基于755首中药处方治疗糖尿病用药规律的研究
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摘要
检索并纳入1995—2016年发表的治疗糖尿病相关文献755篇,涉及中药处方755首,单味中药367味,共治疗糖尿病及其并发症的有效例数为33 330例,探讨中医药治疗糖尿病及其并发症的用药规律。采用Microsoft Excel 2010软件和Clementine 12.0软件,分析与比较各病症类型的单味中药使用频次、功效和组方配伍规律。中医药在治疗糖尿病及其并发症方面,治疗病症类型排名前4位的分别是糖尿病、糖尿病神经系统并发症、糖尿病肾病和糖尿病心血管并发症,分别占总有效病例数的31.62%、29.82%、8.87%和6.47%。进一步对治疗排名前4位的病症进行分析,发现治疗糖尿病的常用单味药为黄芪、山药、地黄、天花粉和麦冬等,常用中药类别依次为补虚药、清热药和活血化瘀药;治疗糖尿病的神经系统并发症常用单味药为黄芪、当归、川芎、丹参和桂枝等,常用中药类别依次为补虚药、活血化瘀药和清热药;治疗糖尿病肾病的常用单味药为黄芪、山药、丹参、茯苓和山茱萸等,常用中药类别依次为补虚药、活血化瘀药和利水渗湿药;治疗糖尿病心血管并发症的常用单味药为黄芪、丹参、当归、红花和川芎等,常用中药类别为活血化瘀药、补虚药和清热药。中医药治疗糖尿病、糖尿病神经系统并发症、糖尿病肾病和糖尿病心血管并发症的用药规律具有一定的相似性,均以补虚药为主,兼以活血化瘀、清热和利水渗湿药等,但具体用药侧重点不同,糖尿病和糖尿病神经系统并发症侧重补虚药,兼以活血化瘀药和清热药的使用,糖尿病肾病侧重于补虚药,兼以活血化瘀药和利水渗湿药的使用,而糖尿病心血管并发症侧重于活血化瘀药和补虚药并重,兼以清热药使用。
To explore the rules of medication for diabetes and diabetic complications based on analysis on 755 traditional Chinese medicine(TCM) prescriptions. The information in 755 papers published from 1995 to 2016 was got including 755 herbal prescriptions, 367 herbs, 33 330 effective cases. Based on the above information, usage frequency of single herb, efficiency and the rules of formulating prescription for different types of diabetes were analyzed and compared using Microsoft Excel 2010 and Clementine 12.0 software. In the treatment of diabetes and its complications, the top four diabetes symptoms are about diabetes, diabetic neurological complications, diabetic nephropathy and diabetic cardiovascular complications, and accounting for 31.62%, 29.82%, 8.87%, and 6.47% of the total number of effective cases. Further analysis of the top four illnesses found that single herb commonly used in the treatment of diabetes was Astragali Radix, Dioscoreae Rhizoma, Rehmanniae Radix, Trichosanthis Radix, Ophiopogonis Radix, etc. The commonly used drugs categories were tonic herbs, heat-clearing herbs and blood activating herbs; The single medicine commonly used in the treatment of diabetic neurological complications was Astragali Radix, Angelicae Sinensis Radix, Chuanxiong Rhizoma, Radix Salviae Miltiorrhizae et Rhizoma, Cinnamomi Ramulus, etc. The commonly used drugs categories were tonic herbs, blood activating herbs and heat-clearing herbs; The single herb commonly used in the treatment of diabetic nephropathy was Astragali Radix, Dioscoreae Rhizoma, Salviae Miltiorrhizae Radix, Poria, Fructus Corni, etc., the commonly used drugs categories were tonic herbs, blood activating herbs and damp-clearing herbs. The single herb commonly used in the treatment of diabetic cardiovascular complications was Astragali Radix, Salviae Miltiorrhizae Radix, Angelicae Sinensis Radix, Carthami Flos, Chuanxiong Rhizoma, etc., the commonly used drugs categories were blood activating herbs, tonic herbs and heat-clearing herbs. The rules of medication of TCM for diabetes, diabetic neurological complications, diabetic nephropathy and diabetic cardiovascular complications showed similar characteristics, tonic herbs were used the most frequently, supplemented by blood activating herbs, heat-clearing herbs and damp-clearing herbs. However, the principle of formula is a little different for different types of diabetes and diabetic complications, specifically. The prescriptions for diabetes and diabetic neurological complications consist of tonic herbs as the principal, supplemented by blood activating herbs and heat-clearing herbs; The prescriptions for diabetic nephropathy are composed of tonic herbs as the principal, supplemented by blood activating herbs and damp-clearing herbs, as well as tonic herbs and blood activating herbs were equal components in the prescriptions for diabetic cardiovascular complications, supplemented by heat-clearing herbs.
