多囊卵巢综合征近20年的中医和中西医结合文献研究
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摘要
目的：
收集及整理近20年有关治疗多囊卵巢综合征的中医和中西医结合文献,对该病的病因病机,治则治法,特别是中医治疗处方用药进行统计分析、归纳及总结,从整体上把握PCOS的证治发展规律,为今后对PCOS的治疗及下一步临床用药提供系统化思路和文献学基础。
方法：
本研究主要通过频数分析对治疗多囊卵巢综合征的各类中药的使用频率进行比较,探析PCOS病因病机、不同种类药物的运用情况,以推论出用药的主导趋势：通过聚类分析,进一步全面、系统地为多囊卵巢综合征的证治规律提出证据。
研究对象来源：1992年1月至2012年12月在国内公开发表的中文学术期刊所刊载的与多囊卵巢综合征的中医及中西医结合研究文献。
文献纳入标准：文章的内容与多囊卵巢综合征有关；发表文献属于国家新闻出版署正规法定期刊,时间为1992年1月-2012年12月；患者被诊断为多囊卵巢综合征,文献中报道中药治疗组或中西医结合治疗组病例数目不少于20例；发表文献中不得含有治疗其他妇科疾病的描述；发表文献以设立随机、对照试验者为优先。
方药纳入标准：所选方药疗效明确；中医药或中西医结合药物；所选方剂有明确的药物组成；凡属于PCOS内治范畴的方剂均可入选。
方药排除标准：不符合纳入标准的方剂；主治症过于庞杂,对PCOS缺乏针对性的方剂；无方名的方剂；单味药方。
数据库的建立：利用Excel软件建立数据库(方剂数据库、药物分类数据库),建立SPSS数据库。
统计分析：利用Excel软件及SPSS统计学软件,通过编写程式,对数据进行频数分析、聚类分析。
结果：
(1)纳入研究文献：根据研究目的和纳入标准最终得到完全符合文献纳入标准的研究对象为209篇,其中106篇为中医疗法文献、103篇为中西医结合疗法文献。1992年—2002年的11年间仅为22篇,2003年后有较大幅度的增加。
在106篇中医疗法文献中,共报告了6,048例多囊卵巢综合征,其中治疗组或实验组4,895例患者,对照组1,153例患者。治疗组的样本量>100例的只有3篇(占2.83%%),31篇(占29.25%)的样本量在50-99例之间,72篇(占69.92%)的样本量在20-49例之间。在103篇中西医结合治疗的文献中,共报告了7,724例多囊卵巢综合征,其中治疗组或实验组4,018例患者,对照组3,706例患者。治疗组的样本量>100例的只有2篇(1.94%),24篇(23.30%)的样本量在50-99例之间,77篇(74.76%)的样本量在20-49例之间。
(2)病因病机学分析
209篇文献中,有141篇(占67.46%)认为多囊卵巢综合征与肾虚关系密切；有11篇(5.26%)认为与脾脏有关,其中9篇认为因脾虚所致；有22篇(10.53%)认为与脾肾相关,即脾肾两虚；有39篇(占18.66%)认为与肝脏有关。209篇文献中,有130篇认为多囊卵巢综合征的发生与痰有关,占62.20%；有77篇认为与血瘀有关,占36.84%；有1篇文献认为与郁热有关。
(3)用药分析
在所研究的209篇文献中,共涉及用药144味,总使用频数(次)2037味次,平均每个方剂使用药物9.75味,平均每味药使用14.15味次。使用频次>2的药物有93味,共出现1966味次,占总用药味次的96.51%；使用频次≤2的药物有51味,共出现71味次,占总用药味次的3.49%。
药物种类分析：就文献中记有的治疗多囊卵巢综合征的144味中药,分属于19个药物种类,依据《中药学》各论中的顺序,分别是解表药、清热药、泻下药、祛风湿药、化湿药、利水渗湿药、温里药、理气药、消食药、止血药、活血化瘀药、化痰止咳平喘药、安神药、平肝熄风药、开窍药、补虚药、收涩药、解毒杀虫燥湿止痒药等。
入选研究文献中治疗多囊卵巢综合征的药物排名前6位、频数相对较高的是：补虚药(42.75%)：常用补阳药有菟丝子、淫羊藿、鹿茸(鹿角胶、鹿角霜)、巴戟天、仙茅、补骨脂、肉苁蓉、杜仲、续断、紫河车等,常用补气药有党参、黄芪、白术、山药、甘草,常用补血药有当归、熟地、白芍、何首乌等,常用补阴药物有枸杞子、女贞子、旱莲草等。活血化瘀药(13.70%)：常用药物有川芎、郁金、丹参、桃仁、红花、益母草、牛膝、鸡血藤、穿山甲、泽兰等。清热药(8.00%)：常用药物有夏枯草、栀子、黄芩、生地、丹皮、赤芍、知母等。理气药(5.99%)：常用药物有陈皮、香附、枳实等。化痰药(5.84%)：常用药物有半夏、胆南星、皂角刺、贝母、白芥子等。利水渗湿药(5.35%)：常用药物有茯苓、泽泻、车前子、薏苡仁等。前六种在用药中所占比例(累计频率)达81.63%。
药物聚类分析：根据药性理论(性味、归经)和临床专业知识,在SPSS18.0数据库中对出现频数大于15次的44种药物进行聚类分析。并确定5个聚类方：
C1方：柴胡、夏枯草。
C2方：胆南星、枳实、穿山甲、仙茅、香附、丹参、赤芍、益母草、丹皮、生地、车前子、白芍、泽泻。
C3方：山药、党参、甘草、枸杞子、牛膝、茯苓、桃仁
C4方：白术、黄芪、石菖蒲、苍术、补骨脂、半夏、陈皮、皂角刺。
