借助中医传承辅助平台探究甲状腺相关性眼病用药规律
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摘要
目的:深层次挖掘当代医家治疗甲状腺相关眼病用药规律。方法:全面搜集整理当代医家治疗甲状腺相关眼病的医案首诊处方,基于中医传承辅助系统软件,采用关联规则apriori算法和复杂系统熵聚类等方法,对纳入处方中药物进行相关分析得出四气、五味、归经及药物功效分类的频次、单味药物应用频次、药物组合频次、用于新方聚类的核心组合及新处方。结果:本研究共纳入首诊处方61首,药物145味。处方药物多具苦、甘、寒性,归经以肝经为主。首选药物夏枯草、甘草、白芍等。高频药物组合包括浙贝母、夏枯草;甘草、泽泻;夏枯草、白芍等。基于熵层次聚类新处方为莪术、黄芪、穿山甲、生地黄、丹参、黄芩、龙胆、栀子、当归、柴胡、石决明。结论:当代医家在治疗甲状腺相关性眼病中以清热、补益为主,其所用药物主入肝经以清肝、柔肝、平肝、疏肝,同时不失其祛湿化痰、活血化瘀之法。
Objective:To profoundly explore the medication rule for modern medical doctors to conduct the treatment of thyroidassociated ophthalmopathy.Methods:In the first place,the first prescription of medical cases of thyroid-associated ophthalmopathy treated by modern medical doctors was comprehensively collected;in the second place,some methods such as the association rule apriori algorithm and the method of complex system entropy clustering were used to make a relevant analysis of the drugs in the prescription on the basis of the software for traditional Chinese medicine inheritance supporting system,which has obtained the four natures of drugs(including cold,head,cold),the five flavors(including sweet,sour,bitter,pungent and salty),meridian tropism;and the frequency of the classification of drug efficacy,the frequency of single-dose drugs,the frequency of drug combinations,core combinations for the clustering of new prescriptions,as well as prescriptions.Result:There are totally 61 first clinical prescriptions and 145 kinds of drugs included in the study.Prescription drugs are mostly featured by bitter nature,sweet nature,and cold nature,and the feature of liver meridian is shown most clearly in meridian tropism.Preferred drugs include prunella vulgaris,licorice,and white peony,etc.The high-frequency drug combination covers the combination of thunberg fritillary bulb and prunella vulgaris;the combination of licorice and rhizoma alismatis;and the combination of prunella vulgaris and white peony,etc.The new prescription based on entropy hierarchical clustering is composed of rhizoma curcumae,astragalus membranaceus,pangolin,dried rehmannia root,salvia miltiorrhizae,scutellaria baicalensis,radix gentian,jasmine,angelica sinensis,bupleurum,and and concha haliotidis.Conclusion:The modern medical doctors mainly pay attention to heat-clearing and tonic in the treatment of thyroid-associated ophthalmopathy,in which liver meridian is selected as the main drug to clear the liver,soften the liver,calm the liver and soothe the liver.At the same time,they would also choose the method of reducing phlegm and removing dampness,as well as the method of promoting blood circulation and removing blood stasis.
Objective:To profoundly explore the medication rule for modern medical doctors to conduct the treatment of thyroidassociated ophthalmopathy.Methods:In the first place,the first prescription of medical cases of thyroid-associated ophthalmopathy treated by modern medical doctors was comprehensively collected;in the second place,some methods such as the association rule apriori algorithm and the method of complex system entropy clustering were used to make a relevant analysis of the drugs in the prescription on the basis of the software for traditional Chinese medicine inheritance supporting system,which has obtained the four natures of drugs(including cold,head,cold),the five flavors(including sweet,sour,bitter,pungent and salty),meridian tropism;and the frequency of the classification of drug efficacy,the frequency of single-dose drugs,the frequency of drug combinations,core combinations for the clustering of new prescriptions,as well as prescriptions.Result:There are totally 61 first clinical prescriptions and 145 kinds of drugs included in the study.Prescription drugs are mostly featured by bitter nature,sweet nature,and cold nature,and the feature of liver meridian is shown most clearly in meridian tropism.Preferred drugs include prunella vulgaris,licorice,and white peony,etc.The high-frequency drug combination covers the combination of thunberg fritillary bulb and prunella vulgaris;the combination of licorice and rhizoma alismatis;and the combination of prunella vulgaris and white peony,etc.The new prescription based on entropy hierarchical clustering is composed of rhizoma curcumae,astragalus membranaceus,pangolin,dried rehmannia root,salvia miltiorrhizae,scutellaria baicalensis,radix gentian,jasmine,angelica sinensis,bupleurum,and and concha haliotidis.Conclusion:The modern medical doctors mainly pay attention to heat-clearing and tonic in the treatment of thyroid-associated ophthalmopathy,in which liver meridian is selected as the main drug to clear the liver,soften the liver,calm the liver and soothe the liver.At the same time,they would also choose the method of reducing phlegm and removing dampness,as well as the method of promoting blood circulation and removing blood stasis.
