基于文献研究的血热型功能失调性子宫出血方药分析
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摘要
目的:探讨血热型功能失调性子宫出血的中医处方用药规律。方法:按照二次文献研究方法,检索近30年治疗功能失调性子宫出血的相关文献,通过纳入排除标准,选择到目标文献109篇,再用描述性统计学方法进行分析整理。结果:最常用的方剂为清热固经方、两地汤、丹栀逍遥散、保阴煎和二至丸;常用于作为试验研究对比的中成药为宫血宁和固经丸;使用频次在30次以上的药物依次为:生地71次,白芍52次,地骨皮44次,阿胶40次,牡丹皮39次,黄芩38次,甘草、地榆各37次,墨旱莲34次,栀子32次。结论:用于治疗血热型功血的方剂中治疗阴虚血热证方剂使用频率更高,方剂功效以滋阴清热,凉血止血为主;中药中以清热凉血滋阴药为君药,兼顾主要病因;凉血止血、收敛止血、化瘀止血、补肾滋阴药物居于臣药位置,兼顾主要病因和次要病因。
Objective: to explore the rule of herbal prescription in the treatment of blood-heat dysfunction induced uterine bleeding.Methods: The secondary literature research method was used to Retrieve the relevant literature on the treatment of dysfunctional uterine bleeding in the last 30 years. Based on the inclusive and exclusive criteria,109 target literatures were selected. The descriptive statistical method was applied for analysis. Results: The most common prescriptions are qingre gujing fang(清热固经方), liangditang(两地汤), danzhixiaoyao san(丹栀逍遥散), baoyinjian(保阴煎), erzhiwan(二至丸), etc. Among them, gu jing fang(固经方) and gong xue ning(宫血宁) are the most frequently used. The use frequency of herbs up to 30 times are Radix Rehmanniae(生地) 71 times, White Peony(白芍) 52 times, Cortex Lycii(地骨皮) 44 times, Donkey-hide Gelatin(阿胶) 40 times, Cortex Moutan(丹皮) 39 times, Radix Scutellariae(黄芩) 38 times, Radix Liquorice(甘草) and Sanguisorba Officinalis(地榆) are 37 times, Eclipta(墨旱莲) 34 times, Fructus Gardeniae(栀子) 34 times. Conclusion: the prescriptions of yin deficiency are used with higher frequency among the prescriptions in the treatment blood-heat syndrome. The main efficacy are nourishing yin and clearing heat, cooling blood and stopping bleeding. The herbs which treat the main causes are put in the first place, they can eliminating pathogenic heat from the blood and nourishing Yin. The herbs which have a minor role of treating the main causes and secondary etiology can have effects on cool blood and hemostasis, astringents, bood stasis, and replenishing vital essence to tonify kidney.
Objective: to explore the rule of herbal prescription in the treatment of blood-heat dysfunction induced uterine bleeding.Methods: The secondary literature research method was used to Retrieve the relevant literature on the treatment of dysfunctional uterine bleeding in the last 30 years. Based on the inclusive and exclusive criteria,109 target literatures were selected. The descriptive statistical method was applied for analysis. Results: The most common prescriptions are qingre gujing fang(清热固经方), liangditang(两地汤), danzhixiaoyao san(丹栀逍遥散), baoyinjian(保阴煎), erzhiwan(二至丸), etc. Among them, gu jing fang(固经方) and gong xue ning(宫血宁) are the most frequently used. The use frequency of herbs up to 30 times are Radix Rehmanniae(生地) 71 times, White Peony(白芍) 52 times, Cortex Lycii(地骨皮) 44 times, Donkey-hide Gelatin(阿胶) 40 times, Cortex Moutan(丹皮) 39 times, Radix Scutellariae(黄芩) 38 times, Radix Liquorice(甘草) and Sanguisorba Officinalis(地榆) are 37 times, Eclipta(墨旱莲) 34 times, Fructus Gardeniae(栀子) 34 times. Conclusion: the prescriptions of yin deficiency are used with higher frequency among the prescriptions in the treatment blood-heat syndrome. The main efficacy are nourishing yin and clearing heat, cooling blood and stopping bleeding. The herbs which treat the main causes are put in the first place, they can eliminating pathogenic heat from the blood and nourishing Yin. The herbs which have a minor role of treating the main causes and secondary etiology can have effects on cool blood and hemostasis, astringents, bood stasis, and replenishing vital essence to tonify kidney.
引文
[1]乐杰.妇产科学[M].北京:人民卫生出版社,2003,17:330-334.
