中医治疗老年性阴道炎的用药规律分析

Analysis on Medication Rule in Herbal Prescriptions for Senile Vaginitis

目的:分析老年性阴道炎内服中药处方并总结其用药规律。方法:检索中国知网、万方、重庆维普、中国生物医学文献数据库,收集2013—2018年治疗老年性阴道炎的中药内服处方,基于TCMISS中医传承辅助平台,提取分析出所收集处方内各中药的使用频次、四气五味、归经归类、药物间的关联规则、核心用药组合以及新处方等。结果:116个中药内服处方中,使用频次较高(频次≥30)的中药有茯苓、黄柏、薏苡仁、牛膝、苍术、甘草、萆薢等。处方内中药四气之分布依次是寒、温、平、凉。五味之分布依次是甘、苦、辛、淡。归经之分布依次为肝、脾、肺、肾。药物归类之分布依次是菊科、毛茛科、豆科等。黄柏、牛膝、薏苡仁、茯苓、苍术、萆薢等均为临床治疗老年性阴道炎最常用的中药。分析得到核心用药组合7个,新处方8首。结论:中药治疗老年性阴道炎以祛湿清热补肾为主要治法,常用处方为萆薢渗湿汤,处方用药应以“祛湿止带不恋邪,清热补肾防亏耗”为则,治顽湿应要“截其源流,围其大道,驱其居所”。

Objective:To analyze the prescription of traditional Chinese medicine for oral administration of senile vaginitis and summarize its medication regularity.Methods:The author searched Chinese Knowledge Network,Wanfang,Chongqing Weipu,China Biomedical Literature Database,collected the traditional Chinese medicine oral prescription for the treatment of senile vaginitis from 2013 to 2018.Based on the TCMISS Chinese medicine inheritance auxiliary platform,the frequency of use,four scents and five flavors,classification of meridians and association rules among drugs in the collected prescriptions were extracted and analyzed.Results:Among 116 prescriptions for oral administration of traditional Chinese medicine,Fuling(Poria cocos),Huangbai(Cortex Phellodendri),Yiyiren(Coix seed),Niuxi(Achyranthes bidentata),Cangzhu(Atractylodes Rhizoma Atractylodis),Gancao(licorice),Bixie(fish poison yam)and so on were used more frequently(frequency≥30).The distribution of the four Qi in the prescription was cold,warm,flat and cool in turn.The distribution of five flavors is sweet,bitter,bitter and light in turn.The distribution of meridian tropism is liver,spleen,lung and kidney in turn.The distribution of drugs is followed by Asteraceae,Ranunculaceae,Leguminosae,etc.Huangbai(Cortex Phellodendri),Niuxi(Achyranthes bidentata),Yiyiren(Coix seed),Fuling(Poria cocos),Cangzhu(Atractylodes Rhizoma Atractylodis)and Bixie(fish poison yam)are the most commonly used traditional Chinese medicines for the treatment of senile vaginitis.Conclusion:The main treatment of senile vaginitis with traditional Chinese medicine is dispelling dampness,clearing heat and tonifying kidney.The commonly used prescription is Bixie Shenshi decoction(萆薢渗湿汤).The prescription should be based on the principle of"dispelling dampness,stopping evil,clearing heat and tonifying the kidney and preventing loss".The treatment of obstinate dampness should be"cut off its source,surround its main road and drive away its residence".