引文
[1]CARRITY JA,Bahn Pathogenesis of graves ophthalmopathy:implications for predition,and treatment[J].Am J Ophthalmol,2006,142(1):147-153.
[2]COLOMA-GONALEZ I,MENGUAL-VERDU E,DOMINGU-EZ-ESCRIBANO JR,et al.Sometostatin analogue treatment in graves ophthalmopathy:a case report[J].Arch Soc Esp Oftalmol,2007,82(1):51-54.
[3]中华医学会内分泌分会《中国甲状腺疾病诊疗指南》编写组.中国甲状腺疾病诊疗指南[J].中华内科杂志,2008,46(10):799-880.
[4]HIGASHIYAMA T,NISHIDA Y,OHJI M.Changes of orbital Tiaaue volumes and proptosis in patients with thyroid extraocular muscle swelling after methyprednisolone pulse therapy[J].Jpn J Ophthalmol,2015,59(6):430-5.
[5]高学敏.中药学[M].北京:中国中医药出版社,2002.
[6]南京中医药大学.中药大辞典[M].上海:上海科学技术出版社,2006.
[7]GARRITY JA,BAHN RS.Pathogenesis of graves ophthalmopathy:implications for prediction,prevention,and treatment[J].American Journal of ophthalmology,2006,142(1):147.
[8]唐仕欢,申丹,吕朋,等.中医传承辅助平台应用评述[J].中华中医药杂志,2015,30(2):329-331.
[9]李盛青,黄兆胜.五味与五脏归经关系探讨[J].中医研究,2000,13(5):5-7.
[10]国家药典委员会.中华人民共和国药典:一部[S].北京:中国医药科技出版社,2015:280.
[11]HAN E H,CHOI J H,HWANG Y P,et al.Immunostimulatory activity of aqueous extract isolated from Prunella vulgaris[J].Food Chem Toxicol,2009,47(1):62-69.
[12]张金华,邱俊娜,等.夏枯草化学成分及药理作用研究进展[J].中草药,2018,49(14):3432-3440.
[13]王志宏,赵勇,左新河.当代医家诊治甲状腺相关眼病经验总结[J].亚太传统医药,2017,13(19):46-48.
[14]左新河,牧亚峰.从络病理论探析甲状腺相关性眼病的辩证[J].湖北中医杂志,2017,39(10):30-33.
[15]周玉,吕萌,王芷乔,等.基于中医传承辅助系统探讨瘿病方剂组方规律[J].中医学报,2016,31(11):1758-1762.
[2]COLOMA-GONALEZ I,MENGUAL-VERDU E,DOMINGU-EZ-ESCRIBANO JR,et al.Sometostatin analogue treatment in graves ophthalmopathy:a case report[J].Arch Soc Esp Oftalmol,2007,82(1):51-54.
[3]中华医学会内分泌分会《中国甲状腺疾病诊疗指南》编写组.中国甲状腺疾病诊疗指南[J].中华内科杂志,2008,46(10):799-880.
[4]HIGASHIYAMA T,NISHIDA Y,OHJI M.Changes of orbital Tiaaue volumes and proptosis in patients with thyroid extraocular muscle swelling after methyprednisolone pulse therapy[J].Jpn J Ophthalmol,2015,59(6):430-5.
[5]高学敏.中药学[M].北京:中国中医药出版社,2002.
[6]南京中医药大学.中药大辞典[M].上海:上海科学技术出版社,2006.
[7]GARRITY JA,BAHN RS.Pathogenesis of graves ophthalmopathy:implications for prediction,prevention,and treatment[J].American Journal of ophthalmology,2006,142(1):147.
[8]唐仕欢,申丹,吕朋,等.中医传承辅助平台应用评述[J].中华中医药杂志,2015,30(2):329-331.
[9]李盛青,黄兆胜.五味与五脏归经关系探讨[J].中医研究,2000,13(5):5-7.
[10]国家药典委员会.中华人民共和国药典:一部[S].北京:中国医药科技出版社,2015:280.
[11]HAN E H,CHOI J H,HWANG Y P,et al.Immunostimulatory activity of aqueous extract isolated from Prunella vulgaris[J].Food Chem Toxicol,2009,47(1):62-69.
[12]张金华,邱俊娜,等.夏枯草化学成分及药理作用研究进展[J].中草药,2018,49(14):3432-3440.
[13]王志宏,赵勇,左新河.当代医家诊治甲状腺相关眼病经验总结[J].亚太传统医药,2017,13(19):46-48.
[14]左新河,牧亚峰.从络病理论探析甲状腺相关性眼病的辩证[J].湖北中医杂志,2017,39(10):30-33.
[15]周玉,吕萌,王芷乔,等.基于中医传承辅助系统探讨瘿病方剂组方规律[J].中医学报,2016,31(11):1758-1762.