数据挖掘浅析陈霞波“治未病”思想防治糖尿病肾病的用药规律
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摘要
目的:基于数据挖掘对陈霞波教授"治未病"为中心思想治疗糖尿病肾病(DN)的用药规律进行整理,为中医药防治DN提供参考。方法:收集陈霞波教授中药防治DN并符合纳入标准病例中的处方162首进行统计,运用SPSS 19 for Windows和clementine 12两款软件对中药的频数、频率、归经、聚类规则和关联法则进行分析。结果:(1)选取符合统计要求的中药219味,共使用中药1998次,其中黄芪、丹参、茯苓、山药、生地等28味中药为高频用药。(2)补虚药、清热药、活血化瘀药,利水渗湿药,收涩药为常用中药类别。(3)高频药物的归经分别为肝经(15次)、心经(14次)、肾经(12次)、肺经(10次)、脾经(10次)、胃经(10次)。(4)常用的药对有:茯苓与泽泻;黄芪与白术;黄芪与山萸肉;茯苓与山药;山药与茯苓;山萸肉与泽泻、山药;黄芪与白术、丹参;山药与山萸肉、茯苓;黄芪与泽兰、车前子;麦冬与熟地、玄参等。(5)除以中药防治DN外,在发病的不同时期还可用"调胃润肠功"、"润肺生津功"、"养肾止消功"等气功疗法防止疾病的发生或进一步加重。结论:陈霞波教授以"治未病"为核心思想防治DN用药中体现以"补益脏腑,肺脾肾主之"并辅以"清热与滋阴并重,活血与祛瘀并重,利湿与化浊并重"的标本兼治治则及以气功疗法防治DN的发生或加重。
Objective: To investigate the medication rule of preventing and treating diabetic nephropathy(DN) by data mining Professor Chen Xiabo's theory of"Preventive Treatment of Disease"and provide methods for the treatment of DN with Traditional Chinese Medicine( TCM). Method: 162 prescriptions used by Professor Chen Xiabo for preventing and treating DN with TCM and conformed to the inclusion criteria were collected.The frequency,meridian tropism,clustering rules and association rule were analzed by using SPSS 19 for Windows and clementine 12. Result:(1) Selected 219 TCM herbs which were in accordance with the statistical requirements,and used 1998 times. Among them,28 kinds of TCM were high-frequency used,including Astragalus membranaceus,Salvia miltiorrhiza,Poria cocos,Yam,Rehmannia glutinosa.(2) Invigoration drugs,heat clearing drugs,activated blood drugs,herbs for diuresis drugs,and astringent medicinal drugs belong to commonly used categories of TCM.(3) Highly-frequence used herbs belong to liver meridian( 15 times),heart meridian(14 times),kidney meridian( 12 times),lung meridian( 10 times),spleen meridian( 10 times),and stomach meridian(10 times) respectively.(4) Commonly used pair-drugs include: Poria cocos and Alisma; Astragalus membranaceus and Atractylodes; Astragalus membranaceus and Cornus; Poria cocos and Yam; Yam and Poria cocos; Cornus,Alisma and Yam; Astragalus membranaceus,Atractylodes and Salvia miltiorrhiza; Yam,Cornus and Poria cocos; Astragalus membranaceus,Eupatorium and Plantain seed; Ophiopogon japonicus,Prepared rehmannia root and Figwort.( 5) In addition to using TCM to treat DN,Qigong Theropies,such as "Regulating stomach and moistening intestines qigong","Moistening lung and promoting fluid production qigong","Tonifying kidney elimination qigong"were alsouse to prevent the occurrence or aggravation of DN at the different periods. Conclusion: Professor Chen Xiabo takes"Preventive Treatment of Disease"as her core vision to prevent and treat DN,and takes traditional Chinese medicine to manifest her treating principles of "Mainly tonifying lung,spleen and kidney ","Assistance with clearing away heat and nourishing yin","activating blood circulation and removing blood stasis","dampness and turbid",as well as qigong therapy to prevent the occurrence or aggravation of DN.
Objective: To investigate the medication rule of preventing and treating diabetic nephropathy(DN) by data mining Professor Chen Xiabo's theory of"Preventive Treatment of Disease"and provide methods for the treatment of DN with Traditional Chinese Medicine( TCM). Method: 162 prescriptions used by Professor Chen Xiabo for preventing and treating DN with TCM and conformed to the inclusion criteria were collected.The frequency,meridian tropism,clustering rules and association rule were analzed by using SPSS 19 for Windows and clementine 12. Result:(1) Selected 219 TCM herbs which were in accordance with the statistical requirements,and used 1998 times. Among them,28 kinds of TCM were high-frequency used,including Astragalus membranaceus,Salvia miltiorrhiza,Poria cocos,Yam,Rehmannia glutinosa.(2) Invigoration drugs,heat clearing drugs,activated blood drugs,herbs for diuresis drugs,and astringent medicinal drugs belong to commonly used categories of TCM.(3) Highly-frequence used herbs belong to liver meridian( 15 times),heart meridian(14 times),kidney meridian( 12 times),lung meridian( 10 times),spleen meridian( 10 times),and stomach meridian(10 times) respectively.(4) Commonly used pair-drugs include: Poria cocos and Alisma; Astragalus membranaceus and Atractylodes; Astragalus membranaceus and Cornus; Poria cocos and Yam; Yam and Poria cocos; Cornus,Alisma and Yam; Astragalus membranaceus,Atractylodes and Salvia miltiorrhiza; Yam,Cornus and Poria cocos; Astragalus membranaceus,Eupatorium and Plantain seed; Ophiopogon japonicus,Prepared rehmannia root and Figwort.( 5) In addition to using TCM to treat DN,Qigong Theropies,such as "Regulating stomach and moistening intestines qigong","Moistening lung and promoting fluid production qigong","Tonifying kidney elimination qigong"were alsouse to prevent the occurrence or aggravation of DN at the different periods. Conclusion: Professor Chen Xiabo takes"Preventive Treatment of Disease"as her core vision to prevent and treat DN,and takes traditional Chinese medicine to manifest her treating principles of "Mainly tonifying lung,spleen and kidney ","Assistance with clearing away heat and nourishing yin","activating blood circulation and removing blood stasis","dampness and turbid",as well as qigong therapy to prevent the occurrence or aggravation of DN.