C5方：续断、鸡血藤、女贞子、鹿茸、杜仲、菟丝子、肉苁蓉、淫羊藿、巴戟天、当归、紫石英、熟地黄、红花、川芎。
结论
(1)肾虚血瘀痰浊是PCOS的基本病机。
(2)多囊卵巢综合征治疗用药以补虚药、活血化瘀药为主导。
(3)依据药性理论和临床专业知识,聚为5个聚类组合体,分别用于治疗多囊卵巢综合征各证型的基础方：肝气郁结型；肾虚痰湿血瘀型；脾肾阳虚、瘀血内阻型；脾肾阳虚、痰湿阻滞型；肾虚血瘀证。
Objective
This research collects and sorts out recent20years'literature about polycystic ovarian syndrome (PCOS) with Chinese Medicine and Integrated Chinese and Western Medicine therapies. By making statistical analysis, concluding and summarizing the etiology, pathogenesis, treatment principles and methods, especially the Chinese Medicine prescriptions, this thesis introduces the syndrome differentiation and treatment rules for PCOS treatment and offers the systematic thoughtways and literature study foundation for future PCOS treatment and further clinical medication.
Methods
This research compares the frequency of usage of various Chinese herbal medicines for PCOS treatment with frequency analysis methods and discusses the etiology, pathogenesis, and medicine application so as to induce the leading tendency for medication. With cluster analysis, this thesis holistically and systematically provides evidence for the syndrome differentiation and treatment rules of PCOS.
Research objects:Chinese Medicine and Integrated Chinese and Western Medicine literature related to PCOS in Chinese academic journals published publicly from January1992to December2012.
Literature inclusion criteria:the literature content is related to PCOS; the journals are legal journals recognized by General Administration of Press and Publication of the People's Republic of China from January1992to December2012; the patients are diagnosed as PCOS and there are no less than 20cases in Chinese Medicine treatment group or Integrated Chinese and Western Medicine treatment group reported in the literature; no description of other gynecological diseases is included in the literature; the literature should take random contrast trial as the priority.
Prescription inclusion criteria:the prescription should have definite curative effect; Chinese Medicine or Integrated Chinese and Western Medicine medications; the prescription have definite medicine formulation; medicine for PCOS endotherapy can be included.
