基于755首中药处方治疗糖尿病用药规律的研究

Research on rules of medication for diabetes mellitus based on analysis on 755 traditional Chinese medicine prescriptions

检索并纳入1995—2016年发表的治疗糖尿病相关文献755篇,涉及中药处方755首,单味中药367味,共治疗糖尿病及其并发症的有效例数为33 330例,探讨中医药治疗糖尿病及其并发症的用药规律。采用Microsoft Excel 2010软件和Clementine 12.0软件,分析与比较各病症类型的单味中药使用频次、功效和组方配伍规律。中医药在治疗糖尿病及其并发症方面,治疗病症类型排名前4位的分别是糖尿病、糖尿病神经系统并发症、糖尿病肾病和糖尿病心血管并发症,分别占总有效病例数的31.62%、29.82%、8.87%和6.47%。进一步对治疗排名前4位的病症进行分析,发现治疗糖尿病的常用单味药为黄芪、山药、地黄、天花粉和麦冬等,常用中药类别依次为补虚药、清热药和活血化瘀药;治疗糖尿病的神经系统并发症常用单味药为黄芪、当归、川芎、丹参和桂枝等,常用中药类别依次为补虚药、活血化瘀药和清热药;治疗糖尿病肾病的常用单味药为黄芪、山药、丹参、茯苓和山茱萸等,常用中药类别依次为补虚药、活血化瘀药和利水渗湿药;治疗糖尿病心血管并发症的常用单味药为黄芪、丹参、当归、红花和川芎等,常用中药类别为活血化瘀药、补虚药和清热药。中医药治疗糖尿病、糖尿病神经系统并发症、糖尿病肾病和糖尿病心血管并发症的用药规律具有一定的相似性,均以补虚药为主,兼以活血化瘀、清热和利水渗湿药等,但具体用药侧重点不同,糖尿病和糖尿病神经系统并发症侧重补虚药,兼以活血化瘀药和清热药的使用,糖尿病肾病侧重于补虚药,兼以活血化瘀药和利水渗湿药的使用,而糖尿病心血管并发症侧重于活血化瘀药和补虚药并重,兼以清热药使用。

To explore the rules of medication for diabetes and diabetic complications based on analysis on 755 traditional Chinese medicine（TCM） prescriptions. The information in 755 papers published from 1995 to 2016 was got including 755 herbal prescriptions, 367 herbs, 33 330 effective cases. Based on the above information, usage frequency of single herb, efficiency and the rules of formulating prescription for different types of diabetes were analyzed and compared using Microsoft Excel 2010 and Clementine 12.0 software. In the treatment of diabetes and its complications, the top four diabetes symptoms are about diabetes, diabetic neurological complications, diabetic nephropathy and diabetic cardiovascular complications, and accounting for 31.62%, 29.82%, 8.87%, and 6.47% of the total number of effective cases. Further analysis of the top four illnesses found that single herb commonly used in the treatment of diabetes was Astragali Radix, Dioscoreae Rhizoma, Rehmanniae Radix, Trichosanthis Radix, Ophiopogonis Radix, etc. The commonly used drugs categories were tonic herbs, heat-clearing herbs and blood activating herbs; The single medicine commonly used in the treatment of diabetic neurological complications was Astragali Radix, Angelicae Sinensis Radix, Chuanxiong Rhizoma, Radix Salviae Miltiorrhizae et Rhizoma, Cinnamomi Ramulus, etc. The commonly used drugs categories were tonic herbs, blood activating herbs and heat-clearing herbs; The single herb commonly used in the treatment of diabetic nephropathy was Astragali Radix, Dioscoreae Rhizoma, Salviae Miltiorrhizae Radix, Poria, Fructus Corni, etc., the commonly used drugs categories were tonic herbs, blood activating herbs and damp-clearing herbs. The single herb commonly used in the treatment of diabetic cardiovascular complications was Astragali Radix, Salviae Miltiorrhizae Radix, Angelicae Sinensis Radix, Carthami Flos, Chuanxiong Rhizoma, etc., the commonly used drugs categories were blood activating herbs, tonic herbs and heat-clearing herbs. The rules of medication of TCM for diabetes, diabetic neurological complications, diabetic nephropathy and diabetic cardiovascular complications showed similar characteristics, tonic herbs were used the most frequently, supplemented by blood activating herbs, heat-clearing herbs and damp-clearing herbs. However, the principle of formula is a little different for different types of diabetes and diabetic complications, specifically. The prescriptions for diabetes and diabetic neurological complications consist of tonic herbs as the principal, supplemented by blood activating herbs and heat-clearing herbs; The prescriptions for diabetic nephropathy are composed of tonic herbs as the principal, supplemented by blood activating herbs and damp-clearing herbs, as well as tonic herbs and blood activating herbs were equal components in the prescriptions for diabetic cardiovascular complications, supplemented by heat-clearing herbs.