug classes. There are a total of 35 kinds Chinese medicines with a frequency ≥10 times,of which the top 3 frequencies were Huang qi [Radix Astragali seu Hedysari( 76) ],Gancao [Radix Glycyrrhizae( 60) ],and Baizhu [Rhizoma Atractylodis Macrocephalae( 56) ]. The top 3 drug categories were replenishing and invigorating drugs( 46),dissipating phlegm,reliving cough and anti-asthmatic drugs( 21),heat-clearing drugs( 19). There are a total of 48 kinds Chinese medicine with a frequency of ≥5,and the top 3 drug natures were warm( 15),neutral( 11),and slight warm( 9),and the top 3 flavors were sweet( 25),pungent( 23),and bitter( 18). The channel tropism was the lung( 26),spleen( 24),and liver( 17). Among the35 drugs with frequency ≥10 times,there were 12 pairs of two associations,and the three associations totaled 9 groups. When clustered into 7 categories,the clustering effect was better. Conclusion The treatment drug of COPD in stable stage was characterized by pungent and warm in nature and channel tropism of the lung and spleen.The prescriptions ideas are mainly to invigorate the lung,spleen and kidney,dissipate phlegm,relive cough and antiasthmatic and resolve the stasis and unblock the collaterals.
引文
[1]Global Initiative for Chronic Obstructive Lung Disease(GOLD). Global Strategy for the Diagnosis,Management and Prevention of COPD(2019 REPORT)[EB/OL].(2018-11-04)[2018-11-19]. https://goldcopd.org.
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[3]GBD 2017 Causes of Death Collaborators. Global,regional,and national age-sex-specific mortality for 282 causes of death in 195 countries and territories,1980—2017:a systematic analysis for the Global Burden of Disease Study2017[J]. Lancet,2018,392(10159):1736-1788.
[4]杨勤军,李泽庚,张星星,等.中医药治疗慢性阻塞性肺疾病稳定期研究进展[J].江西中医药大学学报,2018,30(5):113-116.
[5]吴娟娟,何焕荣.中医药治疗稳定期慢性阻塞性肺疾病作用机制研究述评[J].中医学报,2015,30(12):1735-1738.
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[9]胡宗仁.慢性阻塞性肺疾病稳定期的古代文献研究[D].长沙:湖南中医药大学,2017.
[2]陈云坤,冯英凯. GOLD 2017新版指南要点解读[J].现代医药卫生,2017,33(4):481-483.
[3]GBD 2017 Causes of Death Collaborators. Global,regional,and national age-sex-specific mortality for 282 causes of death in 195 countries and territories,1980—2017:a systematic analysis for the Global Burden of Disease Study2017[J]. Lancet,2018,392(10159):1736-1788.
[4]杨勤军,李泽庚,张星星,等.中医药治疗慢性阻塞性肺疾病稳定期研究进展[J].江西中医药大学学报,2018,30(5):113-116.
[5]吴娟娟,何焕荣.中医药治疗稳定期慢性阻塞性肺疾病作用机制研究述评[J].中医学报,2015,30(12):1735-1738.
[6]南京中医药大学.中药大辞典[M].上海:上海科学技术出版社,2006.
[7]高学敏,王永炎.中药学[M].北京:中国中医药出版社,2007.
[8]薛薇,陈欢歌.基于Clementine的数据挖掘[M].北京:中国人民大学出版社,2012:435-450.
[9]胡宗仁.慢性阻塞性肺疾病稳定期的古代文献研究[D].长沙:湖南中医药大学,2017.