[2]张玉珍.中医妇科学[M].7版.北京:中国中医药出版社,2002:65.
[3]中华人民共和国卫生部.中药新药临床研究指导原则[S].北京:中国医药科技出版社,1993:236-240.
[4]关煜,林运霞,程慕溪.贞茜颗粒治疗阴虚血热型崩漏的临床观察[J].北京中医药,2016,35(5):490-492.
[5]刘恒炼,夏敏,翁双燕,等.仙旱合剂对血热型功能失调性子宫出血止血效果观察[J].陕西中医,2017,38(9):1205-1207.
[6]晏军,汤玲,史梅莹,等.肖承悰教授治疗崩漏的经验浅析[J].环球中医药,2015,08(10):1210-1212.
[7]刘朝圣,李点,何清湖,等.熊继柏教授辨治崩漏经验[J].中华中医药杂志,2015,30(06):2014-2016.
[8]黄国华.功血合剂治疗阴虚型无排卵性功血60例疗效观察[J].中医临床研究,2011,03(17):33-34.
[9]吴虓飞,金翠英,周建平,等.抗炎宫乐胶囊治疗血热型崩漏的机制[J].中国实验方剂学,2012,18(04):205-209.
[10]王名英,全章维,王利,等.固冲调经胶囊治疗崩漏41例临床观察[J].实用中西医结合临床,2015,15(03):10-11.
[11]郁琦.现行各国功能失调性子宫出血临床诊断和治疗指南综合资料[C].高泌乳素血症和功能失调性子宫出血专题研讨会论文集.上海:中华医学会妇产科学分会妇科内分泌学组和绝经学组,2007:55-66.
[12]陈粮,袁玉枝,刁伟坚,等.近10年中医药诊治功血的进展[J].中国中医药现代远程教育,2013,11(09):152-154.
[13]韩萍.辨治更年期功血的临床体会[J].中医临床研究,2017,09(02):109-110.
[14]李绍林.功能性子宫出血的中医病机及治疗思路探析[J].世界中西医结合杂志,2017,12(09):1185-1188.
[15]柴玉霞.中医治疗阴虚血热型围绝经期无排卵性功能失调性子宫出血的疗效观察[J].中医临床研究,2017,09(35):17-18.
[2]张玉珍.中医妇科学[M].7版.北京:中国中医药出版社,2002:65.
[3]中华人民共和国卫生部.中药新药临床研究指导原则[S].北京:中国医药科技出版社,1993:236-240.
[4]关煜,林运霞,程慕溪.贞茜颗粒治疗阴虚血热型崩漏的临床观察[J].北京中医药,2016,35(5):490-492.
[5]刘恒炼,夏敏,翁双燕,等.仙旱合剂对血热型功能失调性子宫出血止血效果观察[J].陕西中医,2017,38(9):1205-1207.
[6]晏军,汤玲,史梅莹,等.肖承悰教授治疗崩漏的经验浅析[J].环球中医药,2015,08(10):1210-1212.
[7]刘朝圣,李点,何清湖,等.熊继柏教授辨治崩漏经验[J].中华中医药杂志,2015,30(06):2014-2016.
[8]黄国华.功血合剂治疗阴虚型无排卵性功血60例疗效观察[J].中医临床研究,2011,03(17):33-34.
[9]吴虓飞,金翠英,周建平,等.抗炎宫乐胶囊治疗血热型崩漏的机制[J].中国实验方剂学,2012,18(04):205-209.
[10]王名英,全章维,王利,等.固冲调经胶囊治疗崩漏41例临床观察[J].实用中西医结合临床,2015,15(03):10-11.
[11]郁琦.现行各国功能失调性子宫出血临床诊断和治疗指南综合资料[C].高泌乳素血症和功能失调性子宫出血专题研讨会论文集.上海:中华医学会妇产科学分会妇科内分泌学组和绝经学组,2007:55-66.
[12]陈粮,袁玉枝,刁伟坚,等.近10年中医药诊治功血的进展[J].中国中医药现代远程教育,2013,11(09):152-154.
[13]韩萍.辨治更年期功血的临床体会[J].中医临床研究,2017,09(02):109-110.
[14]李绍林.功能性子宫出血的中医病机及治疗思路探析[J].世界中西医结合杂志,2017,12(09):1185-1188.
[15]柴玉霞.中医治疗阴虚血热型围绝经期无排卵性功能失调性子宫出血的疗效观察[J].中医临床研究,2017,09(35):17-18.