脉络学说指导调和营卫气血治疗脉络病变方药数据挖掘及用药规律分析
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摘要
目的脉络学说核心内容——营卫理论揭示了血管病变在生理、病理、治疗、转归不同阶段的内在规律。通过挖掘历代医家治疗心脑血管疾病的用药记载,以脉络学说营卫理论为指导分析历代医家治疗脉络病变用药规律。方法根据检索关键词在中国方剂数据库、中国期刊网全文数据库(CNKI)中筛选出治疗冠心病、心律失常、慢性心力衰竭、脑梗死的治疗方剂,分别建立相关疾病方药数据库,采用频次分析方法,以营卫理论为指导总结调和营卫气血用药规律。结果筛选出治疗冠心病方剂489首,共涉及中药262味;治疗心律失常方剂925首,共涉及中药359味;治疗慢性心力衰竭方剂290首,共涉及中药184味;治疗脑梗死方剂855首,共涉及中药209味。以营卫理论为指导总结发现常用药物主要包括益气固卫、温补卫阳、理气解郁、宣卫清热、补益营血、养阴和营、养阴清热、活血通.络、搜剔通络、散结通络、祛痰通络、化湿通络、祛风除湿、祛风通络、调理脏腑等药物。结论历代医家治疗心脑血管疾病的组方用药体现了调和营卫气血用药规律,为临床及科研提供了参考。
Objective Ying-wei theory, the core theory of vessel-collateral theory, reveals the internal rules of vascular diseases in different stages, including physiology, pathology, treatment and prognosis. By exploring the medical records of doctors in the past dynasties for the treatment of cardiovascular and cerebrovascular diseases, this paper analyzes the medication rule for the treatment of vascular diseases by doctors in the past dynasties under the guidance of the ying-wei theory.Methods According to the keywords for searching, in the Chinese prescription database, China journal full-text database and other databases, prescriptions for the treatment of coronary heart disease, arrhythmia, chronic heart failure and cerebral infarction are screened out. The database for prescriptions of related diseases is established. With the frequency analysis method,guided by the ying-wei theory, the medication rule for the adjustment of ying, wei, qi and blood is summarized. Results 489 prescriptions for coronary heart disease are screened out, invol ving 262 kinds of traditional Chinese medicine; 925 prescriptions for arrhythmia are screened out, involved 359 kinds of traditional Chinese medicine; 290 prescriptions for chronic heart failure are screened out, involving 184 kinds of traditional Chinese medicine; and 855 prescriptions for cerebral infarction are screened out, involving 209 kinds of traditional Chinese medicine. The frequency analysis method is used to summarize traditional Chinese medicines where are often used. Guided by the ying-wei theory, commonly used traditional Chinese medicines are summarized and found, mainly including traditional Chinese medicines which tonify qi and consolidate wei, warm and defend yang, regulate qi and resolve depression, disperse wei and clear heat, tonify and nourish blood, nourish yin and harmonize ying, nourish yin and clear heat, promote blood circulation to remove meridian obstruction, check to remove meridian obstruction, eliminate stagnation to remove meridian obstruction, resolve damp to remove meridian obstruction, dispel wind and eliminate dampness, regulate internal organs, etc. Conclusion The prescription medication of doctors in past dynasties in the treatment of cardiovascular and cerebrovascular diseases reflects the medication rules of adjustment of ying, wei, qi and blood, and provides a reference for clinical practice and scientific research.
Objective Ying-wei theory, the core theory of vessel-collateral theory, reveals the internal rules of vascular diseases in different stages, including physiology, pathology, treatment and prognosis. By exploring the medical records of doctors in the past dynasties for the treatment of cardiovascular and cerebrovascular diseases, this paper analyzes the medication rule for the treatment of vascular diseases by doctors in the past dynasties under the guidance of the ying-wei theory.Methods According to the keywords for searching, in the Chinese prescription database, China journal full-text database and other databases, prescriptions for the treatment of coronary heart disease, arrhythmia, chronic heart failure and cerebral infarction are screened out. The database for prescriptions of related diseases is established. With the frequency analysis method,guided by the ying-wei theory, the medication rule for the adjustment of ying, wei, qi and blood is summarized. Results 489 prescriptions for coronary heart disease are screened out, invol ving 262 kinds of traditional Chinese medicine; 925 prescriptions for arrhythmia are screened out, involved 359 kinds of traditional Chinese medicine; 290 prescriptions for chronic heart failure are screened out, involving 184 kinds of traditional Chinese medicine; and 855 prescriptions for cerebral infarction are screened out, involving 209 kinds of traditional Chinese medicine. The frequency analysis method is used to summarize traditional Chinese medicines where are often used. Guided by the ying-wei theory, commonly used traditional Chinese medicines are summarized and found, mainly including traditional Chinese medicines which tonify qi and consolidate wei, warm and defend yang, regulate qi and resolve depression, disperse wei and clear heat, tonify and nourish blood, nourish yin and harmonize ying, nourish yin and clear heat, promote blood circulation to remove meridian obstruction, check to remove meridian obstruction, eliminate stagnation to remove meridian obstruction, resolve damp to remove meridian obstruction, dispel wind and eliminate dampness, regulate internal organs, etc. Conclusion The prescription medication of doctors in past dynasties in the treatment of cardiovascular and cerebrovascular diseases reflects the medication rules of adjustment of ying, wei, qi and blood, and provides a reference for clinical practice and scientific research.
