已上市中成药治疗不同证候冠心病心绞痛的核心处方挖掘
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摘要
基于分析与治疗冠心病心绞痛相关的已上市中成药,探讨冠心病心绞痛用药与组方规律。收集中成药价值评估信息数据库中所有治疗冠心病心绞痛的中成药,建立规范化数据库,进行证型分类,运用频数统计与关联规则(IBM SPSS Modeler 14. 1 Premium软件,Apriori算法)分析主要证型用药特点与组方规律。对最终筛选出的170种中成药、共197味中药进行分析,涉及11个证型,其中血瘀证、气滞血瘀证、气虚血瘀证、气阴两虚兼血瘀证是主要证型,明确治疗主要证型处方的单味药用药频次、归纳常用药物组合,总结出4个主要证型的核心处方,并对4个证型的核心处方进行比较,分析不同证型的用药与组方规律。核心处方体现了已上市中成药治疗冠心病心绞痛的组方法则以活血化瘀为主,兼以行气、补气开窍、补益气阴等,用药以丹参、川芎为主,根据不同的证型予以降香、赤芍、三七、红花、冰片、人参等中药。频率统计与关联规则相结合挖掘治疗冠心病心绞痛的用药特点、核心处方,为冠心病心绞痛的治疗用药及新药研发提供思路。
To analyze the medication features and regularity of prescriptions of traditional Chinese medicines in treating patients with coronary heart disease angina pectoris based on the launched Chinese patent medicines. In the article,we collected all of the launched Chinese patent medicines for treating coronary heart disease and angina pectoris from the Chinese patent medicine value assessment information database,and set up a medical record normalized database,then carried out the classification of syndromes. The medication features and prescription rules for angina pectoris were analyzed by frequency statistics and association rules(IBM SPSS Modeler 14. 1 Premiums software,Apriori algorithm). Finally,a total of 170 prescriptions were selected,and 197 Chinese herbs were included,involving to totally 11 syndrome types,in which blood stasis syndrome,Qi stagnation and blood stasis syndrome,Qi deficiency and blood stasis syndrome,Qi-Yin deficiency and blood stasis syndrome were the main syndrome types. The frequency of single-herb medicines for the four main syndrome types,the combination of commonly used medicines,and the core prescriptions were summarized. After comparing the core prescriptions of the four syndrome types,we could analyze the medication features and prescription rules. In conclusion,the therapeutic principle is blood-activating and stasis-dissolving,and consideration was also given to promoting Qi,invigorating Qi and resuscitation and invigorating Qi-Yin. The main medicines include Danshen(Salvia Miltiorrhizae Radix et Rhizoma) and Chuan-xiong(Chuanxiong Rhizoma). According to different types of syndromes,Chinese herbal medicines are added,such as Jiangxiang(Dalbergiae Odoriferae Lignum), Chishao(Paeoniaeradix Rubra), Sanqi(Notoginseng Radix et Rhizoma), Honghua(Carthami Flos),Bingpian(Borneolum Syntheticum),Renshen(Ginseng Radix et Rhizoma). Frequency statistics and association rules are combined to explore the medication features and core prescriptions,which provide ideas for the treatment of angina pectoris and the development of new drugs.