引文
[1]丁志珍,陈卫东.糖尿病肾病发病机制研究进展[J].中华全科医学,2011,09(2):284-285.
[2]Mogensen C E,Schmitz A,Christensen C K.Comparative renal pathophysiology relevant to IDDM and NIDDM patients[J].Diabetes/metabolism Reviews,1988,4(5):453.
[3]Mogensen C E.Early renal involvement and nephropathy.Can treatment modalitiesbe predicted from identification of risk factors in diabetics[J].Toxicology Letters,1989,46(1-3):213.
[4]蔡丽威,李景华,李想,等.董治中主任医师治疗糖尿病肾病的临床经验[J].中国中医药现代远程教育,2010,08(23):177-178.
[5]王旭,朱垚,陆明.周仲瑛“瘀热致消”学术思想探究[J].中医杂志,2009,50(03):206-207.
[6]李路丹,谢梦洲,赵蒙蒙,等.鬼箭羽对2型糖尿病血瘀证大鼠血糖及血液流变学的影响[J].中南大学学报(医学版),2011,36(2):128.
[7]晏和国,杨博,侯建婷,等.情志因素与糖尿病的关系探讨[J].世界最新医学信息文摘,2017,17(34):10-11.
[8]王勇,王德惠.糖尿病的情志预防[J].辽宁中医药大学学报,2010,12(06):98-100.
[9]赵仁霞.丹参的现代药理研究及临床应用[J].中国医药指南,2011,09(12):291-292.
[10]赵进喜,邓德强,李靖.糖尿病肾病相关中医病名考辨[J].南京中医药大学学报,2005,21(5):288-289.
[11]孙亚招.2型糖尿病患者糖尿病肾病的危险因素分析[J].糖尿病新世界,2016,19(05):57-59.
[12]廖泷,秦岗.2型糖尿病患者糖尿病肾病与血脂相关性分析[J].遵义医学院学报,2007,30(1):76-77.
[13]黄效永,刘卫华.黄连素降压作用临床研究[J].现代中西医结合杂志,2003,12(5):479-480.
[14]陆春桃,王富.大黄功效索解[J].四川中医,2006,24(8):37-38.
[15]万晓青,张伟.当归对血液系统的药理作用研究进展[J].中草药,2009,40(12):2018-2020.
[16]赵进喜.吕仁和临床经验集[M].北京:人民军医出版社,2009.
[2]Mogensen C E,Schmitz A,Christensen C K.Comparative renal pathophysiology relevant to IDDM and NIDDM patients[J].Diabetes/metabolism Reviews,1988,4(5):453.
[3]Mogensen C E.Early renal involvement and nephropathy.Can treatment modalitiesbe predicted from identification of risk factors in diabetics[J].Toxicology Letters,1989,46(1-3):213.
[4]蔡丽威,李景华,李想,等.董治中主任医师治疗糖尿病肾病的临床经验[J].中国中医药现代远程教育,2010,08(23):177-178.
[5]王旭,朱垚,陆明.周仲瑛“瘀热致消”学术思想探究[J].中医杂志,2009,50(03):206-207.
[6]李路丹,谢梦洲,赵蒙蒙,等.鬼箭羽对2型糖尿病血瘀证大鼠血糖及血液流变学的影响[J].中南大学学报(医学版),2011,36(2):128.
[7]晏和国,杨博,侯建婷,等.情志因素与糖尿病的关系探讨[J].世界最新医学信息文摘,2017,17(34):10-11.
[8]王勇,王德惠.糖尿病的情志预防[J].辽宁中医药大学学报,2010,12(06):98-100.
[9]赵仁霞.丹参的现代药理研究及临床应用[J].中国医药指南,2011,09(12):291-292.
[10]赵进喜,邓德强,李靖.糖尿病肾病相关中医病名考辨[J].南京中医药大学学报,2005,21(5):288-289.
[11]孙亚招.2型糖尿病患者糖尿病肾病的危险因素分析[J].糖尿病新世界,2016,19(05):57-59.
[12]廖泷,秦岗.2型糖尿病患者糖尿病肾病与血脂相关性分析[J].遵义医学院学报,2007,30(1):76-77.
[13]黄效永,刘卫华.黄连素降压作用临床研究[J].现代中西医结合杂志,2003,12(5):479-480.
[14]陆春桃,王富.大黄功效索解[J].四川中医,2006,24(8):37-38.
[15]万晓青,张伟.当归对血液系统的药理作用研究进展[J].中草药,2009,40(12):2018-2020.
[16]赵进喜.吕仁和临床经验集[M].北京:人民军医出版社,2009.