基于文献的儿童哮喘缓解期肾阳虚及肾阴虚证用药规律挖掘研究
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摘要
目的用数据挖掘方法,分析期刊文献中儿童哮喘缓解期肾阳虚及肾阴虚证的中医处方用药规律,为中医药临床治疗哮喘提供参考。方法通过检索中国学术期刊网络出版总库(CNKI)、万方数据库、中文科技期刊数据库(维普)及中国生物医学文献数据库中的期刊数据库,筛选出1990-2017年期刊文献中治疗儿童哮喘缓解期肾阳虚及肾阴虚证的临床效验用方,用SPSS modeler 18软件,通过药物频次分析和药物功效频次分析、两味及三味药物配伍关联规则分析、网络路分析等数据挖掘方法进行用药规律分析。结果符合纳排标准的方剂有319首,除甘草以外,有中药79味,治疗儿童哮喘缓解期肾阳虚证、肾阴虚证分别有14、11个功效类别。⑴治疗肾阳虚证共用37味药物,关联规则分析常用两味药物配伍为熟地黄与附子;三味药配伍为熟地黄、山药、附子。网络图分析治疗肾阳虚证常以附子、熟地黄、山药、山茱萸、牡丹皮、茯苓、泽泻、桂枝、车前子、牛膝配伍使用。⑵治疗肾阴证共用42味药物,关联规则分析常用两味药物配伍为山茱萸与熟地黄;三味药配伍为茯苓、山茱萸、熟地黄。网络图分析治疗肾阴虚证常以山茱萸、熟地黄、茯苓、山药、泽泻、牡丹皮配伍使用。结论治疗儿童哮喘缓解期肾阳虚证用药以利水渗湿、补肾阳及补肾阴药物为主,兼用活血、温阳药物;肾阴虚证用药以补阴、益肾、利水药物为主,兼用活血化瘀、温补肾阳、清虚热药。
Objective To analyze the medication rules of TCM prescriptions for pediatric asthma catabasis with kidney-yang deficiency and kidney-yin deficiency by data mining; To provide references for TCM treatment for asthma in clinic. Methods By retrieving CNKI, Wanfang, VIP and journal database in China Biomedical Literature Database, clinical prescriptions for treatment of pediatric asthma catabasis with kidneyyang deficiency and kidney-yin deficiency from 1990 to 2017 were screened. SPSS modeler 18 software was used. Analysis on medication rules was carried out by frequency analysis of medicine and frequency analysis of medicine efficacy, correlation analysis of two-kinds of Chinese materia medica and three-kinds of Chinese materia medica compatibility rules, and network path analysis. Results 319 prescriptions met the standards, in addition to Glycyrrhizae Radix et Rhizoma, 79 kinds of Chinese materia medica could treat pediatric asthma catabasis with kidney-yang deficiency and kidney-yin deficiency, with 14 and 11 efficacy categories, respectively. ⑴ 37 kinds of Chinese materia medica could treat kidney-yang deficiency. Association rule analysis commonly used two kinds of Chinese materia medica compatibility as Rehmanniae Radix Praeparata and Aconiti Lateralis Radix Praeparata; three kinds of Chinese materia medica compatibility was Rehmanniae Radix Praeparata, Dioscoreae Rhizoma and Aconiti Lateralis Radix Praeparata. Network diagram analysis showed that kidney-yang deficiency used compatibility of Aconiti Lateralis Radix Praeparata, Rehmanniae Radix Praeparata, Dioscoreae Rhizoma, Corni Fructus, Moutan Cortex, Poria, Alismatis Rhizoma, Cinnamomi Ramulus, Plantaginis Semen and Achyranthis Bidentatae Radix.(2) 42 kinds of Chinese materia medica could treat kidney-yin deficiency. Association rule analysis commonly used two kinds of Chinese materia medica compatibility as Corni Fructus and Rehmanniae Radix Praeparata. Network diagram analysis showed that kidney-yin deficiency used compatibility of Corni Fructus, Rehmanniae Radix Praeparata, Poria, Dioscoreae Rhizoma, Alismatis Rhizoma and Moutan Cortex. Conclusion Treatment for pediatric asthma catabasis with kidney-yang deficiency often applies Chinese materai medica targeting to clear damp and promote diuresis, tonify kidney-yang and kidney-yin mainly as well as invigorate blood circulation and warm yang. Treatment for pediatric asthma catabasis with kidney-yang deficiency often applies Chinese materia medica committed to tonify yin and kidney, clear damp as well as promote blood circulation and remove blood stasis, warm and invigorate kidney yang and clear deficient heat.
