周福生辨治慢性萎缩性胃炎用药规律分析

Analysis of Medication Regularity for Chronic Atrophic Gastritis Treated by ZHOU Fu-Sheng

【目的】分析周福生教授辨治慢性萎缩性胃炎的用药规律。【方法】收集周福生教授于2018年1月至2020年12月期间治疗慢性萎缩性胃炎患者的有效处方,提取患者一般资料、诊断、处方等数据。基于中医传承辅助平台系统(V2.5),构建处方数据库,采用频次统计分析、关联规则分析等数据挖掘方法,统计处方中药物的四气五味、归经及各药的使用频次,分析药物间的关联规则度,探讨处方规律。【结果】共纳入146首处方,涉及117味药物。药物归经主要归脾、胃经,其次是肺、肝、心经;药味主要为辛、苦、甘;药性主要为温性、平性药。频次≥20次的中药有25味,频次居前10位的中药分别为白术、茯苓、法半夏、砂仁、乌药、甘草、木香、三七、五指毛桃、醋延胡索。药物关联规则分析结果提示治疗慢性萎缩性胃炎用药多采用健脾祛湿、行气活血的药物,核心用药包括白术、甘草、乌药、醋延胡索、五指毛桃、法半夏、砂仁、三七、木香等。【结论】周福生教授治疗慢性萎缩性胃炎以补益脾胃、清热解毒、活血祛瘀、益气养阴为主要治法,用药以“心胃相关”及辨病、辨证、辨体质“三位一体”为指导。

Objective To explore the medication regularity for chronic atrophic gastritis(CAG)treated by Professor ZHOU Fu-Sheng.Methods The prescriptions for the effective CAG cases treated by Professor ZHOU FuSheng from January 2018 to December 2020 were collected,and then the general information of the patients,diagnosis and prescriptions were extracted.Based on the Traditional Chinese Medicine Inheritance Support System(TCMISS V2.5),the prescription database was constructed,and data mining methods of frequency statistical analysis and association rule analysis were used to count the percentages of the four properties and five tastes and meridian tropism,and to calculate the medication frequency of herbs in the prescriptions.After that,the degree of association rule among drugs was analyzed for exploring the prescription regularity.Results A total of146 prescriptions and 117 herbs were included.The included herbs mainly had the meridian tropism of the spleen and stomach meridians,followed by the lung,liver and heart meridian.Most of the herbs were pungent,bitter and sweet,and their properties were mainly warm and mild.Of the included herbs,25 herbs had the medication frequency being or over 20 times,and the top 10 Chinese medicines were Rhizoma Atractylodis Macrocephalae,Poria,Rhizoma Pinelliae Preparata,Fructus Amomi,Radix Linderae,Radix Glycyrrhizae,Radix Aucklandiae,Radix Notoginseng,Radix Fici Hirtae and vinegar-roasted Rhizoma Corydalis.The results of the herbal association rule analysis suggest that most of the herbs used for CAG had the actions of invigorating spleen and removing dampness,promoting qi and activating blood.The core herbs in the prescriptions were Rhizoma Atractylodis Macrocephalae,Radix Glycyrrhizae,Radix Linderae,vinegar-roasted Rhizoma Corydalis,Radix Fici Hirtae,Rhizoma Pinelliae Preparata,Fructus Amomi,Radix Notoginseng and Radix Aucklandiae.Conclusion Professor ZHOU Fu-Sheng usually adopts the therapies of tonifying the spleen and stomach,clearing heat and removing toxin,activating blood and removing stasis,and replenishing qi and nourishing yin for the treatment of CAG,and follows the medication principle of heart-stomach correlation and the three-pronged approach of disease differentiation,syndrome differentiation and constitution differentiation.