黄褐斑中医辨证分型及处方用药规律的文献研究

Literature Research on Traditional Chinese Medicine Syndrome Types of Chloasma and Medication Rules for Chloasma

【目的】运用中医传承辅助平台软件(V2.5),挖掘现代中医文献中黄褐斑的辨证分型及处方用药规律。【方法】检索并筛选中国知网(CNKI)、万方(Wanfang Data)、中国生物医学文献(CBM)、维普(VIP)数据库中采用中药治疗黄褐斑的文献,基于中医传承辅助平台软件(V2.5),对黄褐斑的证候分型及中药处方等相关数据进行分析,挖掘其组方用药规律。【结果】共筛选得到339篇文献,收录343首治疗黄褐斑的中药方剂。黄褐斑的证型主要以肝郁气滞、气滞血瘀、肾虚血瘀为主,肝郁气滞证最常见;涉及中药224味,频次≥100次以上的药物有当归、茯苓、柴胡、川芎、白芍、红花、甘草、白术、丹参、熟地黄、桃仁、牡丹皮、香附等,其中频次最高的为当归。所用中药的药性以温为主;药味以甘为主;归经多见于肝经。聚类分析得到6组核心组合,进一步演化出3首新方。新方1(白芍-柴胡-薄荷-泽泻-山药)适用于黄褐斑脾虚肝郁型;新方2(鸡冠花-瓜蒌-熟大黄-牡蛎-桑椹)适用于血热血瘀型黄褐斑;新方3(白芷-僵蚕-白附子-白芥子)具有美白祛斑作用。【结论】黄褐斑病机主要与肝郁、气滞、血瘀、肾虚有关,中药治疗黄褐斑以疏肝理气、活血化瘀、补肾健脾为主。

Objective To investigate the traditional Chinese medicine(TCM)syndrome types of chloasma and medication rules for chloasma in modern Chinese medicine literature based on the Traditional Chinese Medicine Inheritance Support System(V2.5).Methods The literatures on TCM treatment of chloasma in the databases of CNKI,Wanfang Data,CBM and VIP were searched and screened.The related data of TCM syndrome types and Chinese medicine prescriptions for chloasma were analyzed based on Traditional Chinese Medicine Inheritance Support System(V2.5),and the medication rules for chloasma were explored.Results A total of 339 articles and343 prescriptions for chloasma were screened out.The main syndromes of chloasma are liver depression and qi stagnation type,qi stagnation and blood stasis type,kidney deficiency and blood stasis type,and liver depression and qi stagnation type ranked first.A total of 224 Chinese herbs were involved,and the herbs with the medication frequency being or over 100 times were Radix Angelicae Sinensis,Poria,Radix Bupleuri,Rhizoma Chuanxiong,Radix Paeoniae Alba,Flos Carthami,Radix Glycyrrhizae,Rhizoma Atractylodis Macrocephalae,Radix Salviae Miltiorrhizae,Radix Rehmanniae Preparata,Semen Persicae,Cortex Moutan Radicis and Rhizoma Cyperi,and Radix Angelicae Sinensis had the highest frequency.The property of the included herbs is characterized by being warm,the flavor is mainly sweet,and the meridian tropism is more common in liver meridian.Six groups of core combinations were obtained after cluster analysis,and three new prescriptions were further derived.New prescription 1(Radix Paeoniae Alba-Radix Bupleuri-Herba Menthae-Rhizoma AlismatisRhizoma Dioscoreae)is indicated for chloasma with spleen deficiency and liver stagnation type,new prescription 2(Flos Celosiae Cristatae-Fructus Trichosanthis-Radix et Rhizoma Rhei prepared-Concha Ostreae-Fructus Mori)is indicated for chloasma with blood heat and blood stasis type,and new prescription 3(Radix Angelicae Dahuricae-Bombyx Batryticatus-Rhizoma Typhonii-Semen Sinapis)has whitening and freckle-removing effects.Conclusion The pathogenesis of chloasma is mainly related to liver depression,qi stagnation,blood stasis and kidney deficiency.Chinese medicine treatment of chloasma mainly involves soothing liver and regulating qi,activating blood and removing stasis,and tonifying kidney and strengthening spleen.