黄政德教授治疗慢性胃炎的用药规律聚类分析
|
摘要
目的采用聚类分析统计方法,分析第五批全国老中医药专家学术经验继承工作指导老师黄政德教授治疗慢性胃炎用药规律。方法收集黄政德教授门诊治疗慢性胃炎显效病例,采用Excel统计软件对患者中药处方进行频数统计,并对高频中药功效进行拆分合并,采用SPSS 21.0分析软件,对高频中药基于功效进行聚类分析。结果共收集了127例慢性胃炎患者,总计190次门诊病历,共运用中药95味,其中高频中药46味,使用频次排名前十的中药为甘草、白芍、木香、茯苓、法半夏、陈皮、柴胡、川芎、延胡索、白术。获得4个聚类方,C1方能理气活血、健脾祛湿、消痞止痛,由柴胡疏肝散与六君子汤加减化裁而来;C2方能通调三焦、健脾祛湿消痞、疏肝解郁,由三仁汤化裁而来;C3方能养阴清胃、健脾活血止痛、疏肝解郁,由一贯煎化裁而来;C4方能清肝泻火、降逆止呕、寒热平调,由左金丸化裁而来。结论黄政德教授治疗慢性胃炎强调辨病辨证、重调气血、兼顾情志,治疗慢性胃炎善于理气活血、健脾祛湿、疏肝和胃、寒热平调。
Objective To investigate the medication rule of Professor Huang Zhengde, an advisor for national traditional Chinese medicine(TCM) experience inheritance work(5 th session), in the treatment of chronic gastritis by a cluster analysis.Methods The clinical data of patients with chronic gastritis who were treated by Professor Huang Zhengde in the outpatient service and achieved marked response were collected, and EXCEL was used to analyze the frequency of TCM prescriptions. The function of highly frequently used TCM herbs was analyzed, and SPSS 21.0 was used to perform the cluster analysis. Results A total of 127 patients with chronic gastritis were enrolled, with 190 outpatient medical records in total. A total of 95 TCM herbs were used,among which 46 were highly frequently used herbs. The 10 most frequently used herbs were Radix Glycyrrhizae, Radix Paeoniae Alba, Saussurea costus, Poria cocos, Rhizoma Pinelliae Praeparatum, tangerine peel, Bupleurum chinense, Rhizoma Ligustici Chuanxiong, Rhizoma Corydalis, and Atractylodes macrocephala. Four clustering prescriptions were obtained. C1 prescription could regulate Qi and activate blood circulation, strengthen the spleen and eliminate dampness, and eliminate abdominal mass and alleviate pain and was formed by modifying Chaihu Shugan Powder and Liujunzi Decoction; C2 prescription could regulate triple energizers, strengthen the spleen, eliminate dampness and abdominal mass, and soothe the liver and resolve stagnation and was formed by modifying Sanren Decoction; C3 prescription could nourish Yin and clear the stomach, strengthen the spleen, activate blood circulation, and alleviate pain, and soothe the liver and resolve stagnation and was formed by modifying Yiguan Decoction;C4 prescription could clear liver-fire and purge fire, downbear counterflow and control vomiting, and regulate and balance coldness-warmness and was formed by modifying Zuojin Pill. Conclusion In the treatment of chronic gastritis, Professor Huang Zhengde emphasizes the importance of disease differentiation, syndrome differentiation, and Qi-blood and considers emotion at the same time. Professor Huang Zhengde is good at treating chronic gastritis by regulating Qi and activating blood circulation, strengthening the spleen and eliminating dampness, soothing the liver and harmonizing the stomach, and regulating and balancing coldness-warmness.
Objective To investigate the medication rule of Professor Huang Zhengde, an advisor for national traditional Chinese medicine(TCM) experience inheritance work(5 th session), in the treatment of chronic gastritis by a cluster analysis.Methods The clinical data of patients with chronic gastritis who were treated by Professor Huang Zhengde in the outpatient service and achieved marked response were collected, and EXCEL was used to analyze the frequency of TCM prescriptions. The function of highly frequently used TCM herbs was analyzed, and SPSS 21.0 was used to perform the cluster analysis. Results A total of 127 patients with chronic gastritis were enrolled, with 190 outpatient medical records in total. A total of 95 TCM herbs were used,among which 46 were highly frequently used herbs. The 10 most frequently used herbs were Radix Glycyrrhizae, Radix Paeoniae Alba, Saussurea costus, Poria cocos, Rhizoma Pinelliae Praeparatum, tangerine peel, Bupleurum chinense, Rhizoma Ligustici Chuanxiong, Rhizoma Corydalis, and Atractylodes macrocephala. Four clustering prescriptions were obtained. C1 prescription could regulate Qi and activate blood circulation, strengthen the spleen and eliminate dampness, and eliminate abdominal mass and alleviate pain and was formed by modifying Chaihu Shugan Powder and Liujunzi Decoction; C2 prescription could regulate triple energizers, strengthen the spleen, eliminate dampness and abdominal mass, and soothe the liver and resolve stagnation and was formed by modifying Sanren Decoction; C3 prescription could nourish Yin and clear the stomach, strengthen the spleen, activate blood circulation, and alleviate pain, and soothe the liver and resolve stagnation and was formed by modifying Yiguan Decoction;C4 prescription could clear liver-fire and purge fire, downbear counterflow and control vomiting, and regulate and balance coldness-warmness and was formed by modifying Zuojin Pill. Conclusion In the treatment of chronic gastritis, Professor Huang Zhengde emphasizes the importance of disease differentiation, syndrome differentiation, and Qi-blood and considers emotion at the same time. Professor Huang Zhengde is good at treating chronic gastritis by regulating Qi and activating blood circulation, strengthening the spleen and eliminating dampness, soothing the liver and harmonizing the stomach, and regulating and balancing coldness-warmness.
