基于复杂网络分析系统性红斑狼疮热毒炽盛证中医临床症方药规律

Analysis on Laws of Syndrome and Prescription in severe heat toxin syndrome of Systemic Lupus Erythematosus Based on Complex Network Analysis

目的:挖掘系统性红斑狼疮(systemic lupus erythematosus, SLE)热毒炽盛证临床核心症状及方药,为中医临床辨证及治疗SLE热毒炽盛证提供参考。方法:用复杂网络分析方法,通过临床回顾病案室322例SLE患者病历,对SLE热毒炽盛证中医临床的症状、用药进行复杂网络构建,计算网络的拓扑性质参数,分析SLE热毒炽盛证中医临床核心症状、方药、配伍规律和组方特点。结果:运用复杂网络分析方法得出,本研究中SLE热毒炽盛证的核心症状主要有疲乏、眠差、纳差、高热、神昏、脱发、红色皮疹、四肢红斑、面部鲜红蝶形红斑、关节痛、关节肿痛、口舌生疮、口渴、咳嗽、咯黄痰、舌红、苔黄、脉滑数、脉弦数;核心治疗中药主要有水牛角、生地黄、赤芍、牡丹皮清热凉血,黄芩清热燥湿,金银花清热解毒,薏苡仁、茯苓利水消肿,甘草补气调和;核心处方为犀角地黄汤。核心症状与证候诊断标准进行比较,有新的临床常见症状出现,即疲乏、眠差、纳差、脱发、红色皮疹、关节肿痛、口舌生疮、咳嗽、咯黄痰、脉滑数。结论:本文运用复杂网络分析法对临床病历回顾性研究探讨SLE热毒炽盛证中医临床的症方药规律得出结论与临床基本一致,可为SLE热毒炽盛证中医临床辨证治疗作参考。

Objective: To explore the laws of core symptom, Chinese medicine and prescription of traditional Chinese medicine in treatment of the severe heat toxin syndrome of systemic lupus erythematosus(SLE) and provide objective basis for Chinese medicine treatment of SLE based on complex network. Methods: Complex network analysis method was used to retrospectively study 322 Chinese herbal prescriptions collected from January 2011 to May 2017 in The First Affiliated Hospital of Guangzhou University of Chinese Medicine, and 134 pieces of literature of Chinese medicine treatment of SLE were searched by computer retrieval. The topological property parameters of the complex network were calculated and used to analyze the structure of the core network and the compatibility rule of symptom and Chinese medicine. Then the core syndrome, herbs, compatibility rules and characteristics of commonly-used prescriptions for severe heat toxin syndrome of SLE were analyzed.Results: The results of analysis of complex network showed that the core TCM herbs for severe heat toxin syndrome of SLE mainly included Bubali Cornu, Rehmanniae Radix, Paeoniae Radix Rubra, Moutan Cortex, Scutellariae Radix, Lonicerae Japonicae Flos, Coicis Semen, Poria, Glycyrrhizae Radix et Rhizoma. The core prescription was Xijiao Dihuang Decoction. Core syndromes included fatigue, poor sleep, anorexia, high fever, dizziness, alopecia, red rash, limb erythema, red butterfly-shaped erythema on the face, joint pain, joint swelling and pain, oral ulcer, thirst, cough, yellow sputum, red tongue, yellow tongue fur, slippery and rapid pulse, wiry and rapid pulse. Compared with the diagnostic criteria of the syndrome, the core symptoms have new common clinical symptoms, including fatigue, poor sleep, anorexia, red butterfly-shaped erythema on the face, oral ulcer, cough, yellow sputum, slippery and rapid pulse. Conclusion: The results of clinical retrospective review and computer retrieval by complex network analysis method of this paper were basically consistent with the clinical application. It can be used as a reference for the clinical syndrome differentiation and treatment of severe heat toxin syndrome of SLE.