中医药治疗慢性阻塞性肺疾病急性加重期组方规律探讨

Composing Prescription Principles of Chinese Medicine Treating Chronic Obstructive Pulmonary Disease at Acute Exacerbation Stage

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组方规律。方法以中国期刊全文数据库、中国医院数字图书馆、万方数据库、中国生物医学文献数据库为主要检索目标,纳入中医药复方治疗COPD急性加重期临床研究文献,提取药物建立数据库,统计药物使用频次,并分别对高频药物对药、三药组合、四药组合、五药组合、六药组合进行关联规则分析。结果共纳入文献251篇,涉及中药181味,共计使用2612频次,使用频次>15的药物共44味。关联规则显示,COPD急性加重期高频药物组方中,置信度最高的药对为紫苏子、莱菔子;三药组合为半夏、紫苏子、陈皮;四药组合为杏仁、桑白皮、黄芩、半夏;五药组合为半夏、桑白皮、黄芩、杏仁、甘草;六药组合为紫苏子、桑白皮、黄芩、杏仁、半夏、甘草。结论 COPD急性加重期的用药是以祛邪为主,重在清肺化痰、宣肺止咳、降气平喘。

Objective To explore the composing prescription principles of common herbs of Chinese medicine treating chronic obstructive pulmonary disease （COPD） at acute exacerbation stage. Methods The authors took Chinese Journal Full Text Database, China Hospital Digital Library, Wan Fang Data and Chinese Biological Medical Literature Database on disc as main retrieval targets. Clinical research papers of compound Chinese medicine treating COPD at acute exacerbation stage were included. Herbs were extracted to build database, and herb use frequency was accounted. The authors made analysis of association rules on paired herbs, three herbs combination, four herbs com- bination, five herbs combination, six herbs combination of high frequency herbs. Results In total, 251 papers were included, 381 herbs involved, with the use frequency of 2612. There were 44 herbs of which the use frequency was more than 15. Association rules showed that in the prescriptions with high frequency herbs of treating COPD at acute exacerbation stage, the paired herbs with the highest confidence level were Zisuzi [ Fructus Perillae ] and Laifuzi [ Semen Raphani ]. Three herbs combination was Banxia [ Rhizoma Pinelliae], Zisuzi and Chenpi [ Pericarpium Cirri Reticulatae ]. Four herbs combination was Xingren [ Semen Armeniacae Amarum ], Sangbaipi [ Cortex Mori], Huangqin [ Radix Scutellariae ] and Banxia. Five herbs combination was Banxia, Sangbaipi, Huangqin, Xingren and Gancao [ Radix liquiritiae ]. Six herbs combination was Zisuzi, Sangbaipi, Huangqin, Xingren, Banxia and Gancao. Con- clusion The herbs used to treat COPD at acute exacerbation lung-heat, eliminating phlegm, ventilating lung Qi, relieving sized. stage were most eliminating pathogen. Herbs of clearing cough, descending Qi and relieving asthma were emphasized.