Prescription exclusion criteria:prescription that can't meet the inclusion criteria; the indications are over complicated and lack of pertinence; prescriptions without titles; single medicine formulations.
Database establishment:Use Excel software to set up a database (prescription database, medicine classification database) and set up SPSS database.
Statistics:Use Excel and SPSS software and write programmes in order to make frequency and cluster analysis.
Results
(1) Inclusion of literature
According to research aim and inclusion criteria,209articles conforming to the inclusion criteria are selected, including106Chinese Medicine therapy articles and103Integrated Chinese and Western Medicine therapy articles. There are only22articles from1992to2002and there's a huge Increase after2003.
The106articles concerning Chinese Medicine therapy report6048PCOS cases, including4895in the Treatment or Trial Group and1153in the Control Group.3articles has a sample size of over100cases (2.83%of the total),31has a sample size of50-99(29.25%) and72has a sample size of20-49(69.92%). The103articles concerning Integrated Chinese and Western Medicine therapy report7724PCOS cases, including4018in the Treatment or Trial Group and3706in the Control Group.2articles has a sample size of over100cases (1.94%of the total),24has a sample size of50-99(23.30%) and77has a sample size of20-49(74.76%).
(2) Etiology and pathogenesis analysis
Among209articles,141articles (67.46%of the total) believe PCOS is related to kidney deficiency;11(5.26%) believe it's related to spleen among which9believe it's due to spleen deficiency;22(10.53%) believe it's related to spleen and kidney deficiency;39(18.66%) believe it's related to liver.130(62.20%) believe its occurrence is related to phlegm;77(36.84%) believe it's related to blood stasis;1believes it's related to phlegm-heat.
(3) Medication analysis
209articles mention144ingredients. The total application frequency is2037times and on average each prescription adopts9.75ingredients and each ingredient is used14.15times.93ingredients have a frequency of over2and takes place1966times, making up96.51%of the total times.51ingredients have a frequency of twice or less than twice and takes place71times, making up3.49%of the total times.
Medicine type analysis:144Chinese herbal medicines for PCOS appear in the literature which belongs to19types. According to the order of Chinese Materia Medica, they are drugs for relieving exterior syndrome, heat-clearing drug, purgation drug, antirheumatic, dampness relieving medicine, diuretics for eliminating dampness, drugs for dispelling internal cold, drugs for regulating Qi flow, medicine for digestion, restringent, drug for invigorating blood circulation and eliminating stasis, medicine for eliminating phlegm and relieving cough and asthma, tranquilizer, drugs for calming liver to stop endogenous wind, drugs for inducing resuscitation, tonics, astringent drug, medicine for insecticide, detoxification, dampness-relieving and antipruritic.
The top6medicine with high frequency for PCOS treatment recorded in the literature are tonic (42.75%):The common yang reinforcing medicines are semen cuscutae, herba epimedii, velvet antler (antler glue and gelatinum cornus cervis), radix morindae officinalis, rhizoma curculiginis, psoralens, cistanche, eucommia ulmoides, radix dipsaci, placenta hominis, etc. The common qi reinforcing medicines are codonopsis, astragalus, actractylodes macrocephala, yam, licorice. The common blood reinforcing medicine are angelica, prepared radix rehmanniae, radices paeoniae alba, polygonum multiflorum, etc.The common yin reinforcing medicine are medlar, fructus ligustri lucidi, herba celiptae, etc.; medicine for promoting blood circulation and removing blood stasis (13.70%), including ligustrazin, radix curcumae, red sage root, peach seed, safflower, motherwort, radix achyranthis bidentatae, caulis spatholobi, pangolin, herba lycopi, etc. medicine for relieving fever (8.00%), including prunella, fructus gardeniae, radix scutellariae, root of rehmannia, cortex moutan, radix paeoniae alba, anemarrhena asphodeloides, etc.; medicine for regulating qi (5.99%), including dried tangerine peel, rhizoma cyperi, fructus aurantii immaturus, etc.; medicine for removing phlegm (5.84%), including pinellia ternata, arisaema cum bile, spina gleditsiae, caladium, semen brassicae, etc. medicine for clearing dampness and promoting diuresis (5.35%), including tuckahoe, rhizoma alismatis, plantain seeds, semen coicis, etc. These six kinds of medicine make up81.63%of the total medicine used.