To explore the rules of medication for diabetes and diabetic complications based on analysis on 755 traditional Chinese medicine(TCM) prescriptions. The information in 755 papers published from 1995 to 2016 was got including 755 herbal prescriptions, 367 herbs, 33 330 effective cases. Based on the above information, usage frequency of single herb, efficiency and the rules of formulating prescription for different types of diabetes were analyzed and compared using Microsoft Excel 2010 and Clementine 12.0 software. In the treatment of diabetes and its complications, the top four diabetes symptoms are about diabetes, diabetic neurological complications, diabetic nephropathy and diabetic cardiovascular complications, and accounting for 31.62%, 29.82%, 8.87%, and 6.47% of the total number of effective cases. Further analysis of the top four illnesses found that single herb commonly used in the treatment of diabetes was Astragali Radix, Dioscoreae Rhizoma, Rehmanniae Radix, Trichosanthis Radix, Ophiopogonis Radix, etc. The commonly used drugs categories were tonic herbs, heat-clearing herbs and blood activating herbs; The single medicine commonly used in the treatment of diabetic neurological complications was Astragali Radix, Angelicae Sinensis Radix, Chuanxiong Rhizoma, Radix Salviae Miltiorrhizae et Rhizoma, Cinnamomi Ramulus, etc. The commonly used drugs categories were tonic herbs, blood activating herbs and heat-clearing herbs; The single herb commonly used in the treatment of diabetic nephropathy was Astragali Radix, Dioscoreae Rhizoma, Salviae Miltiorrhizae Radix, Poria, Fructus Corni, etc., the commonly used drugs categories were tonic herbs, blood activating herbs and damp-clearing herbs. The single herb commonly used in the treatment of diabetic cardiovascular complications was Astragali Radix, Salviae Miltiorrhizae Radix, Angelicae Sinensis Radix, Carthami Flos, Chuanxiong Rhizoma, etc., the commonly used drugs categories were blood activating herbs, tonic herbs and heat-clearing herbs. The rules of medication of TCM for diabetes, diabetic neurological complications, diabetic nephropathy and diabetic cardiovascular complications showed similar characteristics, tonic herbs were used the most frequently, supplemented by blood activating herbs, heat-clearing herbs and damp-clearing herbs. However, the principle of formula is a little different for different types of diabetes and diabetic complications, specifically. The prescriptions for diabetes and diabetic neurological complications consist of tonic herbs as the principal, supplemented by blood activating herbs and heat-clearing herbs; The prescriptions for diabetic nephropathy are composed of tonic herbs as the principal, supplemented by blood activating herbs and damp-clearing herbs, as well as tonic herbs and blood activating herbs were equal components in the prescriptions for diabetic cardiovascular complications, supplemented by heat-clearing herbs.
引文
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[4]姚晓文,阳国华,林家坤.补肾宣肺活血通腑法治疗糖尿病便秘30例[J].中国中医药现代远程教育,2016,14(21):73-75.
