基于文献挖掘的分水岭脑梗死中医处方规律研究

Research on the TCM prescriptions regularity of cerebral watershed infarction based on literature mining

目的:探讨急性分水岭脑梗死(Cerebral Watershed Infarction,CWI)的中医处方规律。方法:应用中国学术期刊全文数据库(China Academic Journal Network Publishing Database,CAJD)检索1980-2018年间应用传统中医药治疗急性CWI的临床研究文献,统计应用处方及中药频数,记录常用中药性味,用Excel2010进行统计分析,采用权重系数评价药类对治疗的积极度。结果:符合纳入标准的文献共9篇,涉及9首方剂,11类、共计37味中药,中药累计使用频次为97次。治疗急性CWI主要应用经典方剂(77.8%),其中以补阳还五汤化裁者(44.5%)居多,其次为补中益气汤(33.3%);前5位高频应用中药为当归(9次)、黄芪(8次)、赤芍(6次)、川芎(6次)、丹参(5次);前4位权重系数较高的药类为补虚药(81.8%)、活血化瘀药(54.5%)、清热药(54.5%)、解表药(54.5%),其中补虚药以补气药所占构成比最高(55.6%);中药性味以辛、甘、温为主,其次为苦寒;药物主要归于脾经,其次为肺经、肝经。结论:目前关于急性CWI中医药治疗的研究甚少,以甘温药物益气活血为CWI急性期的主要治法,同时兼顾清热、熄风、化痰等。CWI早期即应注重“补虚”,尤其是补气药的应用。

Objective: To study the TCM prescriptions regularity of acute CWI. Methods: CAJD was used to retrieve the clinical research literature of treating acute CWI with TCM from 1980 to 2018. The frequency of prescriptions and herbs, the nature and taste of herbs were recorded and analyzed by using excel 2010. Weight coefficient was used to evaluate the positive degree of drug treatment. Results: A total of 9 articles met the inclusion criteria, involving 9 prescriptions, 11 categories, a total of 37 herbs, the cumulative use of herbs is 97 times. Classical prescriptions (77.8%) were mainly used in the treatment of acute CWI, of which the Buyang Huanwu decoction (补阳还五汤)(44.5%) was the most common prescription, followed by the Buzhong Yiqi decoction (补中益气汤)(33.3%). The first 5 high-frequency applications of Chinese herbs are Danggui (当归)(9 times), Huangqi (黄芪)(8 times), Chishao (赤芍)(6 times), Chuanxiong (川芎)(6 times), Danshen (丹参)(5 times). The top 4 drugs with higher weight coefficient are Buxu (补虚) herbs (81.8%), Huoxue Huayu (活血化瘀) herbs (54.5%), Qingre (清热) herbs (54.5%), Jiebiao (解表) herbs (54.5%). The proportion of Buqi (补气) herbs in Buxu herbs was the highest (55.6%). The main flavor of herbal medicine was Xin (辛), Gan (甘) and Wen (温), followed by Ku (苦) and Han (寒). The drugs were mainly attributed to Pijing (脾经), followed by Feijing (肺经) and Ganjing (肝经). Conclusion: At present, there are few researches on the treatment of acute CWI in TCM. The main treatment of acute CWI is using Ganwen (甘温) herbs, in order to Yiqi Huoxue (益气活血), at the same time taking account of Qingre (清热), Xifeng (熄风) and Huatan (化痰), etc.. CWI should pay attention to Buxu in early stage, especially the application of Buqi medicine.