真性红细胞增多症中医辨治规律系统综述

Red Blood Cell Characteristics in TCM Syndrome Differentiation System Increased Review

[目的]分析真性红细胞增多症病因、病机、辨证分型、证候要素及用药规律。[方法]系统综述方法,关键词:中医、中医药、中西医结合、真性红细胞增多症、骨髓增殖性疾病,检索中国知网(CNKI)、万方数据库(Wanfang Data)、维普中文科技期刊数据库(VIP)1980年1月—2016年9月RCT文献,同时追溯纳入文献参考文献,建立数据库,统计分析证型、证素、中药使用。[结果]初筛文献153篇,逐层筛选,最终纳入文献95篇,获取101个证候类型,规范为69个证候类型。纯实证类证型43个,虚实夹杂类证型23个,纯虚类证型3个。证型频率顺序:气滞血瘀、肝热血瘀、血瘀证、气虚血瘀、肝胆实火。病位证素频率顺序:肝、肾、胆、血分、经络、营分;病性证素类中病因证素频率顺序:热(火)、湿、毒(疫疠)。实证证素频率顺序血瘀、气滞、血热。虚证证素频率顺序:阴虚、气虚、血虚。用药:共使用18大类199味药,前5位种类频率顺序:清热、活血化瘀、补虚、解表、平肝息风。前8位药物频率顺序:生地、赤芍、当归、红花、桃仁、甘草、丹参、柴胡。[结论]合理使用清热解毒药-提高疗效关键,活血化瘀-贯穿治疗始终,重视理气药使用。

[Objective] The purpose of this article is to analyze polycythemia vera disease etiology,pathogenesis,syndrome differentiation,syndrome factor and the regularity of medication.[Methods] We use systematic review method to retrieve the China National Knowledge Infrastructure(CNKI),Wanfang Data,VIP database and references during January 1980 to September 2016.Then,we build and analysis the database,certificate and traditional Chinese medicine.[Results] We get 153 articles which were checked through literature method and 95 articles were studied among them.Then,we summarize analyze 69 syndrome from 101 syndrome.There are 43 pure empirical class type certificate,23 class certificate type and 3 Pure virtual class card type.Card type frequency order:Qi and blood stasis,liver Qi deficiency and blood stasis,blood stasis,blood stasis,liver fire.Disease syndrome factor frequency sequence:liver,kidney,bravery,blood,meridians,camp;Disease of sex of syndrome element class causes frequency sequence:heat(fire),wet and epidemic.The empirical frequency factor order:blood stasis,and Qi stagnation,blood hot.Deficiency syndrome factor frequency in order:Yin deficiency,Qi deficiency,blood deficiency.There are 18 kinds,199 herbs used in the treatment of polycythemia vera.The top 5 kinds of frequency order:clear heat,promoting blood circulation to remove blood stasis,tonify deficiency,nourish the liver Xi Feng,flat.The top 8 drugs frequency order:radix rehmanniae,radix paeoniae rubra,angelica,safflower,peach kernel,liquorice,red sage root,radix bupleuri.[Conclusion] The rational use of heat poison medicine and Qi-regulating drugs are the key to improve curative effect and treatment required for activating blood circulation must be throughout the treatment process.