中医药治疗细菌性上呼吸道感染用药规律研究
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摘要
目的采用数据挖掘方法分析中医药治疗细菌性上呼吸道感染的用药配伍规律,为临床提供参考。方法以古今医案云平台V1.4中整理的名医经验书籍、公开发表的期刊文献、国家级名中医工作室共享的1949年1月1日-2016年12月1日的现代中医医案为数据来源,检索筛选中医治疗细菌性上呼吸道感染验案数据。建立标准化医案数据库,采用系统集成的统计分析、聚类分析、复杂网络等方法,分析医案的组方用药频次、药性、核心处方等。结果纳入医案数据1259例、1877诊次,涉及处方1877首、药物712味,总用药频次18 056次。高频药物有黄芩(632次)、甘草(570次)、连翘(563次)、桔梗(535次)、金银花(523次)等,多属苦、寒、归肺经药物。组方以普济消毒饮和银翘散为核心处方加减。结论中医药治疗细菌性上呼吸道感染多以清热、化痰、疏风、解表为法,药物多为寒、苦、辛、归肺经者,在清肺泻热、化痰驱邪的同时兼顾脾胃,养阴益气以扶助正气。
Objective To analyze the medication rules of TCM for the treatment of bacterial upper respiratory tract infection by data mining methods; To provide references for clinic. Methods Famous doctors' experience books, published journal articles, and modern TCM cases shared by national-level TCM studios from January 1, 1949 to December 1, 2016 screened by Ancient and Modern Consilia Cloud Platform V1.4 were set as data resources. Data of medical cases about TCM for the treatment of bacterial upper respiratory tract infection were retrieved and screened. A standardized medical record database was established, and system integration statistical analysis, cluster analysis, complex network and other methods were used to analyze the frequency of drug use, property, core prescription, etc. Results Totally 1259 medical cases and 1877 times of visits were included, involving 1877 prescriptions, 712 kinds of Chinese materia medica and 18 056 times of frequency. The high-frequency Chinese materia medica were Scutellariae Radix(632 times), Glycyrrhizae Radix et Rhizoma(570 times), Forsythiae Fructus(563 times), Platycodonis Radix(535 times) and Lonicerae Japonicae Flos(523 times), most of which belonged to medicines of bitter, cold and lung meridian. Other prescriptions were modified based on the core prescriptions of Puji Xiaodu Decoction and YinqiaoPowder. Conclusion TCM for the treatment of bacterial upper respiratory tract infection mostly applies the methods of clearing heat, reducing phlegm, inducing mild diaphoresis and relieving exterior syndrome. The medicines are mostly cold, bitter, spicy and belong to lung meridian. While clearing the lung and purging heat, reducing phlegm and dispelling pathogens, it should also give consideration to spleen and stomach, nourish yin and replenish qi in order to support the healthy qi.
Objective To analyze the medication rules of TCM for the treatment of bacterial upper respiratory tract infection by data mining methods; To provide references for clinic. Methods Famous doctors' experience books, published journal articles, and modern TCM cases shared by national-level TCM studios from January 1, 1949 to December 1, 2016 screened by Ancient and Modern Consilia Cloud Platform V1.4 were set as data resources. Data of medical cases about TCM for the treatment of bacterial upper respiratory tract infection were retrieved and screened. A standardized medical record database was established, and system integration statistical analysis, cluster analysis, complex network and other methods were used to analyze the frequency of drug use, property, core prescription, etc. Results Totally 1259 medical cases and 1877 times of visits were included, involving 1877 prescriptions, 712 kinds of Chinese materia medica and 18 056 times of frequency. The high-frequency Chinese materia medica were Scutellariae Radix(632 times), Glycyrrhizae Radix et Rhizoma(570 times), Forsythiae Fructus(563 times), Platycodonis Radix(535 times) and Lonicerae Japonicae Flos(523 times), most of which belonged to medicines of bitter, cold and lung meridian. Other prescriptions were modified based on the core prescriptions of Puji Xiaodu Decoction and YinqiaoPowder. Conclusion TCM for the treatment of bacterial upper respiratory tract infection mostly applies the methods of clearing heat, reducing phlegm, inducing mild diaphoresis and relieving exterior syndrome. The medicines are mostly cold, bitter, spicy and belong to lung meridian. While clearing the lung and purging heat, reducing phlegm and dispelling pathogens, it should also give consideration to spleen and stomach, nourish yin and replenish qi in order to support the healthy qi.
引文
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[11]张安玲.关于肺胃生理相关性的探讨[J].中医药学报,2004,32(3):3-4.
[12]王燕,咸庆飞.普济消毒饮治疗流感临床疗效分析[J].中国中医基础医学杂志,2013,19(4):474-475.
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[14]路广义,郭洁.普济消毒饮对化脓性链球菌的体外抑菌作用[J].中国中医基础医学杂志,2014,20(9):1288-1305.
[2]陈小可,刘慧,彭蕻琳,等.不同咽痛症状对急性细菌性上呼吸道感染的诊断意义[J].临床肺科杂志,2010,15(7):1018.
[3]于琦,李敬华,李宗友,等.基于本体的中医医案知识服务与共享系统构建研究[J].中国数字医学,2017,12(5):103-105.
[4]孙春全,李金玲,庞亚铮,等.强直性脊柱炎名医医案用药规律研究[J].国际中医中药杂志,2017,39(9):807-810.
[5]于琦,王映辉,李宗友,等.名医余瀛鳌432例调肝法医案辨治规律研究[J].国际中医中药杂志,2017,39(3):225-229.
[6]刘源香,孙春全,杨继国.针灸治疗阿尔茨海默病取穴规律研究[J].中国中医药信息杂志,2017,24(10):90-93.
[7]刘冲.数据挖掘严光俊教授运用“治肠六法”治疗“慢性结肠炎”的临床经验[D].武汉:湖北中医药大学,2017.
[8]周仲瑛.中医内科学:供中医药类专业用[M].北京:中国中医药出版社,2003:63-67.
[9]任占敏,张世恭.“辛甘发散为阳”探析[J].北京中医,1995(6):45.
[10]周宜强,李宏杰.双黄连口服液的临床应用与开发前景[J].中国中医药信息杂志,1995,2(12):12-13.
[11]张安玲.关于肺胃生理相关性的探讨[J].中医药学报,2004,32(3):3-4.
[12]王燕,咸庆飞.普济消毒饮治疗流感临床疗效分析[J].中国中医基础医学杂志,2013,19(4):474-475.
[13]张保国,程铁峰,刘庆芳.普济消毒饮药效及临床研究[J].中成药,2010,32(1):117-120.
[14]路广义,郭洁.普济消毒饮对化脓性链球菌的体外抑菌作用[J].中国中医基础医学杂志,2014,20(9):1288-1305.