基于文献分析的多囊卵巢综合征中医辨治规律研究

Law of syndrome differentiation and treatment on polycystic ovary syndrome: in perspective of literature analysis

目的基于文献分析,探讨多囊卵巢综合征的中医辨证分型及用药规律,为临床处方遣药提供参考。方法检索中国学术期刊全文数据库(CNKI)2000年1月至2015年1月收录的中医药治疗多囊卵巢综合征的临床研究文献,建立中医辨治多囊卵巢综合征的证型、方药数据库,统计、分析其中的辨证分型、证候要素,以及核心药物的功效、性味、归经。结果 1共纳入符合标准的文献40篇,涉及病例1 790例,证型7类,证候要素6种,方剂53首,核心药物99味、共计640次;27类证型按频率列前3位的依次为肾虚血瘀型、肾虚痰阻型、痰瘀内蕴型,6种证候要素按频率列前3位的依次为肾虚、血瘀、痰阻;399味药物按功效可分为8类,按频率列前3位的依次为补虚药、活血化瘀药、利湿化痰药;4使用频次≥8的药物共30味,按频率列前5位的依次为当归、熟地黄、香附、菟丝子、茯苓;5药性频数统计前3位依次为温、寒、平,药味频数统计前3位依次为甘、苦、辛,归经频数统计前3位依次为肝、肾、脾。结论中医药治疗多囊卵巢综合征注重扶正与祛邪相结合,在补肾调周的基础上,常辨证施以活血化瘀和利湿化痰等。

Objective To analyze the law of traditional Chinese medicine （TCM） syndrome differentiation and medication on polycystic ovary syndrome based in perspective of literature research, hereby to provide reference for clinical practice. Methods The clinical research literature on TCM for polycystic ovary syndrome from January 2000 to January 2015 was searched in China National Knowledge Infrastructure（CNKI）. A database of TCM for polycystic ovary syndrome was established. The frequency of medication was analyzed. The effect, nature, flavor and channel entry of herbs were descriptively analyzed. Results （1）40 articles were included in the research, during which 1790 cases, 7 syndrome types, 6 syndrome factors, 53 prescriptions and 99 core prescription drugs were included, and 640 herb frequency involved. （2）The top 3 syndrome types were deficiency of kidney and blood stasis type, deficiency of kidney and sputum dampness type, phlegm and blood stasis intrinsic type. The top 3 syndrome factors were deficiency of the kidney, blood stasis, phlegm obstruction. （3）The 99 herbs could be divided into 8 categories according to the effect. The top 3 were deficiency-supplementing herb, blood-quickening stasis-transforming herb and dampness-removing phlegm- reducing herb.（4）There were 30 herbs with a frequency greater than 8, and the top 5 were Danggui, Shudi, Xiangfu, Tusizi and FuIing. （5）In the frequency of herb nature, the top 3 were warm, cold and calm. In the frequency of herb flavor, the top 3 were sweet, bitter and pungent： In the frequency of meridian tropism, the top 3 were liver, kidney and spleen. Conclusion Traditional Chinese medicine syndrome differentiation and medication on polYcYStiC ovary syndrome pay attention to the combination of supporting the healthy energy and eliminating the evil factors, promoting blood circulation to remove blood stasis and dampness-removing phlegm-reducing are often used in treating polycystic ovary syndrome on the base of tonifying kidney and regulating menstrual cycle.