基于中医传承辅助平台挖掘早发性卵巢功能不全的用药规律

Medication Rule of Premature Ovarian Dysfunction Based on Traditional Chinese Medicine Inheritance Assistant Platform

目的通过收集、整理治疗早发性卵巢功能不全(premature ovarian insufficiency,POI)疗效确切的中医医案,通过数据挖掘,分析中医医案治疗POI的用药经验、组方规律,总结诊疗思路。方法检索中国知网、万方数据库、维普数据库、中国生物医学文献数据库及北京中医药大学图书馆馆藏书籍中应用中医处方治疗POI的经典医案,提取首诊处方,运用中医传承辅助平台挖掘处方的组方规律和用药特点。结果共纳入处方131首,涉及中药188味,常用药物为菟丝子、熟地黄、当归、甘草、枸杞子、白芍、淫羊藿、女贞子、丹参、山药等;常用药物的四气以温性药和平性药为主;常用药物的五味中甘味药使用最多,苦味次之;按归经,常用药物主入肝经、肾经、脾经;常用药对以熟地黄,菟丝子,当归,枸杞子互相组合为主;进一步聚类分析得到潜在核心组合8个,新处方4首。结论中医经典医案中治疗POI以补虚药为主,兼顾清虚热、化瘀血,标本兼治,聚类分析得出的潜在药物组合和新方具有一定理论价值及代表性,可为临床探索及实验研究提供参考。

Objective To analyze the medication experience and prescription rules of traditional Chinese medicine(TCM)medical cases in the treatment of premature ovarian insufficiency(POI),and to summarize the diagnosis and treatment ideas though collecting and sorting out the medical records of TCM with definite curative effect in the treatment of POI,as well as data mining.Methods The CNKI,Wanfang database,VIP database,China Biology Medicine disc(CBM)and the books from Beijing University of Chinese Medicine Library about the treatment of POI with TCM were searched,and the prescription of the first diagnosis was extracted.The TCM inheritance support platform was used to mine the prescription rules and medication characteristics.Results A total of 131 prescriptions were included,involving 188 Chinese materia medica.The commonly used herbs were Semen Cuscutae,Radix Rehmanniae Preparata,Radix Angelicae Sinensis,Radix Glycyrrhizae,Fructus Lycii,Radix Paeoniae Alba,Herba Epimedii,Fructus Ligustri Lucidi,Radix Salviae Miltiorrhizae,Rhizoma Dioscoreae,etc.;in terms of four Qi,the common herbs were mainly warm and neutral;in terms of five tastes,the common herbs were sweet and followed by bitter herbs;in terms of channel tropism,the common drugs were mainly in the liver,kidney and spleen channels.;the commonly used herbs were mainly composed of Radix Rehmanniae Preparata,Semen Cuscutae,Radix Angelicae Sinensis,and Fructus Lycii;further cluster analysis was carried out to get 8 potential core combination and 4 new prescriptions.Conclusion The TCM classical medical cases in the treatment of POI mainly used tonifying deficiency herbs,taking into account the clearing deficiency heat,resolving blood stasis,with treating both the symptoms and the root causes.The potential herb combination and new prescriptions obtained by cluster analysis might have certain theoretical value and representativeness,which could provide references for clinical exploration and experimental research.