Cluster analysis of medicine:According to medicine property theory (property and flavor and channel tropism) and clinical knowledge, the author makes cluster analysis of44medicines that has frequency above15in SPSS18.0database and determines5cluster prescriptions:
Cl prescription:radix bupleuri, prunella
C2prescription:arisaema cum bile, fructus aurantii immaturus, pangolin, rhizoma curculiginis, rhizoma cyperi, red sage root, radix paeoniae alba, motherwort, cortex moutan, root of rehmannia, plantain seeds, radices paeoniae alba, rhizoma alismatis。
C3prescription:yam, codonopsis, licorice, medlar, radix achyranthis bidentatae, tuckahoe, peach seed。
C4prescription:actractylodes macrocephala, astragalus, acorus gramineus soland, atractylodes rhizome, psoralens, pinellia ternata, dried tangerine peel, spina gleditsiae。
C5prescription:radix dipsaci, caulis spatholobi, fructus ligustri lucidi, velvet antler, eucommia ulmoides, semen cuscutae, istanche, herba epimedii, radix morindae officinalis, angelica, amethyst, prepared radix rehmanniae, safflower, ligustrazin.
Conclusion
(1) Kidney deficiency, blood stasis and phlegm are the basic pathogenesis of PCOS.
(2) PCOS medicines are generally tonics and medicine for promoting blood circulation and removing stasis.
(3) According to the medicine theory and clinical knowledge, the author clusters the medicine into5groups and summarizes the basic prescription for various PCOS types:liver qi stagnation; kidney deficiency, dampness and blood stasis; spleen and kidney yang deficiency and blood stasis; spleen and kidney yang deficiency and phlegm and dampness stagnation; kidney deficiency and blood stasis.
收集及整理近20年有关治疗多囊卵巢综合征的中医和中西医结合文献,对该病的病因病机,治则治法,特别是中医治疗处方用药进行统计分析、归纳及总结,从整体上把握PCOS的证治发展规律,为今后对PCOS的治疗及下一步临床用药提供系统化思路和文献学基础。
方法：
本研究主要通过频数分析对治疗多囊卵巢综合征的各类中药的使用频率进行比较,探析PCOS病因病机、不同种类药物的运用情况,以推论出用药的主导趋势：通过聚类分析,进一步全面、系统地为多囊卵巢综合征的证治规律提出证据。
研究对象来源：1992年1月至2012年12月在国内公开发表的中文学术期刊所刊载的与多囊卵巢综合征的中医及中西医结合研究文献。
文献纳入标准：文章的内容与多囊卵巢综合征有关；发表文献属于国家新闻出版署正规法定期刊,时间为1992年1月-2012年12月；患者被诊断为多囊卵巢综合征,文献中报道中药治疗组或中西医结合治疗组病例数目不少于20例；发表文献中不得含有治疗其他妇科疾病的描述；发表文献以设立随机、对照试验者为优先。
方药纳入标准：所选方药疗效明确；中医药或中西医结合药物；所选方剂有明确的药物组成；凡属于PCOS内治范畴的方剂均可入选。
方药排除标准：不符合纳入标准的方剂；主治症过于庞杂,对PCOS缺乏针对性的方剂；无方名的方剂；单味药方。
数据库的建立：利用Excel软件建立数据库(方剂数据库、药物分类数据库),建立SPSS数据库。
