穴位贴敷治疗原发性痛经的选穴与用药规律分析
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摘要
目的:探索穴位贴敷治疗原发性痛经(PD)的选穴与用药规律,以用于提升临床疗效及为新药开发提供理论指导。方法:纳入PubMed、Medline、Embase、中国知网、维普、万方6个数据库中1978年-2017年间穴位贴敷治疗PD的全部文献,利用聚类算法及Apriori算法进行数据挖掘,提取并分析用药及选穴的频次、组合以及核心药物/穴位的关联情况。结果:纳入80篇文献,涵盖98味中药和23个穴位,涉及药物和穴位总频次分别为578、193次。治疗核心药物为肉桂、当归、延胡索、细辛、川芎、香附等,药性以温热性质为主;多见活血化瘀药、温里药、补虚药、理气药、止血药同用。治疗核心穴位为关元、神阙、中极、气海等,多集中在任脉。对高频用药及选穴进行聚类分析,高频用药聚成5类,高频选穴聚成4类。通过关联规则分析,高频药物得出23条关联规则,其中2味药组合16条,3味药组合7条;高频选穴得出10条关联规则,其中2个穴位组合4条,3个穴位组合5条,4个穴位组合1条。结论:中药穴位贴敷治疗PD,其治则为活血行气以治其标,温里补虚以固其本;选穴应以通调冲任胞宫为要;需对寒湿、气滞、血瘀、气血虚弱等因素辨证论治。高频用药及选穴的聚类及关联规则分析结果可为保证疗效、替代性的用药或选穴提供借鉴性参考。
Objective: To explore the point selection and medication rule of primary dysmenorrhea(PD) with point application for the purpose of improving clinical efficacy and providing theoretical guidance for the development of new drugs.Methods: All the literatures of PD treated by point application between 1978 and 2017 in six databases(PubMed, Medline,Embase, CNKI, VIP and Wanfang) were included. Data mining was performed using clustering algorithm and Apriori algorithm.The frequency and combination of medication and point selection, and the association of core drugs/points were extracted and analyzed. Results: A total of 80 articles were included, covering 98 herbs and 23 points. The total frequency of herbs and points involved were 578 and 193, respectively. The core herbs for the treatment were Cinnamon, Angelica, Rhizoma Corydalis,chuanxiong, Cyperus rotundus, etc. The herbal nature were mainly warm. Blood-activating and stasis-eliminating drugs, warming the internal drugs, tonic drugs, qi regulating drugs, and hemostatic drugs were used together. The core points for treatment were Guanyuan, Shenfu, Zhongji, Qihai and they were concentrated in Ren Meridian. High-frequency herbs and points for cluster analysis, high frequency medication into 5 categories, high-frequency points into 4 categories. Through association rule analysis,23 association rules including 16 association rules of 2 herbs and 7 association rules of 3 herbs were obtained in high-frequency drugs; 10 association rules including 4 association rules of 2 points, 5 association rules of 3 points and 1 association rule of 4 points. Conclusion: Point application with Chinese medicine treatment of PD, the rule is promoting blood and qi circulation for temporary solution, warming inside and reinforcing deficiency for timeproof solution. Points selection should be considered the uterus and Ren Meridian. Treatment need to be focus on cold-dampness, qi stagnation, blood stasis and deficiency of qi and blood. The results of clustering and association rules analysis of high-frequency medication and points can provide reference for guaranteeing clinical effect and alternative medications or selecting points.
Objective: To explore the point selection and medication rule of primary dysmenorrhea(PD) with point application for the purpose of improving clinical efficacy and providing theoretical guidance for the development of new drugs.Methods: All the literatures of PD treated by point application between 1978 and 2017 in six databases(PubMed, Medline,Embase, CNKI, VIP and Wanfang) were included. Data mining was performed using clustering algorithm and Apriori algorithm.The frequency and combination of medication and point selection, and the association of core drugs/points were extracted and analyzed. Results: A total of 80 articles were included, covering 98 herbs and 23 points. The total frequency of herbs and points involved were 578 and 193, respectively. The core herbs for the treatment were Cinnamon, Angelica, Rhizoma Corydalis,chuanxiong, Cyperus rotundus, etc. The herbal nature were mainly warm. Blood-activating and stasis-eliminating drugs, warming the internal drugs, tonic drugs, qi regulating drugs, and hemostatic drugs were used together. The core points for treatment were Guanyuan, Shenfu, Zhongji, Qihai and they were concentrated in Ren Meridian. High-frequency herbs and points for cluster analysis, high frequency medication into 5 categories, high-frequency points into 4 categories. Through association rule analysis,23 association rules including 16 association rules of 2 herbs and 7 association rules of 3 herbs were obtained in high-frequency drugs; 10 association rules including 4 association rules of 2 points, 5 association rules of 3 points and 1 association rule of 4 points. Conclusion: Point application with Chinese medicine treatment of PD, the rule is promoting blood and qi circulation for temporary solution, warming inside and reinforcing deficiency for timeproof solution. Points selection should be considered the uterus and Ren Meridian. Treatment need to be focus on cold-dampness, qi stagnation, blood stasis and deficiency of qi and blood. The results of clustering and association rules analysis of high-frequency medication and points can provide reference for guaranteeing clinical effect and alternative medications or selecting points.