[5]赵菁,耿文静,翟博智.银丹心脑通软胶囊联合瑞舒伐他汀钙和硫酸氢氯吡格雷对伴有2型糖尿病急性脑梗死患者血脂、颈动脉粥样硬化斑块及神经功能恢复的影响[J].中草药,2016,47(15):2707-2712.
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[10]高曌,骆天炯,叶晨玉.玉泉丸对气阴两虚型接受胰岛素治疗的糖尿病患者血糖波动的影响[J].中草药,2015,46(15):2275-2278.
[11]张建霞.中西医结合治疗糖尿病合并脑梗死恢复期临床观察[J].新中医,2015,47(3):33-35.
[12]吴雅梅,卢翠舫.中西药结合治疗老年糖尿病合并高血压的效果分析[J].当代医药论丛,2014,12(18):179-180.
[13]吴亚靓.中药干预糖尿病周围神经病变28例临床观察[J].中医临床研究,2014,6(29):87-88.
[14]吴荣庆.自制中药治疗糖尿病的疗效分析[J].中医临床研究,2014,6(2):71-72.
[15]余仙梅.糖尿病周围神经病变的中西医治疗探讨[J].中国医药指南,2014,12(9):195-196.
[16]张玲.自拟中药方辅助西医治疗老年糖尿病合并高血压临床疗效探讨[J].亚太传统医药,2014,10(23):111-112.
[17]葛家亮.中西医结合治疗糖尿病的临床分析[J].临床合理用药杂志,2013,6(12):39.
[18]李彦彬.糖尿病胃肠功能紊乱的中医治疗研究[J].中国医疗前沿,2013,8(20):17.
[19]王子成.中医治疗33例糖尿病腹泻的临床疗效分析[J].中国医药指南,2013,11(9):638-639.
[20]李增祥,李朝.身痛逐瘀汤加减治疗糖尿病周围神经病变疗效观察[J].四川中医,2013,31(6):112-114.
[21]黄景玉,崔建敏,王祥麒,等.血栓心脉宁胶囊治疗糖尿病周围神经病变临床观察[J].中草药,2001,32(8):103-104.
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[27]邱作成,张振国,李志钢,等.糖尿病周围神经病变病因病机浅析及治法探讨[J].中国实验方剂学杂志,2010,16(17):255-256.
[28]高彦彬,刘铜华,李平.糖尿病肾病中医防治指南[J].中国中医药现代远程教育,2011,9(4):151-153.
[29]王圳,吴金玉,姜芳.从痰瘀毒试论糖尿病肾病中医病机[J].辽宁中医杂志,2010,37(S1):364-365.
[30]冯兴中,张宁,谢春光.糖尿病中医防治指南糖尿病合并脑血管病[J].中国中医药现代远程教育,2011,9(19):138-140.
[31]郭蕾,李振中,丁学屏,等.糖尿病血管病变的中医病机理论诠释[J].中华中医药杂志,2009,24(7):885-888.
[32]徐梓辉,陈大舜,周世文.糖尿病合并冠心病病机及治则探讨[J].中医杂志,2003,44(7):485-487.
[2]杨昭凤,裴友翠.柴胡消渴汤治疗糖尿病胰岛素抵抗疗效观察[J].世界中西医结合杂志,2016,11(8):1153-1155.
[3]徐慧青.芪丹通络汤对糖尿病周围神经及血管活性物质的影响[J].中华中医药学刊,2016,34(6):1530-1533.
[4]姚晓文,阳国华,林家坤.补肾宣肺活血通腑法治疗糖尿病便秘30例[J].中国中医药现代远程教育,2016,14(21):73-75.
[5]赵菁,耿文静,翟博智.银丹心脑通软胶囊联合瑞舒伐他汀钙和硫酸氢氯吡格雷对伴有2型糖尿病急性脑梗死患者血脂、颈动脉粥样硬化斑块及神经功能恢复的影响[J].中草药,2016,47(15):2707-2712.
