基于数据分析李宜瑞治疗儿童抽动障碍的用药规律研究

Study on the Medication Rule of Professor LI Yi-rui in the Treatment of Tic Disorder of Children Based on Data Analysis

目的:探析研究李宜瑞教授治疗儿童抽动障碍(TD)的用药经验规律。方法:采用回顾性病例系列研究和专家访谈结合设计,将临床收集的120例TD患儿的基本资料及临床用药信息,以Epidate软件进行数据录入整理后,采用统计描述和二分类Logistic回归分析确定证型和初步的主药及加减变化,然后进行专家访谈讨论形成最终的证型及用药。结果:最终确定了4个证型6味主药,证型包括风邪犯肺证、肝亢风动证、痰热动风证、脾虚肝亢证,6味主药包括钩藤、炒僵蚕、法半夏、天麻、甘草、龙骨,并确定了加减变化等用药信息。结论:本病的基本病机为“风动痰扰”,病位主要在肝,与肺、脾、心、肾相关,总的治疗原则为祛风化痰、平肝息风。

Objective:To analyze and summarize Professor LI Yi-rui’s clinical experience on Tic Disorder(TD)disease.Methods:The study group adopted the retrospective study for case series and expert interview,The basic data and clinical herbs information of 120 TD patients were recorded and classified by Epidate software.Statistical description and binary Logistic regression were used for the identification and modification of syndrome type and initial core herbs.After expert interviews were performed for the syndrome type and herbs,the final scheme were formed.Results:4 syndromes and 6 flavors of main drugs were determined finally.The syndromes included wind evil invading lung syndrome,hyperactivity of the liver causing liver-wind syndrome,phlegm-heat stirring wind syndrome,hyperactivity of liver with spleen deficiency syndrome,and 6 core herbs for TD treatment were Tianma(Gastrodia Elata Bl),Gouteng(Uncaria Rhynchophylla(Miq.)Miq.Ex Havil.),Fabanxia(Rhizoma Pinelliae),Chaojiangcan(Bombyx Batryticatus),Longgu(Os Draconis),Gancao(Glycyrrhizae Radix Et Rhizoma).The modification of herbs were also identified.Conclusion:The basic mechanism of TD was wind driven phlegm disturbance.The main location for TD was in liver and often related to lung,spleen,heart,and kindey in the process of disease.The general treatment principle is dispelling pathogenic wind and eliminating phlegm and relieving spasm by calming endogenous wind.