Objective To analyze the medication rules of TCM prescriptions for pediatric asthma catabasis with kidney-yang deficiency and kidney-yin deficiency by data mining; To provide references for TCM treatment for asthma in clinic. Methods By retrieving CNKI, Wanfang, VIP and journal database in China Biomedical Literature Database, clinical prescriptions for treatment of pediatric asthma catabasis with kidneyyang deficiency and kidney-yin deficiency from 1990 to 2017 were screened. SPSS modeler 18 software was used. Analysis on medication rules was carried out by frequency analysis of medicine and frequency analysis of medicine efficacy, correlation analysis of two-kinds of Chinese materia medica and three-kinds of Chinese materia medica compatibility rules, and network path analysis. Results 319 prescriptions met the standards, in addition to Glycyrrhizae Radix et Rhizoma, 79 kinds of Chinese materia medica could treat pediatric asthma catabasis with kidney-yang deficiency and kidney-yin deficiency, with 14 and 11 efficacy categories, respectively. ⑴ 37 kinds of Chinese materia medica could treat kidney-yang deficiency. Association rule analysis commonly used two kinds of Chinese materia medica compatibility as Rehmanniae Radix Praeparata and Aconiti Lateralis Radix Praeparata; three kinds of Chinese materia medica compatibility was Rehmanniae Radix Praeparata, Dioscoreae Rhizoma and Aconiti Lateralis Radix Praeparata. Network diagram analysis showed that kidney-yang deficiency used compatibility of Aconiti Lateralis Radix Praeparata, Rehmanniae Radix Praeparata, Dioscoreae Rhizoma, Corni Fructus, Moutan Cortex, Poria, Alismatis Rhizoma, Cinnamomi Ramulus, Plantaginis Semen and Achyranthis Bidentatae Radix.(2) 42 kinds of Chinese materia medica could treat kidney-yin deficiency. Association rule analysis commonly used two kinds of Chinese materia medica compatibility as Corni Fructus and Rehmanniae Radix Praeparata. Network diagram analysis showed that kidney-yin deficiency used compatibility of Corni Fructus, Rehmanniae Radix Praeparata, Poria, Dioscoreae Rhizoma, Alismatis Rhizoma and Moutan Cortex. Conclusion Treatment for pediatric asthma catabasis with kidney-yang deficiency often applies Chinese materai medica targeting to clear damp and promote diuresis, tonify kidney-yang and kidney-yin mainly as well as invigorate blood circulation and warm yang. Treatment for pediatric asthma catabasis with kidney-yang deficiency often applies Chinese materia medica committed to tonify yin and kidney, clear damp as well as promote blood circulation and remove blood stasis, warm and invigorate kidney yang and clear deficient heat.
引文
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[8]甘晓霞,曾庆芳,张黎黎,等.金匮肾气丸合参蛤散治疗小儿肾不纳气型哮喘疗效观察[J].现代中西医杂志,2016,25(2):162-163.
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[2]徐丽,贾连群,张哲,等.小儿支气管哮喘的中西医病机及治疗[J].中华中医药学刊,2018,36(3):552-554.
[3]刘斐,虞坚尔,白莉,等.中药内服治疗支气管哮喘的Meta分析[J].中华中医药学刊,2016,34(2):299-303.
[4]中华医学会呼吸病学分会哮喘学组.支气管哮喘防治指南(支气管哮喘的定义、诊断、治疗及教育和管理方案)[J].中华结核和呼吸杂志,2003,26(3):132-138.
[5]中华中医药学会肺系病分会.支气管哮喘中医诊疗专家共识(2012)[J].中医杂志,2013,54(7):627-629.
[6]钟赣生.中药学[M].北京:中国中医药出版社,2016.
[7]董竞成,吴金峰,张红英,等.从补肾益气法的理论研究及临床应用浅释中医“异病同治”[J].中国中西医结合杂志,2013,33(5):695-700.
[8]甘晓霞,曾庆芳,张黎黎,等.金匮肾气丸合参蛤散治疗小儿肾不纳气型哮喘疗效观察[J].现代中西医杂志,2016,25(2):162-163.
[9]李敏,丁丹丹.从肺脾肾论治儿童难治性哮喘30例临床观察[J].中国中医基础医学杂志,2016,22(3):426-427,封4.
[10]傅小达,李翠玲,傅小建.八宝哮咳散合六味地黄丸治疗咳嗽变异性哮喘35例[J].中国实验方剂学杂志,2011,17(4):199-201.