统计分析：利用Excel软件及SPSS统计学软件,通过编写程式,对数据进行频数分析、聚类分析。
结果：
(1)纳入研究文献：根据研究目的和纳入标准最终得到完全符合文献纳入标准的研究对象为209篇,其中106篇为中医疗法文献、103篇为中西医结合疗法文献。1992年—2002年的11年间仅为22篇,2003年后有较大幅度的增加。
在106篇中医疗法文献中,共报告了6,048例多囊卵巢综合征,其中治疗组或实验组4,895例患者,对照组1,153例患者。治疗组的样本量>100例的只有3篇(占2.83%%),31篇(占29.25%)的样本量在50-99例之间,72篇(占69.92%)的样本量在20-49例之间。在103篇中西医结合治疗的文献中,共报告了7,724例多囊卵巢综合征,其中治疗组或实验组4,018例患者,对照组3,706例患者。治疗组的样本量>100例的只有2篇(1.94%),24篇(23.30%)的样本量在50-99例之间,77篇(74.76%)的样本量在20-49例之间。
(2)病因病机学分析
209篇文献中,有141篇(占67.46%)认为多囊卵巢综合征与肾虚关系密切；有11篇(5.26%)认为与脾脏有关,其中9篇认为因脾虚所致；有22篇(10.53%)认为与脾肾相关,即脾肾两虚；有39篇(占18.66%)认为与肝脏有关。209篇文献中,有130篇认为多囊卵巢综合征的发生与痰有关,占62.20%；有77篇认为与血瘀有关,占36.84%；有1篇文献认为与郁热有关。
(3)用药分析
在所研究的209篇文献中,共涉及用药144味,总使用频数(次)2037味次,平均每个方剂使用药物9.75味,平均每味药使用14.15味次。使用频次>2的药物有93味,共出现1966味次,占总用药味次的96.51%；使用频次≤2的药物有51味,共出现71味次,占总用药味次的3.49%。
药物种类分析：就文献中记有的治疗多囊卵巢综合征的144味中药,分属于19个药物种类,依据《中药学》各论中的顺序,分别是解表药、清热药、泻下药、祛风湿药、化湿药、利水渗湿药、温里药、理气药、消食药、止血药、活血化瘀药、化痰止咳平喘药、安神药、平肝熄风药、开窍药、补虚药、收涩药、解毒杀虫燥湿止痒药等。
入选研究文献中治疗多囊卵巢综合征的药物排名前6位、频数相对较高的是：补虚药(42.75%)：常用补阳药有菟丝子、淫羊藿、鹿茸(鹿角胶、鹿角霜)、巴戟天、仙茅、补骨脂、肉苁蓉、杜仲、续断、紫河车等,常用补气药有党参、黄芪、白术、山药、甘草,常用补血药有当归、熟地、白芍、何首乌等,常用补阴药物有枸杞子、女贞子、旱莲草等。活血化瘀药(13.70%)：常用药物有川芎、郁金、丹参、桃仁、红花、益母草、牛膝、鸡血藤、穿山甲、泽兰等。清热药(8.00%)：常用药物有夏枯草、栀子、黄芩、生地、丹皮、赤芍、知母等。理气药(5.99%)：常用药物有陈皮、香附、枳实等。化痰药(5.84%)：常用药物有半夏、胆南星、皂角刺、贝母、白芥子等。利水渗湿药(5.35%)：常用药物有茯苓、泽泻、车前子、薏苡仁等。前六种在用药中所占比例(累计频率)达81.63%。
药物聚类分析：根据药性理论(性味、归经)和临床专业知识,在SPSS18.0数据库中对出现频数大于15次的44种药物进行聚类分析。并确定5个聚类方：
C1方：柴胡、夏枯草。
C2方：胆南星、枳实、穿山甲、仙茅、香附、丹参、赤芍、益母草、丹皮、生地、车前子、白芍、泽泻。
C3方：山药、党参、甘草、枸杞子、牛膝、茯苓、桃仁
C4方：白术、黄芪、石菖蒲、苍术、补骨脂、半夏、陈皮、皂角刺。
C5方：续断、鸡血藤、女贞子、鹿茸、杜仲、菟丝子、肉苁蓉、淫羊藿、巴戟天、当归、紫石英、熟地黄、红花、川芎。
结论
(1)肾虚血瘀痰浊是PCOS的基本病机。
(2)多囊卵巢综合征治疗用药以补虚药、活血化瘀药为主导。
(3)依据药性理论和临床专业知识,聚为5个聚类组合体,分别用于治疗多囊卵巢综合征各证型的基础方：肝气郁结型；肾虚痰湿血瘀型；脾肾阳虚、瘀血内阻型；脾肾阳虚、痰湿阻滞型；肾虚血瘀证。
Objective
This research collects and sorts out recent20years'literature about polycystic ovarian syndrome (PCOS) with Chinese Medicine and Integrated Chinese and Western Medicine therapies. By making statistical analysis, concluding and summarizing the etiology, pathogenesis, treatment principles and methods, especially the Chinese Medicine prescriptions, this thesis introduces the syndrome differentiation and treatment rules for PCOS treatment and offers the systematic thoughtways and literature study foundation for future PCOS treatment and further clinical medication.
