基于中医传承辅助系统挖掘刘启泉治疗慢性萎缩性胃炎伴肠上皮化生用药规律
|
摘要
目的:运用中医传承辅助平台(V2.5)软件,挖掘刘启泉教授治疗慢性萎缩性胃炎伴肠上皮化生的经验及用药规律。方法:收集刘启泉教授2014年10月至2016年10月在河北省中医院脾胃病科门诊治疗慢性萎缩性胃炎伴肠上皮化生的有效病案286例,录入中医传承辅助平台(V2.5)软件,利用该软件集成的规则分析、改进互信息法、熵聚类等数据挖掘方法,分析用药规律及常用处方的药物特点。结果:286首有效病例中,药性多苦、辛、温、寒,主归脾、胃、肝经;出现频次在40次以上的药物有44味,按功效分类,共计使用14类药,其中清热药和理气药使用频次最高;得到8味核心药物,包括石菖蒲、郁金、百合、白芍、延胡索、茯苓、当归、蒲公英;得出药物核心组合18个,新方9首。结论:刘启泉教授治疗慢性萎缩性胃炎伴肠上皮化生临证用药多辛开苦降,寒温并用,认为热毒血瘀是病机关键,以"清热解毒,行气活血"贯穿始终,同时不忘顾护阴液及情志的调护。
Objective:To mine Professor Liu Qiquan's experience of treating chronic atrophic gastritis(CAG) combined with intestinal metaplasia(IM) and drug-use rules by using TCM inheritance auxiliary system(V2.5) software.Methods:Two hundred and eighty-six outpatients with CAG combined with IM who were treated in Spleen and Stomach Department of Hebei Provincial Hospital of Traditional Chinese Medicine between October 2014 and October 2016 were chosen as the research subjects,and their information was entered into TCM inheritance auxiliary system(V2.5) software.Then using data mining methods including rules analysis,improved mutual information method,entropy clustering method,etc.integrated from the software,the characteristics of drug-use rules and commonly-used prescriptions were analyzed.Results:Among the 286 effective cases,the used drugs are mostly bitter,pungent,warm and cold,and attributive to the spleen,stomach,liver meridians.There are 44 types of drugs with appearance frequency of more than 40; according to the classification of functions,a total of 14 kinds of medicine were used,and among of them,heat-clearing Chinese medicinal herbs and qi-regulating Chinese medicinal herbs were in the highest frequency of use.There were 8 kinds of core drugs,including Shichangpu(Rhizoma Acori Tatarinowii),Yujin(Radix Curcumae),Baihe(Bulbus Lilii),Baishao(Radix Paeoniae Alba),Yanhusuo(Rhizoma Corydalis),Fuling(Poria),Danggui(Radix Angelicae Sinensis),Pugongying(Herba Taraxaci).There were 18 drug core combinations,including 9 new ones.Conclusion:In treating CAG combined with IM,Professor Liu Qi-quan always uses drugs with pungent flavor and cold nature to release and descend,and usually drugs with cold and warm nature together.He thinks toxic heat and blood stasis are the key pathogenesis,so he often not only uses drugs to clear away heat and remove toxicity,regulate qi and invigorate blood circulation,but also protects yin fluid and regulates emotions.
Objective:To mine Professor Liu Qiquan's experience of treating chronic atrophic gastritis(CAG) combined with intestinal metaplasia(IM) and drug-use rules by using TCM inheritance auxiliary system(V2.5) software.Methods:Two hundred and eighty-six outpatients with CAG combined with IM who were treated in Spleen and Stomach Department of Hebei Provincial Hospital of Traditional Chinese Medicine between October 2014 and October 2016 were chosen as the research subjects,and their information was entered into TCM inheritance auxiliary system(V2.5) software.Then using data mining methods including rules analysis,improved mutual information method,entropy clustering method,etc.integrated from the software,the characteristics of drug-use rules and commonly-used prescriptions were analyzed.Results:Among the 286 effective cases,the used drugs are mostly bitter,pungent,warm and cold,and attributive to the spleen,stomach,liver meridians.There are 44 types of drugs with appearance frequency of more than 40; according to the classification of functions,a total of 14 kinds of medicine were used,and among of them,heat-clearing Chinese medicinal herbs and qi-regulating Chinese medicinal herbs were in the highest frequency of use.There were 8 kinds of core drugs,including Shichangpu(Rhizoma Acori Tatarinowii),Yujin(Radix Curcumae),Baihe(Bulbus Lilii),Baishao(Radix Paeoniae Alba),Yanhusuo(Rhizoma Corydalis),Fuling(Poria),Danggui(Radix Angelicae Sinensis),Pugongying(Herba Taraxaci).There were 18 drug core combinations,including 9 new ones.Conclusion:In treating CAG combined with IM,Professor Liu Qi-quan always uses drugs with pungent flavor and cold nature to release and descend,and usually drugs with cold and warm nature together.He thinks toxic heat and blood stasis are the key pathogenesis,so he often not only uses drugs to clear away heat and remove toxicity,regulate qi and invigorate blood circulation,but also protects yin fluid and regulates emotions.