引文
[1]吴以岭.脉络学说构建及其指导血管病变防治研究[J].中国中西医结合杂志,2017, 37(2):147-148. DOI:10. 7661/CJIM.2017. 02. 0147.
[2]吴以岭,魏聪,贾振华,等.脉络学说的核心理论——营卫承制调平[J].中医杂志,2013, 54(1):3-7.
[3]吴以岭,栗彦宁,齐锦生,等.通心络对气虚和气滞型血管内皮损伤相关基因表达谱的影响[J].中国中药杂志,2007, 32(21):2268-2272.
[4]陈炜,梁春,刘星,等.血管外膜损伤致动脉粥样硬化形成对兔局部交感神经功能的影响[J].第二军医大学学报,2010, 31(6):585-589. DOI:10.3724/SP. J. 1008.2010.00585.
[5]吴以岭,赵珊珊,魏聪,等.“脉络一血管系统病”调和营卫气血用药规律及常用通络药物[J].疑难病杂志,2018,17(3):282-285,289. DOI:10.3969/j. issn. 1671-6450,2018.03.016.
[6]吴以岭.脉络学说构建及其指导血管病变防治药物的研究[J].实用心电学杂志,2018,27(4):229-233. DOI:10. 13308/j.issn.2095-9354.2018.04.001.
[7]秘红英,魏聪,李红蓉,等.以脉络学说营卫理论为指导治疗冠心病心绞痛络气虚滞证辨治规律的数据挖掘[J].中医杂志,2018,59(5):381-385. DOI:10. 13288/j. 11-2166/r. 2018. 05.006.
[8]李红蓉,秘红英,孙颖,等.基于脉络学说对动脉粥样硬化病因病机的认识[J].中医杂志,2017,58(16):1359-1363, 1367.DOI:10.13288/j. 11-2166/r.2017. 16.003.
[9]常成成,李红蓉,刘红利,等.脉络学说营卫交会生化理论探讨[J].中医杂志,2017,58(1):2-5. DOI:10. 13288/j. 11-2166/r.2017.01.001.
[10]魏聪,常丽萍,赵珊珊.脉络学说指导防治“脉络一血管系统病”的理论探微[J].疑难病杂志,2015,(11):1101-1103.DOI:10.3969/j. issn. 1671-6450.2015.11.001.
[11]尹玉洁,马柳一,张军芳,等.脉络学说指导的通心络治疗动脉粥样硬化的进展[J].中国老年学杂志,2016,36(7):1760-1762.DOI:10.3969/j. issn. 1005-9202.2016.07.101.
[12]张军芳,魏聪,王宏涛,等.从脉络学说探讨慢性心力衰竭病机[J].中医杂志,2014,55(13):1086-1089. DOI:10. 13288/j. 11-2166/r. 2014.13.002.
[13] Mao HM, Liu M, Qu H, et al. Tongxinluo capsule for cardiac syndrome X:A systematic review and Meta-analysis[J]. Chin J Integr Med, 2018, 24(4):296-303. DOI:10.1007/s11655-017-2762-8.
[14] Wang X, Hu D, Dang S, et al. Effects of traditional Chinese medicine Shensong Yangxin capsules on heart rhythm and function in con-gestive heart failure patients with frequent ventricular premature complexes:A randomized, double-blind, multicenter clinical trial[J].Chin Med J(Engl), 2017, 130(14):1639-1647. DOI:10.4103/0366-6999. 209906.
[15] Li XL, Zhang J, Huang J, et al. A multicenter randomized doubleblind parallel-group placebo-controlled study of the effects of Qili Qiangxin capsules in patients with chronic heart failure[J]. Journal of the American College of Cardiology, 2013, 62(12):1065-1072.DOI:10.1016/j.jacc.2013.05.035.
[16] Liu S, Wei C, Kang N, et al. Chinese medicine Tongxinluo capsule alleviates cerebral microcirculatory disturbances in ischemic stroke by modulating vascular endothelial function and inhibiting leukocyte-endothelial cell interactions in mice:A two-photon laser scanning microscopy study[J]. Microcirculation, 2018, 25(2):1-14. DOI:10.1111/micc. 12437.