Methods
This research compares the frequency of usage of various Chinese herbal medicines for PCOS treatment with frequency analysis methods and discusses the etiology, pathogenesis, and medicine application so as to induce the leading tendency for medication. With cluster analysis, this thesis holistically and systematically provides evidence for the syndrome differentiation and treatment rules of PCOS.
Research objects:Chinese Medicine and Integrated Chinese and Western Medicine literature related to PCOS in Chinese academic journals published publicly from January1992to December2012.
Literature inclusion criteria:the literature content is related to PCOS; the journals are legal journals recognized by General Administration of Press and Publication of the People's Republic of China from January1992to December2012; the patients are diagnosed as PCOS and there are no less than 20cases in Chinese Medicine treatment group or Integrated Chinese and Western Medicine treatment group reported in the literature; no description of other gynecological diseases is included in the literature; the literature should take random contrast trial as the priority.
Prescription inclusion criteria:the prescription should have definite curative effect; Chinese Medicine or Integrated Chinese and Western Medicine medications; the prescription have definite medicine formulation; medicine for PCOS endotherapy can be included.
Prescription exclusion criteria:prescription that can't meet the inclusion criteria; the indications are over complicated and lack of pertinence; prescriptions without titles; single medicine formulations.
Database establishment:Use Excel software to set up a database (prescription database, medicine classification database) and set up SPSS database.
Statistics:Use Excel and SPSS software and write programmes in order to make frequency and cluster analysis.
Results
(1) Inclusion of literature
According to research aim and inclusion criteria,209articles conforming to the inclusion criteria are selected, including106Chinese Medicine therapy articles and103Integrated Chinese and Western Medicine therapy articles. There are only22articles from1992to2002and there's a huge Increase after2003.
The106articles concerning Chinese Medicine therapy report6048PCOS cases, including4895in the Treatment or Trial Group and1153in the Control Group.3articles has a sample size of over100cases (2.83%of the total),31has a sample size of50-99(29.25%) and72has a sample size of20-49(69.92%). The103articles concerning Integrated Chinese and Western Medicine therapy report7724PCOS cases, including4018in the Treatment or Trial Group and3706in the Control Group.2articles has a sample size of over100cases (1.94%of the total),24has a sample size of50-99(23.30%) and77has a sample size of20-49(74.76%).
(2) Etiology and pathogenesis analysis
Among209articles,141articles (67.46%of the total) believe PCOS is related to kidney deficiency;11(5.26%) believe it's related to spleen among which9believe it's due to spleen deficiency;22(10.53%) believe it's related to spleen and kidney deficiency;39(18.66%) believe it's related to liver.130(62.20%) believe its occurrence is related to phlegm;77(36.84%) believe it's related to blood stasis;1believes it's related to phlegm-heat.
(3) Medication analysis
209articles mention144ingredients. The total application frequency is2037times and on average each prescription adopts9.75ingredients and each ingredient is used14.15times.93ingredients have a frequency of over2and takes place1966times, making up96.51%of the total times.51ingredients have a frequency of twice or less than twice and takes place71times, making up3.49%of the total times.