To analyze the medication features and regularity of prescriptions of traditional Chinese medicines in treating patients with coronary heart disease angina pectoris based on the launched Chinese patent medicines. In the article,we collected all of the launched Chinese patent medicines for treating coronary heart disease and angina pectoris from the Chinese patent medicine value assessment information database,and set up a medical record normalized database,then carried out the classification of syndromes. The medication features and prescription rules for angina pectoris were analyzed by frequency statistics and association rules(IBM SPSS Modeler 14. 1 Premiums software,Apriori algorithm). Finally,a total of 170 prescriptions were selected,and 197 Chinese herbs were included,involving to totally 11 syndrome types,in which blood stasis syndrome,Qi stagnation and blood stasis syndrome,Qi deficiency and blood stasis syndrome,Qi-Yin deficiency and blood stasis syndrome were the main syndrome types. The frequency of single-herb medicines for the four main syndrome types,the combination of commonly used medicines,and the core prescriptions were summarized. After comparing the core prescriptions of the four syndrome types,we could analyze the medication features and prescription rules. In conclusion,the therapeutic principle is blood-activating and stasis-dissolving,and consideration was also given to promoting Qi,invigorating Qi and resuscitation and invigorating Qi-Yin. The main medicines include Danshen(Salvia Miltiorrhizae Radix et Rhizoma) and Chuan-xiong(Chuanxiong Rhizoma). According to different types of syndromes,Chinese herbal medicines are added,such as Jiangxiang(Dalbergiae Odoriferae Lignum), Chishao(Paeoniaeradix Rubra), Sanqi(Notoginseng Radix et Rhizoma), Honghua(Carthami Flos),Bingpian(Borneolum Syntheticum),Renshen(Ginseng Radix et Rhizoma). Frequency statistics and association rules are combined to explore the medication features and core prescriptions,which provide ideas for the treatment of angina pectoris and the development of new drugs.
引文
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[26]袁蓉,王燕,丛伟红,等.芎芍胶囊治疗心血管病研究进展[J].中国中药杂志,2017,42(4):640.
[27]陈斌斌,石文文,孙利华,等.速效救心丸和麝香保心丸治疗冠心病心绞痛的成本-效果分析[J].中国现代应用药学,2015,32(5):599.
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[29]宋晓静.论中药开窍药的临床应用及药理作用[J].中外医疗,2009,28(17):105.
[30]刘文雅,王曙东.地龙药理作用研究进展[J].中国中西医结合杂志,2013,33(2):282.
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[32]宰军华,张建文,蔡三军,等.丹参饮合生脉散治疗不稳定性心绞痛[J].中国中西医结合急救杂志,1998(9):423.
[33]焦岩,张艳,王东海.生脉散、桃红四物汤联合西药治疗冠心病心绞痛对照临床观察[J].实用中医内科杂志,2012(8):34.
[34]陈岩,刘秀琴.《丹芎冠心汤》治疗冠心病心绞痛40例[C].北京:全国中医药心脑病中药用药临床评价研讨会,1998.
[35]刘嵋松,温富春,纪凤兰,等.中药新药“丹芎救心气雾剂”对胸痹-心血瘀阻证的临床疗效及安全性评价[J].中国当代医药,2017,24(2):4.
[2] Benjamin E J,Virani S S,Callaway C W,et al. Heart disease and stroke statistics-2018 update:a report from the american heart association[J]. Circulation,2018,137(12):558.
[3]韩雅玲.心血管药物治疗无创性检查最新进展[M]. 6版.沈阳:辽宁科学技术出版社,2007.
[4]李立志,董国菊,葛长江,等.宽胸气雾剂缓解冠心病心绞痛的多中心随机对照临床研究[J].中国中西医结合杂志,2014,34(4):396.
[5]王海波,战树森.一种治疗冠心病的中药临床应用1 122例观察[J].中国医药指南,2015(34):197.
[6]彭立萍.冠心止痛合剂治疗冠心病心绞痛临床疗效观察[J].辽宁中医杂志,2016(4):788.
[7]高学敏.中药学[M].北京:中国中医药出版社,2007.
[8]中国药典.一部[S]. 2015.
[9]陈可冀,赵福海,蒋跃绒.慢性稳定性也绞痛的中西医结合治疗进展[C].广州:2011中国医师协会中西医结合医师大会,2011.
[10]张京春.陈可冀院士治疗冠心病心绞痛学术思想与经验[J].中西医结合心脑血管病杂志,2005,3(7):634.
[11]王安璐,罗静,于美丽,等.基于陈可冀院士血瘀证辨证方法治疗冠心病稳定性心绞痛的实用性随机对照研究[J].中国中西医结合杂志,2017,37(10):1174.
