脱发与白发的中医证候和方药规律分析

Analysis of the TCM syndrome and prescription rules of alopecia and leukotrichia

目的:探讨脱发、白发的中医证候和方药规律。方法:检索1980年1月至2014年10月中国期刊全文数据库(CNKI)收录的中医及中西医结合诊治脱发、白发的临床研究和个人经验类文献,规范纳入文献中的证型及所用方剂和药物,并对其进行频数和聚类分析。结果:总纳入文献156篇,共涉及脱发、白发中医证型27种。其中,肝肾亏虚、气滞血瘀、肝气郁结、心肝血虚、湿热内蕴、气血亏虚、血热、脾虚湿盛、肾精亏虚、精血不足为主要证型,涉及痰凝、湿郁、气滞、火热、风淫、阴虚、阳虚、血虚、气虚、精亏10个病机要素和肝、肾、心、脾、胃、胆6个脏腑病位。共得方剂103首,其中成方42首,以补益剂、和解剂、活血祛瘀剂、清热剂、祛湿剂为主。共涉及中药269味20大类,以补虚药、清热药、活血化瘀药、解表药、利水渗湿药、安神药、平肝熄风药为主;使用频次较高的50味中药可分为6个聚类方,分别适用于治疗湿热内蕴、肝气郁结及阴虚火旺、气虚、气滞血瘀、脾虚、心肝血虚及肝肾阴虚等证型的脱发、白发。结论:中医对脱发、白发的证候要素、辨证分型、遣方用药的规律分析可为目前该病的临床诊断、治疗和研究提供有用的参考。

Objective：To study the traditional Chinese medicine（TCM） syndrome and prescription rules of alopecia and leukotrichia.Methods：The literatures of clinical research and personal experience in treating alopecia and leukotrichia with traditional Chinese medicine or the integrative medicine from January 1980 to October 2014 were searched in China National Knowledge Infrastructure（CNKI）.The frequency analysis and cluster analysis methods were used to analyze the syndrome,prescriptions and Chinese medicine.Results：A total of 156 articles were included.There were 27 syndromes of alopecia and leukotrichia,mainly dei ciency of liver and kidney,qi stagnation and blood stasis,depression of liver qi,blood dei ciency of heart and liver,internal accumulation of damp-heat,dei ciency of qi and blood,blood-heat,excess of damp due to spleen dei ciency,dei ciency of kidney-essence,and dei ciency of blood-essence.Ten pathogenesis factors such as coagulation of phlegm,dampness obstruction,qi stagnation,fire-heat,wind evil,yin deficiency,yang deficiency,blood deficiency,qi deficiency,and essence dei ciency and 6 organs such as liver,kidney,heart,spleen,stomach and gallbladder were involved.103 prescriptions were attained with 42 set formulas.The commonly used formulas were supplementing formula,harmonizing formula,blood-activating and stasisremoving formula,heat-clearing formula,damp-removing formula.269 medicines were included,which could be classified into 20 categories,and among that,supplementing medicinal,heat-clearing medicine,blood-activating and stasis-removing medicine,exterior-evil relieving medicine,diuresis-inducing and damp-removing medicine,mind-calming medicine,liver-calming and windremoving medicine were commonly used.50 frequently counted Chinese medicines were categorized into 6 clustering formulae which were applied to alopecia and leukotrichia of the following types：syndrome of internal accumulation of dampness-heat,depression and stagnation of liver-qi,yin dei ciency and fire excess,qi dei ciency,qi and blood stasis,spleen dei ciency,blood dei ciency of both heart and liver,yin dei ciency of liver and kidney.Conclusion：Research on analyzing TCM syndromes and pathogenesis factors,syndrome differentiation,prescription and medication in the treatment of alopecia and leukotrichia can provide useful reference for the clinical diagnosis,syndrome differentiation and treatment and study of this disease.