袁少英治疗精索静脉曲张致不育症用药规律分析
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摘要
目的:挖掘并探讨袁少英治疗精索静脉曲张致不育症的用药规律。方法:收集由袁少英诊断为精索静脉曲张致不育症并疗效较好的132例患者病历处方,运用中医传承辅助平台(V2.5)对病历处方药物进行频次、四气五味归经统计,并基于关联规则及复杂系统熵聚类进行用药规律分析及挖掘探讨。结果:聚类获得4对中药核心组合、2个中药新处方。在药物四气方面,以温平为主,根据辨证施治兼顾寒凉药;五味方面甘味为主,占48%;归经方面则以肝肾经为主。使用频次前5位的药物为枸杞子、黄芪、菟丝子、丹参、黄精,频次最高的对药是菟丝子-枸杞子、药物组合是菟丝子-枸杞子-覆盆子。结论:袁少英治疗精索静脉曲张致不育症着重调理肝肾经,药物以补益药与活血化瘀药为主,采用活血逐瘀通络、补肾滋阴调精为主线的治法及以"活血-逐瘀-补肾"为主轴的用药思路。
Objective:To mine and explore Professor YUAN Shaoying's medication rules in the treatment of infertility caused by varicocele. Methods:The prescriptions of total 132 patients diagnosed by Professor YUAN Shaoying with infertility caused by varicocele were collected,and the frequency of medication,four properties and five tastes,channel tropism were calculated using the Chinese medicine inheritance support platform(V2.5). The medication rules were analyzed and mined based on Association Rules and Entropy Clustering of Complex Systems. Results:Total 4 pairs of core combination of Chinese medicine and2 new prescriptions were determined through the cluster analysis. In terms of the four properties,warm and bland in property was the mainstay. According to the syndrome differentiation,herbs cold and cold in nature were also used. In terms of the five flavors,sweet accounted for 48%. In terms of the channel tropism,the liver and kidney channels were the most. The top 5 frequently used medicine were Gouqizi(Lych Fructus),Huangqi(Astragali Radix),Tusizi(Cuscutae Semen),Danshen(Salviae Miltior rhizae Radix Et Rhizoma),Huangjing(Polygonati Rhizoma). The herbal pair with the highest frequency was Tusizi(Cuscutae Semen)-Gouqizi(Lych Fructus),and the drug combination is Tusizi-Gouqizi-Fupenzi. Conclusions:Professor Yuan Shaoying's treatment of infertility caused by varicocele focuses on the regulation of liver and kidney meridians. The medicine is mainly based on tonic and blood-activating and stasis-removing medicine. Activating blood and resolving stasis,relieving collaterals,replenishing kidney,nourishing yin and regulating essence are used as the main therapeutic methods. The method of activating blood-resolving stasis-replenishing kidney is the main idea of medication.
Objective:To mine and explore Professor YUAN Shaoying's medication rules in the treatment of infertility caused by varicocele. Methods:The prescriptions of total 132 patients diagnosed by Professor YUAN Shaoying with infertility caused by varicocele were collected,and the frequency of medication,four properties and five tastes,channel tropism were calculated using the Chinese medicine inheritance support platform(V2.5). The medication rules were analyzed and mined based on Association Rules and Entropy Clustering of Complex Systems. Results:Total 4 pairs of core combination of Chinese medicine and2 new prescriptions were determined through the cluster analysis. In terms of the four properties,warm and bland in property was the mainstay. According to the syndrome differentiation,herbs cold and cold in nature were also used. In terms of the five flavors,sweet accounted for 48%. In terms of the channel tropism,the liver and kidney channels were the most. The top 5 frequently used medicine were Gouqizi(Lych Fructus),Huangqi(Astragali Radix),Tusizi(Cuscutae Semen),Danshen(Salviae Miltior rhizae Radix Et Rhizoma),Huangjing(Polygonati Rhizoma). The herbal pair with the highest frequency was Tusizi(Cuscutae Semen)-Gouqizi(Lych Fructus),and the drug combination is Tusizi-Gouqizi-Fupenzi. Conclusions:Professor Yuan Shaoying's treatment of infertility caused by varicocele focuses on the regulation of liver and kidney meridians. The medicine is mainly based on tonic and blood-activating and stasis-removing medicine. Activating blood and resolving stasis,relieving collaterals,replenishing kidney,nourishing yin and regulating essence are used as the main therapeutic methods. The method of activating blood-resolving stasis-replenishing kidney is the main idea of medication.
引文
[1]游旭军,袁少英,何超拔,等.丹红通精方对精索静脉曲张不育症患者精液质量、缺氧诱导因子-1α的影响[J].中医药导报,2017,23(10):72-74,78.
[2]杜宝俊,闫朋宣,罗然,等.桂枝茯苓胶囊治疗精索静脉曲张性不育症60例临床观察[J].中医杂志,2014,55(4):311-314.
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[7] BAAZCCM A,BCLZILC E,CIAMPI A,et al. Varicocclc andmale factor infertility treatment:a new meta-analysis and review of the role of varicocclc repair[J]. Fur Urol,2011,60(1):796-808.
[8]徐福松.徐福松实用中医男科学[M].北京:中国中医药出版社,2009:561-562.
[9]王琦.王琦男科学[M]. 2版.郑州:河南科学技术出版社,2007:591-592.
[2]杜宝俊,闫朋宣,罗然,等.桂枝茯苓胶囊治疗精索静脉曲张性不育症60例临床观察[J].中医杂志,2014,55(4):311-314.
[3]袁少英.精索静脉曲张合并男性不育的论治难点与对策[J].中国中西医结合杂志,2013,33(9):1165-1167.
[4]那彦群,叶章群,孙颖浩.中国泌尿外科疾病诊断治疗指南[M].北京:人民卫生出版社,2014:596-601.
[5]王晓峰,朱积川,邓春华.中国男科疾病诊断治疗指南[M].北京:人民卫生出版社,2013:2-3.
[6]陈志强.中医临床诊治男科专病[M]. 3版.北京:人民卫生出版社,2013:150-151,318.
[7] BAAZCCM A,BCLZILC E,CIAMPI A,et al. Varicocclc andmale factor infertility treatment:a new meta-analysis and review of the role of varicocclc repair[J]. Fur Urol,2011,60(1):796-808.
[8]徐福松.徐福松实用中医男科学[M].北京:中国中医药出版社,2009:561-562.
[9]王琦.王琦男科学[M]. 2版.郑州:河南科学技术出版社,2007:591-592.