引文
[1]KIM N,PARK R Y,CHO S I,et al.Helicobacter pylori infection and development of gastric cancer in Korea:long-term follow-up[J].Journal Clininal Gastroenterololy,2008,42(5):448-454.
[2]中华医学会消化病学分会.中国慢性胃炎共识意见[J].胃肠病学,2013,18(1):24-36.
[3]张颖,王文苹,季旭明.基于中医传承辅助系统分析治疗胃痛的方剂用药规律[J].中国实验方剂学杂志,2013,19(2):331-334.
[4]李海峰,石若娜,韩文静,等.石菖蒲药理作用及其机制的研究进展[J].时珍国医国药,2016,27(11):2728-2730.
[5]NI G,SHI G R,ZHANG D,et al.Cytotoxic lignans and sesquiterpenoids from the rhizomes of Acorus tatarinowii[J].Planta Med,2016,82(7):632-638.
[6]金海峰,吕宾,戴金峰.温郁金二萜类化合物C对不同分化胃腺癌细胞株的抑制作用[J].中华中医药杂志,2015,30(9):3356-3360.
[7]SHEN Y,LU B,ZHANG S,et al.Diterpenoid C of Radix Curcumae:an inhibitor of proliferation and inducer of apoptosis in human colon adenocarcinoma cells acting via inhibiting MAPK signaling pathway[J].Pharm Biol,2014,52(9):1158-1165.
[8]崔丽,孙世华,张艳霞.刘启泉从毒瘀论治胃癌前病变经验[J].辽宁中医杂志,2007,34(8):1043.
[9]于立恒.蒲公英药理作用研究进展[J].实用中医药杂志,2012,28(7):617-620.
[10]刘启泉,王志坤.刘启泉胃病临证录[M].北京:人民军医出版社,2013:88-93.
[11]张纨.刘启泉医案医话集[M].北京:中国医药科技出版社,2016:198.
[2]中华医学会消化病学分会.中国慢性胃炎共识意见[J].胃肠病学,2013,18(1):24-36.
[3]张颖,王文苹,季旭明.基于中医传承辅助系统分析治疗胃痛的方剂用药规律[J].中国实验方剂学杂志,2013,19(2):331-334.
[4]李海峰,石若娜,韩文静,等.石菖蒲药理作用及其机制的研究进展[J].时珍国医国药,2016,27(11):2728-2730.
[5]NI G,SHI G R,ZHANG D,et al.Cytotoxic lignans and sesquiterpenoids from the rhizomes of Acorus tatarinowii[J].Planta Med,2016,82(7):632-638.
[6]金海峰,吕宾,戴金峰.温郁金二萜类化合物C对不同分化胃腺癌细胞株的抑制作用[J].中华中医药杂志,2015,30(9):3356-3360.
[7]SHEN Y,LU B,ZHANG S,et al.Diterpenoid C of Radix Curcumae:an inhibitor of proliferation and inducer of apoptosis in human colon adenocarcinoma cells acting via inhibiting MAPK signaling pathway[J].Pharm Biol,2014,52(9):1158-1165.
[8]崔丽,孙世华,张艳霞.刘启泉从毒瘀论治胃癌前病变经验[J].辽宁中医杂志,2007,34(8):1043.
[9]于立恒.蒲公英药理作用研究进展[J].实用中医药杂志,2012,28(7):617-620.
[10]刘启泉,王志坤.刘启泉胃病临证录[M].北京:人民军医出版社,2013:88-93.
[11]张纨.刘启泉医案医话集[M].北京:中国医药科技出版社,2016:198.