中医治疗慢性肾衰竭用药规律探析

Analysis on the principles of Chinese medicine for the treatment of chronic renal failure

目的基于文献分析,探讨中医治疗慢性肾衰竭的用药规律。方法通过数据库检索2004-2014年发表的有关中药治疗慢性肾衰竭的临床研究文献,运用频数分析、因子分析、聚类分析等方法分析相关方剂的药物组成、功能分类、治法等情况,进而探讨其中的用药规律。结果 1共纳入73篇文献,收集中药方剂73首,涉及药物131味,药物总频次784次。2因子分析及频数分析发现,最能体现本病证治特点的15味药物为大黄、黄芪、丹参、茯苓、白术、当归、淫羊藿、川芎、党参、半夏、土茯苓、山茱萸、枸杞、牛膝、杜仲。3治法频数统计发现,益气健脾、通腑降浊、活血化瘀、补益肝肾法应用最为广泛。4聚类分析发现有意义的两组药物组合,分别为大黄、黄芪、丹参(C1),当归、茯苓、白术(C2)。结论慢性肾衰竭临床常从虚、浊、瘀论治,治法以通腑降浊、扶正补益、活血化瘀、化湿解毒等为主,常用药物如大黄、黄芪、丹参、茯苓、白术等。

Objective To analyze the principles of Chinese medicine for the treatment of chronic renal failure （CRF） based on literature analysis. Methods Search and screen out the articles published through the database from 2004 to 2014 on Chinese medicine for the treatment of CRF with Chinese medicine. We analyzed the composition, function category and therapeutic methods of the medicine by frequency analysis, factor analysis and cluster analysis to discuss the medication law. Results ①Seventy-three articles were involved in the research, collecting 73 prescriptions and 131 kinds of herbs and 784 times of total medicine frequency. ②Through factor analysis and frequency analysis, the herbs which can mostly reflect the treating principles are the 15 kinds： Dahuang （ Radix et Rhizoma Rhei ）, Huangqi （ Radix Astragali seu Hedysari ）, Danshen （ Radix Salviae giltiorrhizae ）, Fuling （ Poria ）, Baizhu （ Rhizoma Atractylodis Macrocephalae） , Danggui （ Radix Angelicae Sinensis ）, Xianlingpi （ Herba Epimedii ）, Chuangxiong （ Rhizoma Ligustici Chuanxiong ）, Dangshen （ Radix Codonopsis ）, Banxia （ Rhizoma Pinelliae ） , Tufuling （ Poria ） , Shanzhuyu （ Fructus Corni ） , Gouqi （ Fructus Lycii ） , Niuxi （ Radix Achyranthis Bidentatae ） , Duzhong （ Cortex Eucommiae）.③Treatment frequency shows that measures like purging fu-organs and Turbid-Expelling, nourishing qi to invigorate spleen, activating blood and touify the liver and kidney are the most widely used. ~）Cluster analysis reveals two significant herb combinations： C1 [ Dahuang（ Radix et Rhizoma Rhei）, Huangqi （ Radix Astragali sea Hedysari ）, Danshen （ Radix Salviae Miltiorrhizae） ] and C2 [ Fuling （ Poria ）, Baizhu （ Rhizoma Atractylodis Macrocephalae ）, Danggui （Radix Angelicae Sinensis） ]. Conclusion Treating CRF with Chinese medicine can focus on the ＂weakness turbid＂ and ＂stasis＂, so the main therapies are tonifying deficiency, purging fu-organs and expelling turbid, activating blood, dissipating dampness and poison. The most frequently used medicines are Dahuang （ Radix et Rhizoma Rhei ） , Huangqi （ Radix Astragali seu Hedysari ） , Danshen （ Radix Salviae Miltiorrhizae ）, Fuling （ Poria ） , Baizhu （ Rhizoma Atractylodis Macrocephalae ） , etc.