摘要
目的基于文献探讨中药治疗糖尿病视网膜病变(diabetic retinopathy, DR)常用药物的用药特点和组方规律,为DR的中医药治疗提供参考依据。方法检索中国知网、万方数据知识服务平台、维普数据库、中国生物医学文献数据库,获取中药治疗DR的汤剂复方,对纳入文献的提取资料信息进行编码并建立数据库,通过SPSS20.0统计分析软件、RapidMiner6.0数据挖掘软件对DR按分期对用药规律进行挖掘。结果最终纳入中药复方治疗DR的中文文献152篇,涉及中药方剂152首,含中药1657味,用药频次占50%以上的中药有:非增殖期DR病变为黄芪、丹参、生地黄(54首方剂,572味中药);增殖期DR病变为蒲黄、三七(4首方剂,41味中药)。整体用药频次前5位的是黄芪、丹参、生地黄、枸杞子、葛根(152首方剂,中药1657味)。药物归类:各期DR均以补虚药为主,其次为清热药,再次为活血化瘀药、解表药和止血药;各期用药药性均偏寒凉。关联规则分析显示:所有组合以黄芪为中心,丹参、生地黄、枸杞子、葛根4味药分别与黄芪有较强关联,另外进行关联规则分析发现当归、赤芍、川芎3味药相互间也存在组方关联。结论中药治疗非增殖期DR病变以益气活血滋阴药为主,增殖期DR病变以活血化瘀药为主,在增殖期DR病变中清热药、活血化瘀药以及寒凉药的比例稍增加;核心药物组合以黄芪为中心,并与丹参、生地黄、枸杞子、葛根等组合用药。
OBJECTIVE To discuss the characteristics and the rules of Chinese medicinal decoction based on the literature and to provide references for the treatment of diabetic retinopathy using Chinese medicine.METHODS We searched four Chinese databases(including CNKI, Wan Fang, VIP, SinoMed) up to May2018, and included the clinical trials concerning Chinese medicinal decoction on diabetic retinopathy, extracted the data of included articles then coded and build the database. The SPSS20.0 and RapidMiner6.0 data mining software was used in our study to evaluate the characteristics and the rules of Chinese medicinal decoction in treatment of different stage diabetic retinopathy.RESULTS A total of 152 articles(involving 152 Chinese medicinal decoctions with 1657 Chinese herbs) were included in this article. Drugs in frequency more than 50% were as below: huangqi, danshen, sheng di for nonproliferative diabetic retinopathy(54 Chinese medicinal formulae with 572 herbs);Puhuang, sanqiforproliferative diabetic retinopathy(4 formulae with41 herbs);Huangqi, danshen, shengdi, gouqiandgegen were the most frequently used herbs in the whole(involving 152 formulae with 1657 herbs).Chinese herb classification:tonifying drugs were the most common herb in the whole stage, heat herbs was the secondly common herb, and then followed the circulation-activating herbs. The medicinal of the most common used herbwas cold. The result of association rules mining showed that the combinations were centered on huangqi and danshen, shendi, gouqi, gegen had strong correlations with huangqi.Inaddition,danggui, chishao and chuanxiong also shared a strong correlation.CONCLUSIONS The qi-boosting, blood-activating and yin-nourishing herbs were commonly used in nonproliferative diabetic retinopathy; blood-activating and stasis-removing herbs were most common ones for proliferative diabetic retinopathy. The proportion ofheat-removing blood-activating stasis-removing herbs and cold herbs increased in management of proliferative diabetic retinopathy. The core drug was huangqi and it was often used in combinations withdanshen, shengdi, gouqi, gegen.
引文
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