Medicine type analysis:144Chinese herbal medicines for PCOS appear in the literature which belongs to19types. According to the order of Chinese Materia Medica, they are drugs for relieving exterior syndrome, heat-clearing drug, purgation drug, antirheumatic, dampness relieving medicine, diuretics for eliminating dampness, drugs for dispelling internal cold, drugs for regulating Qi flow, medicine for digestion, restringent, drug for invigorating blood circulation and eliminating stasis, medicine for eliminating phlegm and relieving cough and asthma, tranquilizer, drugs for calming liver to stop endogenous wind, drugs for inducing resuscitation, tonics, astringent drug, medicine for insecticide, detoxification, dampness-relieving and antipruritic.
The top6medicine with high frequency for PCOS treatment recorded in the literature are tonic (42.75%):The common yang reinforcing medicines are semen cuscutae, herba epimedii, velvet antler (antler glue and gelatinum cornus cervis), radix morindae officinalis, rhizoma curculiginis, psoralens, cistanche, eucommia ulmoides, radix dipsaci, placenta hominis, etc. The common qi reinforcing medicines are codonopsis, astragalus, actractylodes macrocephala, yam, licorice. The common blood reinforcing medicine are angelica, prepared radix rehmanniae, radices paeoniae alba, polygonum multiflorum, etc.The common yin reinforcing medicine are medlar, fructus ligustri lucidi, herba celiptae, etc.; medicine for promoting blood circulation and removing blood stasis (13.70%), including ligustrazin, radix curcumae, red sage root, peach seed, safflower, motherwort, radix achyranthis bidentatae, caulis spatholobi, pangolin, herba lycopi, etc. medicine for relieving fever (8.00%), including prunella, fructus gardeniae, radix scutellariae, root of rehmannia, cortex moutan, radix paeoniae alba, anemarrhena asphodeloides, etc.; medicine for regulating qi (5.99%), including dried tangerine peel, rhizoma cyperi, fructus aurantii immaturus, etc.; medicine for removing phlegm (5.84%), including pinellia ternata, arisaema cum bile, spina gleditsiae, caladium, semen brassicae, etc. medicine for clearing dampness and promoting diuresis (5.35%), including tuckahoe, rhizoma alismatis, plantain seeds, semen coicis, etc. These six kinds of medicine make up81.63%of the total medicine used.
Cluster analysis of medicine:According to medicine property theory (property and flavor and channel tropism) and clinical knowledge, the author makes cluster analysis of44medicines that has frequency above15in SPSS18.0database and determines5cluster prescriptions:
Cl prescription:radix bupleuri, prunella
C2prescription:arisaema cum bile, fructus aurantii immaturus, pangolin, rhizoma curculiginis, rhizoma cyperi, red sage root, radix paeoniae alba, motherwort, cortex moutan, root of rehmannia, plantain seeds, radices paeoniae alba, rhizoma alismatis。
C3prescription:yam, codonopsis, licorice, medlar, radix achyranthis bidentatae, tuckahoe, peach seed。
C4prescription:actractylodes macrocephala, astragalus, acorus gramineus soland, atractylodes rhizome, psoralens, pinellia ternata, dried tangerine peel, spina gleditsiae。
C5prescription:radix dipsaci, caulis spatholobi, fructus ligustri lucidi, velvet antler, eucommia ulmoides, semen cuscutae, istanche, herba epimedii, radix morindae officinalis, angelica, amethyst, prepared radix rehmanniae, safflower, ligustrazin.
Conclusion
(1) Kidney deficiency, blood stasis and phlegm are the basic pathogenesis of PCOS.
(2) PCOS medicines are generally tonics and medicine for promoting blood circulation and removing stasis.
(3) According to the medicine theory and clinical knowledge, the author clusters the medicine into5groups and summarizes the basic prescription for various PCOS types:liver qi stagnation; kidney deficiency, dampness and blood stasis; spleen and kidney yang deficiency and blood stasis; spleen and kidney yang deficiency and phlegm and dampness stagnation; kidney deficiency and blood stasis.
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