高脂血症的中医临床用药规律分析

An analysis of treating hyperlipidemia in TCM

目的:对近30年以来中国期刊全文数据库(CNKI)收录的中医药治疗高脂血症文献,通过频数分析和系统聚类分析总结出中医证型和用药规律,为临床治疗和科学研究提供新的思路。方法:对符合纳入标准的文献进行整理分析,再用统计软件SPSS 18.0整理数据,采用频数分析、系统聚类分析,结合中医基础理论对统计结果做深层次的阐述。结果:高脂血症常见证型34个,其中肝肾阴虚、痰浊内阻、痰瘀互结、气滞血瘀、脾肾阳虚、气虚血瘀、脾虚痰阻、湿热蕴结、肝郁气滞、脾虚湿盛、瘀血内结、肝胆湿热、肝阳上亢累计频率达81.44%;用药共322味,按功能分为39类,进一步合并为19类,其中补虚药、活血化瘀药、利水渗湿药、清热药、消食药、化痰止咳平喘药、解表药、理气药、平肝息风药、泻下药出现频率累计达到90.80%;此外,在数据分析的基础上还得出一些聚类方。结论:中医对高脂血症的治疗有一定的优势,根据中医辨证对高脂血症的分型、以及治疗所用药物的功效、性味、归经等与高脂血症的病因、病机密切相关,发现这些特点和规律可以为临床治疗提供新的思路和参考。

Objective： The literatures of treating hyperlipidemia with TCM medicine from CNKI were frequency and cluster analyzed, to summarize the TCM syndromes and medication laws and provide new ideas for treatment and scientific research. Methods： The literatures were frequency and cluster analyzed by SPSS 18.0; the results were further elaborated according to the basic theory of TCM medicine. Results： There were 34 common syndrome types of hyperlipidemia, including Ganshen Yinxu（ 肝肾阴虚）, Tanzhuo Neizu（ 痰浊内阻）, Tanyu Hujie（ 痰瘀互结）, Qizhi Xueyu（ 气滞血瘀）, Pishen Yangxu（ 脾肾阳虚）, Qixu Xueyu（ 气虚血瘀）, Pixu Tanzu（ 脾虚痰阻）, Shire Yunjie（ 湿热蕴结）, Ganyu Qizhi（ 肝郁气滞）, Pixu Shisheng（ 脾虚湿盛）, Yuxue Neijie（ 瘀血内结）, Gandan Shire（ 肝胆湿热）, Ganyang Shangkang（ 肝阳上亢）, for 81.44%. The 322 medicine were divided into 39 categories according to their functions and further merged into 19 categories. Then, the frequency of medicines of Buxu（ 补虚）, Huoxue Huayu（ 活血化瘀）, Lishui Shenshi（ 利水渗湿）, Qingre（ 清热）, Xiaoshi（ 消食）, Huatan Zhike Pingchuan（ 化痰止咳平喘）, Jiebiao（ 解表）, Liqi（ 理气）, Pinggan Xifeng（ 平肝息风）, Xiexia（ 泻下） was 90.80%. In addition, some clustering prescriptions were also obtained. Conclusion： TCM medicine has a certain advantage on treating hyperlipidemia. The dialectical classification of hyperlipidemia, the Xingwei（ 性味） and（ 归经） of TCM medicine are closely related to the etiology and pathogenesis of hyperlipidemia. The new ideas and reference were provided according to the characteristics and rules.