[17] Zhao HY, Zhang SD, Zhang K, et al. Effect of Shensong Yangxin on the progression of paroxysmal atrial fibrillation is correlated with regulation of autonomic nerve activity[J]. Chin Med J(Engl),2017. 130(2):171-178. DOI:10.4103/0366-6999.197997.
[2]吴以岭,魏聪,贾振华,等.脉络学说的核心理论——营卫承制调平[J].中医杂志,2013, 54(1):3-7.
[3]吴以岭,栗彦宁,齐锦生,等.通心络对气虚和气滞型血管内皮损伤相关基因表达谱的影响[J].中国中药杂志,2007, 32(21):2268-2272.
[4]陈炜,梁春,刘星,等.血管外膜损伤致动脉粥样硬化形成对兔局部交感神经功能的影响[J].第二军医大学学报,2010, 31(6):585-589. DOI:10.3724/SP. J. 1008.2010.00585.
[5]吴以岭,赵珊珊,魏聪,等.“脉络一血管系统病”调和营卫气血用药规律及常用通络药物[J].疑难病杂志,2018,17(3):282-285,289. DOI:10.3969/j. issn. 1671-6450,2018.03.016.
[6]吴以岭.脉络学说构建及其指导血管病变防治药物的研究[J].实用心电学杂志,2018,27(4):229-233. DOI:10. 13308/j.issn.2095-9354.2018.04.001.
[7]秘红英,魏聪,李红蓉,等.以脉络学说营卫理论为指导治疗冠心病心绞痛络气虚滞证辨治规律的数据挖掘[J].中医杂志,2018,59(5):381-385. DOI:10. 13288/j. 11-2166/r. 2018. 05.006.
[8]李红蓉,秘红英,孙颖,等.基于脉络学说对动脉粥样硬化病因病机的认识[J].中医杂志,2017,58(16):1359-1363, 1367.DOI:10.13288/j. 11-2166/r.2017. 16.003.
[9]常成成,李红蓉,刘红利,等.脉络学说营卫交会生化理论探讨[J].中医杂志,2017,58(1):2-5. DOI:10. 13288/j. 11-2166/r.2017.01.001.
[10]魏聪,常丽萍,赵珊珊.脉络学说指导防治“脉络一血管系统病”的理论探微[J].疑难病杂志,2015,(11):1101-1103.DOI:10.3969/j. issn. 1671-6450.2015.11.001.
[11]尹玉洁,马柳一,张军芳,等.脉络学说指导的通心络治疗动脉粥样硬化的进展[J].中国老年学杂志,2016,36(7):1760-1762.DOI:10.3969/j. issn. 1005-9202.2016.07.101.
[12]张军芳,魏聪,王宏涛,等.从脉络学说探讨慢性心力衰竭病机[J].中医杂志,2014,55(13):1086-1089. DOI:10. 13288/j. 11-2166/r. 2014.13.002.
[13] Mao HM, Liu M, Qu H, et al. Tongxinluo capsule for cardiac syndrome X:A systematic review and Meta-analysis[J]. Chin J Integr Med, 2018, 24(4):296-303. DOI:10.1007/s11655-017-2762-8.
[14] Wang X, Hu D, Dang S, et al. Effects of traditional Chinese medicine Shensong Yangxin capsules on heart rhythm and function in con-gestive heart failure patients with frequent ventricular premature complexes:A randomized, double-blind, multicenter clinical trial[J].Chin Med J(Engl), 2017, 130(14):1639-1647. DOI:10.4103/0366-6999. 209906.
[15] Li XL, Zhang J, Huang J, et al. A multicenter randomized doubleblind parallel-group placebo-controlled study of the effects of Qili Qiangxin capsules in patients with chronic heart failure[J]. Journal of the American College of Cardiology, 2013, 62(12):1065-1072.DOI:10.1016/j.jacc.2013.05.035.
[16] Liu S, Wei C, Kang N, et al. Chinese medicine Tongxinluo capsule alleviates cerebral microcirculatory disturbances in ischemic stroke by modulating vascular endothelial function and inhibiting leukocyte-endothelial cell interactions in mice:A two-photon laser scanning microscopy study[J]. Microcirculation, 2018, 25(2):1-14. DOI:10.1111/micc. 12437.
[17] Zhao HY, Zhang SD, Zhang K, et al. Effect of Shensong Yangxin on the progression of paroxysmal atrial fibrillation is correlated with regulation of autonomic nerve activity[J]. Chin Med J(Engl),2017. 130(2):171-178. DOI:10.4103/0366-6999.197997.