功能性消化不良的常用方剂及药对规律总结

Commonly Used Prescriptions and Herbal Pairs for Functional Dyspepsia

目的:通过对文献的学习,归纳总结功能性消化不良(functional dyspepsia,FD)的常用方剂及高频使用药对。方法:检索1995—2015年中医药治疗功能性消化不良的相关文献共4 055篇,经总结文献中涉及辨证分型的共593篇,以此作为研究对象,通过分析发现功能性消化不良常见的8种证候类型为肝胃不和证、脾胃虚弱证、肝郁脾虚证、肝郁气滞证、脾虚气滞证、寒热错杂证、饮食积滞证及脾胃虚寒证,并提取其辨证使用的方剂及常用药对等信息,建立Microsoft Excel 2003数据库,录入SPSS 11.5软件进行统计,采用Crosstabs方法进行频数分析,对文献进行数据挖掘。结果:功能性消化不良肝胃不和证治疗以柴胡疏肝散为主;脾胃虚弱证中香砂六君子汤居多;肝郁脾虚证常见逍遥散;肝郁气滞证治疗以柴胡疏肝散为主;脾虚气滞证以香砂六君子汤见长;寒热错杂证中半夏泻心汤居多;饮食积滞证中保和丸为主;脾胃虚寒证附子理中汤多见。文献中高频使用的药对组合是茯苓-白术,柴胡-白芍,党参-茯苓,茯苓-枳壳等17对。结论:中医药在治疗功能性消化不良时有其独特的优势,整体观念和辨证论治是其基本特点,故多从整体出发,辨证施治,在证型基础上选择主方主药并进行配伍,从而扩大治疗范围,起到相辅相成的作用,还可防止主药太过,佐治其潜在副作用。

Objective： To summarize the commonly used prescriptions and highly frequently used herbal pairs for functional dyspepsia（ FD） from literatures. Method： A total of 4 055 literatures related to traditional Chinese medicine（ TCM） in the treatment of functional dyspepsia from 1995 to 2015 were retrieved,including 593 involving syndrome differentiation,which were taken as the research object. Through the analysis,eight common syndrome types of functional dyspepsia are liver-stomach disharmony syndrome,spleen and stomach deficiency syndrome,liver depression and spleen deficiency syndrome,liver depression and Qi stagnation syndrome,spleen deficiency and Qi stagnation syndrome,intermingled cold and heat syndrome,food stagnation syndrome,and spleen and stomach deficiency-cold syndrome. Information of prescriptions and common herbal pairs used for syndrome differentiation were extracted to establish a Microsoft Excel 2003 database. Efforts were made to enter in SPSS 11. 5 software for statistics,make a frequency analysis by using Crosstabs methods,and conduct data mining for the literatures. Result： FD with liver and stomach syndrome was mainly treated with Chaihu Shugan San;spleen and stomach deficiency syndrome was mainly treated with Xiangsha Liujunzi Tang; liver depression and spleen deficiency syndrome was commonly treated with Xiaoyao San; liver depression and Qi stagnation syndrome was principally treated with Chaihu Shugan San; spleen deficiency and Qi stagnation syndrome was principally treated with Xiangsha Liujunzi Tang; intermingled cold and heat syndrome was mostly treated with Banxia Xiexin Tang; food stagnation syndrome was mainly treated with Baohewan; and spleen and stomach deficiency-cold syndrome was mostly treated with Fuzi Lizhong Tang. There were 17 high-frequency herbal pairs used in the literatures,including Poria-Atractylodis Macrocephalae,Rhizama Bupleuri Radix-Paeoniae Radix Alba,Codonopsis Radix-Poria,and Poria- Aurantii Fructus. Conclusion： TCMs have unique advantages in the treatment of functional dyspepsia. With overall concept and syndrome differentiation as the basic characteristics,TCM doctors always make treatment based on overall syndrome differentiation,and combine herbs based on main prescriptions and medicines,so as to expand the range of treatment,play a complementary role,and prevent adverse effects of the main medicine.