西药辨证应用研究的关键问题

Key Issues in Study on Western Medicine Syndrome Differentiation

目前已有研究发现,西药的临床疗效、不良反应发生与患者的中医证候存在一定规律性联系,但尚未形成一个广泛实用的西药辨证应用研究规范和平台。为了促进西药辨证应用研究,明确西药的药性、归经、功效等中药学特征,我们根据长期临证思考和实践体会,参照中医的各种规范,初步建立了"整体观念"指导下的普适的、可以高效进行西药辨证应用研究的35条中医基本证。在此基础上,建立了符合中医辨证实质的、可量化的证候疗效评判体系,并创建了包含"临床信息采集系统"和"辨证应用挖掘系统"两大部分的"西药辨证应用研究平台"。进一步将该系统运用于阿司匹林辨证应用研究,通过对75例高血压病患者使用阿司匹林肠溶片前后各基本证证候积分变化的分析发现,阿司匹林药性寒凉,归心经、胆经;其最好的功效是活血化瘀,其次是理气解郁、益气血、滋阴液。研究结果表明,"西药辨证应用研究平台"可以高效地进行西药辨证应用研究,是广泛迅速进行各种西药辨证应用研究切实可行的工具。

At present, research has found that there exists certain regular relations between clinical effect and adverse reaction of western medicine and traditional Chinese medicine （TCM） syndrome. However, comprehensive and practical standard and platform of application research of western medicine syndrome differentiation has not formed. In order to promote application research of western medicine syndrome differentiation and determine property, channel entry, effect and other features of western medicine, the authors established 35 universal items of TCM basic syn- dromes that can effectively carry on application research of western medicine syndrome differentiation under the guid- ance of holism concept. The quantifiable effect evaluation system was established according with TCM syndrome differentiation nature. The application research platform of western medicine syndrome differentiation was built , including a collection system of clinical information and a data mining system of syndrome differentiation application. The re- searchers have further applied the system in aspirin syndrome differentiation. They analyzed the basic syndrome score changes of 75 patients with hypertension after took aspirin enteric-coated tablets. What they have found is that aspirin is cold and cool in property, it belongs to heart meridian and gallbladder meridian, and its most significant effect is activating blood and removing stasis, and its other function includes regulating qi to reduce depression, benefiting qi and blood, and nourishing yin fluid. The result has shown that application research platform of western medicine syn- drome differentiation can effectively carry out the application research of western medicine syndrome differentiation, and it is available for extensive and quick application researches of various kinds of western medicine syndrome differ- entiation.