基于聚类分析的慢性阻塞性肺疾病急性加重期用药规律探讨

Exploration of Regularity of Treating AECOPD Based on Cluster Analysis

目的探讨中医药治疗慢性阻塞性肺疾病(COPD)急性加重期的常用药物和配伍规律。方法以1991年1月至2013年12月在省级以上期刊发表,且经过临床观察有效的治疗COPD急性加重期的中药复方为研究对象,对其用药进行聚类分析,探索治疗COPD急性加重期的中药用药规律。结果 COPD急性加重期使用频率较高的药物依次为甘草、半夏、杏仁、茯苓、黄芩、陈皮、瓜蒌。聚类分析显示COPD急性加重期常用药物可分为止咳化痰平喘、温肺化饮、活血化瘀、清肺化痰、通腑泄热、益气养阴等6类药物。从以上聚类结果可以看出,到聚六类为止,各类药物基本上达到稳定。结合临床专业知识考虑聚六类的结果较为合理。结论COPD急性加重期的用药以化痰止咳平喘、活血化瘀、益气养阴类中药为主,化痰瘀、益气阴是COPD急性加重期的基本治则。

Objective： To discuss commonly used drugs and its law of compatibility in treatment of AECOPD. Method： TCM compound was taken to study,which was effective in clinical combined with Western Medicine such as anti-infection,expectorant ,cough mixture in the treatment of AECOPD published in January 1991 to December 2013 on the journal. Cluster analysis was performed on the drug,to explore the commonly used drugs and law of compatibility of TCM in treatment of AECOPD. Result： The most frequently used drugs in TCM treating AECOPD were lined successively as follows： Licorice,Pinellia,Almond,Poria,Radix,Scutellariae,Tangerine,and Trichosanthis. Clustering analysis showed that the drugs could be divided into six categories including eliminating cough and phlegm to smooth wheezing ,warming lung to reduce watery phlegm, promoting blood circulation to remove blood stasis,clearing lung and eliminating phlegm,purging fu-organs to eliminate heat,and supplementing Qi and nourishing Yin. Conclusion： The main dmgs treating AECOPD shall focus on the effects of eliminating cough and phlegm to smooth wheezing,promoting blood circulation to remove blood stasis, and supplementing Qi and nourishing Yin. Therefore,promoting blood circulation and eliminating phlegm,supplementing Qi and nourishing Yin is the basic method in the treatment of AECOPD.