引文
[1]朱春平.基于胃癌危险因素和血清胃功能建立胃癌筛查策略的全国多中心研究[D].上海:中国人民解放军海军军医大学,2017.
[2]陈国伟.慢性胃炎的中医证型分布及主要证素的临床分析[J].现代消化及介入诊疗,2018,23(1):45-47.
[3]吴若霞,谢雪姣,黄政德.黄政德教授治疗慢性胃炎寒热错杂型经验[J].中医药导报,2012,18(3):8-9.
[4]钟小雪.基于聚类分析和对应分析的1 019例血脂异常患者的中医证候研究[D].北京:北京中医药大学,2017.
[5]葛均波,徐永健.内科学[M].8版.人民卫生出版社,2013,北京.
[6]房静远,杜奕奇,刘文忠,等.中国慢性胃炎共识意见(2017年,上海)[J].胃肠病学,2017,22(11):670-687.
[7]高学敏.中药学[M].北京:中国中医药出版社,2017.
[8]徐大志,王艳,张维,等.慢性胃炎常见中医证候及证候要素的文献分析[J].湖南中医药大学学报,2015,35(7):54-56.
[9]冯珂,纪立金.论脾“居中央”“灌四旁”[J].山东中医药大学学报,2016,40(5):404-406,411.
[10]张喜林.从“通调”论治脾胃病经验[J].环球中医药,2014,7(12):964-965.
[11]赵琰.王庆国教授学术思想、临床经验总结及其治疗脾胃病的用药规律研究[D].北京:北京中医药大学,2016.
[12]李冀,赵志宏.柴胡疏肝散的内科临床应用研究进展[J].中医药学报,2016,44(3):117-119.
[13]李良.柴胡疏肝散治疗慢性浅表性胃炎的临床分析[J].中国卫生标准管理,2017,8(1):83-84.
[14]段印会,张春玲.柴胡疏肝散治疗肝胃气滞型慢性胃炎40例[J].世界最新医学信息文摘,2016,16(93):155.
[15]谢晟洁,朱凌宇.柴胡疏肝散合香砂六君子汤加减治疗慢性萎缩性胃炎肝胃不和型85例临床观察[J].中医临床研究,2017,9(33):29-31.
[2]陈国伟.慢性胃炎的中医证型分布及主要证素的临床分析[J].现代消化及介入诊疗,2018,23(1):45-47.
[3]吴若霞,谢雪姣,黄政德.黄政德教授治疗慢性胃炎寒热错杂型经验[J].中医药导报,2012,18(3):8-9.
[4]钟小雪.基于聚类分析和对应分析的1 019例血脂异常患者的中医证候研究[D].北京:北京中医药大学,2017.
[5]葛均波,徐永健.内科学[M].8版.人民卫生出版社,2013,北京.
[6]房静远,杜奕奇,刘文忠,等.中国慢性胃炎共识意见(2017年,上海)[J].胃肠病学,2017,22(11):670-687.
[7]高学敏.中药学[M].北京:中国中医药出版社,2017.
[8]徐大志,王艳,张维,等.慢性胃炎常见中医证候及证候要素的文献分析[J].湖南中医药大学学报,2015,35(7):54-56.
[9]冯珂,纪立金.论脾“居中央”“灌四旁”[J].山东中医药大学学报,2016,40(5):404-406,411.
[10]张喜林.从“通调”论治脾胃病经验[J].环球中医药,2014,7(12):964-965.
[11]赵琰.王庆国教授学术思想、临床经验总结及其治疗脾胃病的用药规律研究[D].北京:北京中医药大学,2016.
[12]李冀,赵志宏.柴胡疏肝散的内科临床应用研究进展[J].中医药学报,2016,44(3):117-119.
[13]李良.柴胡疏肝散治疗慢性浅表性胃炎的临床分析[J].中国卫生标准管理,2017,8(1):83-84.
[14]段印会,张春玲.柴胡疏肝散治疗肝胃气滞型慢性胃炎40例[J].世界最新医学信息文摘,2016,16(93):155.
[15]谢晟洁,朱凌宇.柴胡疏肝散合香砂六君子汤加减治疗慢性萎缩性胃炎肝胃不和型85例临床观察[J].中医临床研究,2017,9(33):29-31.
© 2004-2018 中国地质图书馆版权所有 京ICP备05064691号 京公网安备11010802017129号 地址：北京市海淀区学院路29号 邮编：100083 电话：办公室：(+86 10)66554848；文献借阅、咨询服务、科技查新：66554700 |