[6]肖洋,李婷.健脾消痞汤治疗糖尿病胃轻瘫40例[J].陕西中医,2015,36(3):306-307.
[7]邢海伶.中药方剂联合拜糖平结合治疗糖尿病临床效果[J].黑龙江医药,2015,28(1):138-139.
[8]章福宝,陶怡,宁静.中药自拟方辅助治疗2型糖尿病的疗效观察[J].中国中医药科技,2015,22(2):186-187.
[9]岳增宝,柯明辉,马文君,等.补肾活血法治疗糖尿病勃起功能障碍临床疗效观察[J].现代中医临床,2015,22(2):36-38.
[10]高曌,骆天炯,叶晨玉.玉泉丸对气阴两虚型接受胰岛素治疗的糖尿病患者血糖波动的影响[J].中草药,2015,46(15):2275-2278.
[11]张建霞.中西医结合治疗糖尿病合并脑梗死恢复期临床观察[J].新中医,2015,47(3):33-35.
[12]吴雅梅,卢翠舫.中西药结合治疗老年糖尿病合并高血压的效果分析[J].当代医药论丛,2014,12(18):179-180.
[13]吴亚靓.中药干预糖尿病周围神经病变28例临床观察[J].中医临床研究,2014,6(29):87-88.
[14]吴荣庆.自制中药治疗糖尿病的疗效分析[J].中医临床研究,2014,6(2):71-72.
[15]余仙梅.糖尿病周围神经病变的中西医治疗探讨[J].中国医药指南,2014,12(9):195-196.
[16]张玲.自拟中药方辅助西医治疗老年糖尿病合并高血压临床疗效探讨[J].亚太传统医药,2014,10(23):111-112.
[17]葛家亮.中西医结合治疗糖尿病的临床分析[J].临床合理用药杂志,2013,6(12):39.
[18]李彦彬.糖尿病胃肠功能紊乱的中医治疗研究[J].中国医疗前沿,2013,8(20):17.
[19]王子成.中医治疗33例糖尿病腹泻的临床疗效分析[J].中国医药指南,2013,11(9):638-639.
[20]李增祥,李朝.身痛逐瘀汤加减治疗糖尿病周围神经病变疗效观察[J].四川中医,2013,31(6):112-114.
[21]黄景玉,崔建敏,王祥麒,等.血栓心脉宁胶囊治疗糖尿病周围神经病变临床观察[J].中草药,2001,32(8):103-104.
[22]中国药典[S].一部.2015.
[23]葛均波,徐永健.内科学[M].第8版.北京:人民卫生出版社,2013.
[24]许曼音.糖尿病学[M].第2版.上海:上海科学技术出版社,2010.
[25]庞国明,闫镛,郑晓东.糖尿病周围神经病变中医防治指南[J].中国中医药现代远程教育,2011,9(22):119-121.
[26]郑红.基于多元统计分析糖尿病性周围神经病变的组方证治规律[J].辽宁中医杂志,2010,37(1):36-37.
[27]邱作成,张振国,李志钢,等.糖尿病周围神经病变病因病机浅析及治法探讨[J].中国实验方剂学杂志,2010,16(17):255-256.
[28]高彦彬,刘铜华,李平.糖尿病肾病中医防治指南[J].中国中医药现代远程教育,2011,9(4):151-153.
[29]王圳,吴金玉,姜芳.从痰瘀毒试论糖尿病肾病中医病机[J].辽宁中医杂志,2010,37(S1):364-365.
[30]冯兴中,张宁,谢春光.糖尿病中医防治指南糖尿病合并脑血管病[J].中国中医药现代远程教育,2011,9(19):138-140.
[31]郭蕾,李振中,丁学屏,等.糖尿病血管病变的中医病机理论诠释[J].中华中医药杂志,2009,24(7):885-888.
[32]徐梓辉,陈大舜,周世文.糖尿病合并冠心病病机及治则探讨[J].中医杂志,2003,44(7):485-487.