引文
[1]Harel Z.Dysmenorrhea in adolescents and young adults:from pathophysiology to pharmacological treatments and management strategies.Expert Opinion Pharmacother,2008,9(15):2661-2672
[2]张艺然,朱佳卿.2011年-2015年国内中医药治疗原发性痛经研究现状的文献计量学分析.中华中医药杂志,2017,32(6):2776-2778
[3]French L.Dysmenorrhea in adolescents:diagnosis and treatment.Pediatric Drugs,2008,10(1):1-7
[4]Parvaneh M,Seideh H A,Seddigheh E,et al.Effect of medicinal herbs on primary dysmenorrhea-a systematic review.IJPR.2014,13(3):757-767
[5]Proctor M L,Latthe P M,Farquhar C M,et al.Surgical interruption of pelvic nerve pathways for primary and secondary dysmenorrhoea.Cochrane Database Syst Rev,2002,2(4):CD001896
[6]贺艳萍,肖小芹,邓桂明,等.中药穴位贴敷作用机理研究概况.中国中医药信息杂志,2017,24(3):134-136
[7]胡年春,熊森林,刘四军.中药穴位贴敷法缓解女性学生原发性痛经的效果研究.广州中医药大学学报,2016,33(6):817-822
[8]何瑶,王丽娟,刘婷婷,等.基于代谢组学技术分析四物汤治疗原发性痛经证的作用机制.中国实验方剂学杂志,2017,23(12):82-89
[9]周荣荣,闫润红,王丽萍,等.数据挖掘技术在中医方剂科学问题研究中的应用.中华中医药杂志,2018,33(9):4016-4020
[10]国家药典委员会.中华人民共和国药典.一部.北京:中国医药科技出版社,2015:1-1268
[11]中国国家标准化管理委员会,中国国际标准化管理委员会.中华人民共和国国家标准·腧穴名称与定位.GB/T12346-2006.北京:中国标准出版社,2006
[12]杜萍,庞会明,卢金福.基于数据挖掘治疗肾虚型月经病的用药分析.中国实验方剂学杂志,2017,23(15):211-215
[13]赵艳青,李青松,项敏泓,等.中医药数据挖掘中常见问题的思考与策略--以中医药术语及用药规律总结为例.中华中医药杂志,2018,33(4):1220-1225
[14]冯宗文.中医妇科用药十讲.北京:中国中医药出版社,2016:20,30-31
[15]马大正.妇科用药400品历验心得.北京:人民卫生出版社,2014
[16]余思奕,杨洁,任玉兰,等.基于数据挖掘技术分析艾灸治疗原发性痛经的选穴特点.中国针灸,2015,35(8):845-849
[17]韩东岳,刘畅,郄丽丽,等.基于数据挖掘技术的穴位贴敷治疗过敏性鼻炎的选穴与用药规律分析.中国针灸,2015,35(11):1177-1180
[18]蔡向红,谢文英.国家级名老中医验案--妇科病.北京:人民军医出版社,2014
[19]赵京生.论腧穴的基本作用:近治作用.中国针灸,2015,35(11):1196-1198
[2]张艺然,朱佳卿.2011年-2015年国内中医药治疗原发性痛经研究现状的文献计量学分析.中华中医药杂志,2017,32(6):2776-2778
[3]French L.Dysmenorrhea in adolescents:diagnosis and treatment.Pediatric Drugs,2008,10(1):1-7
[4]Parvaneh M,Seideh H A,Seddigheh E,et al.Effect of medicinal herbs on primary dysmenorrhea-a systematic review.IJPR.2014,13(3):757-767
[5]Proctor M L,Latthe P M,Farquhar C M,et al.Surgical interruption of pelvic nerve pathways for primary and secondary dysmenorrhoea.Cochrane Database Syst Rev,2002,2(4):CD001896
[6]贺艳萍,肖小芹,邓桂明,等.中药穴位贴敷作用机理研究概况.中国中医药信息杂志,2017,24(3):134-136
[7]胡年春,熊森林,刘四军.中药穴位贴敷法缓解女性学生原发性痛经的效果研究.广州中医药大学学报,2016,33(6):817-822
[8]何瑶,王丽娟,刘婷婷,等.基于代谢组学技术分析四物汤治疗原发性痛经证的作用机制.中国实验方剂学杂志,2017,23(12):82-89
[9]周荣荣,闫润红,王丽萍,等.数据挖掘技术在中医方剂科学问题研究中的应用.中华中医药杂志,2018,33(9):4016-4020
[10]国家药典委员会.中华人民共和国药典.一部.北京:中国医药科技出版社,2015:1-1268
[11]中国国家标准化管理委员会,中国国际标准化管理委员会.中华人民共和国国家标准·腧穴名称与定位.GB/T12346-2006.北京:中国标准出版社,2006
[12]杜萍,庞会明,卢金福.基于数据挖掘治疗肾虚型月经病的用药分析.中国实验方剂学杂志,2017,23(15):211-215
[13]赵艳青,李青松,项敏泓,等.中医药数据挖掘中常见问题的思考与策略--以中医药术语及用药规律总结为例.中华中医药杂志,2018,33(4):1220-1225
[14]冯宗文.中医妇科用药十讲.北京:中国中医药出版社,2016:20,30-31
[15]马大正.妇科用药400品历验心得.北京:人民卫生出版社,2014
[16]余思奕,杨洁,任玉兰,等.基于数据挖掘技术分析艾灸治疗原发性痛经的选穴特点.中国针灸,2015,35(8):845-849
[17]韩东岳,刘畅,郄丽丽,等.基于数据挖掘技术的穴位贴敷治疗过敏性鼻炎的选穴与用药规律分析.中国针灸,2015,35(11):1177-1180
[18]蔡向红,谢文英.国家级名老中医验案--妇科病.北京:人民军医出版社,2014
[19]赵京生.论腧穴的基本作用:近治作用.中国针灸,2015,35(11):1196-1198