[12]杨桦,李红,刁志光.血府逐瘀汤治疗冠心病心绞痛疗效观察[J].辽宁中医药大学学报,2011(5):202.
[13]李玉峰,杜亚薇,吴圣贤,等.注射用丹参治疗冠心病心绞痛(血瘀证)多中心随机对照临床研究[J].中外医疗,2014(11):131.
[14]张国珍.丹参酮ⅡA磺酸钠注射液治疗冠心病心绞痛(血瘀证)的疗效观察[J].现代诊断与治疗,2015,26(12):2680.
[15]陈芬燕,郭韧,张毕奎.丹参酮ⅡA的心血管药理作用研究进展[J].中国中药杂志,2015,40(9):1649.
[16]王冰瑶,吴晓燕,樊官伟.丹参素保护心血管系统的药理作用机制研究进展[J].中草药,2014,45(17):2571.
[17]武永刚,李雪莹,王苏丽,等.红花黄色素化学成分及对心脑血管作用研究进展[J].药学研究,2011,30(8):481.
[18]韩炜.川芎的化学成分与药理作用研究进展[J].中国现代中药,2017,19(9):1341.
[19]冀兰鑫,黄浩,李长志,等.赤芍药理作用的研究进展[J].药物评价研究,2010,33(3):233.
[20]杨娟,袁一怔,尉广飞,等.三七植物化学成分及药理作用研究进展[J].世界科学技术———中医药现代化,2017(10):1641.
[21]尚坤,李敬文,常美月,等.中药冰片药理作用研究进展[J].吉林中医药,2018,38(4):439.
[22]刘德丽,包华音,刘杨.近5年黄芪化学成分及药理作用研究进展[J].食品与药品,2014(1):68.
[23]路放,杨世海,孟宪兰.人参药理作用研究新进展[J].人参研究,2013,25(1):46.
[24]穆尼热,古丽巴哈尔,阿依努尔.谈中药药对在方剂中的作用[J].新疆中医药,2001(s1):59.
[25]杨育同.丹红注射液治疗冠心病不稳定型心绞痛90例临床观察[J].中西医结合心脑血管病杂志,2010,8(4):392.
[26]袁蓉,王燕,丛伟红,等.芎芍胶囊治疗心血管病研究进展[J].中国中药杂志,2017,42(4):640.
[27]陈斌斌,石文文,孙利华,等.速效救心丸和麝香保心丸治疗冠心病心绞痛的成本-效果分析[J].中国现代应用药学,2015,32(5):599.
[28]刘定辉.参芪扶正注射液治疗稳定型心绞痛的临床研究及对血浆ET水平的影响[D].哈尔滨:黑龙江中医药大学,2007.
[29]宋晓静.论中药开窍药的临床应用及药理作用[J].中外医疗,2009,28(17):105.
[30]刘文雅,王曙东.地龙药理作用研究进展[J].中国中西医结合杂志,2013,33(2):282.
[31]王潮临,宁耀瑜.珍珠粉对大鼠免疫功能的影响[J].广西医科大学学报,1994(3):280.
[32]宰军华,张建文,蔡三军,等.丹参饮合生脉散治疗不稳定性心绞痛[J].中国中西医结合急救杂志,1998(9):423.
[33]焦岩,张艳,王东海.生脉散、桃红四物汤联合西药治疗冠心病心绞痛对照临床观察[J].实用中医内科杂志,2012(8):34.
[34]陈岩,刘秀琴.《丹芎冠心汤》治疗冠心病心绞痛40例[C].北京:全国中医药心脑病中药用药临床评价研讨会,1998.
[35]刘嵋松,温富春,纪凤兰,等.中药新药“丹芎救心气雾剂”对胸痹-心血瘀阻证的临床疗效及安全性评价[J].中国当代医药,2017,24(2):4.