中医治疗寻常型银屑病的证候分布及用药规律的文献分析

Modern Literature Study on Syndrome Distribution and Chinese Medicine Medication Regularity in Treatment of Psoriasis Vulgaris

检索中国知网(CNKI)、万方数据、维普等数据库中有关中药治疗寻常型银屑病的临床文献,采用频数分析及Ward’s层次聚类分析方法探讨中药治疗寻常型银屑病的证候分布和用药规律。结果显示,共检索得到文献256篇,涉及证型52个,证素24个,方剂214首,中药223味。寻常型银屑病的常见证型为血热瘀滞证、血热毒盛证和阴虚血燥证;对用药频次≥30的中药采用R型系统聚类生成2首聚类方,聚类方1以凉血解毒、活血化瘀为主要功效,由生地黄、牡丹皮、赤芍和土茯苓等组成;聚类方2以清热解毒、凉血滋阴为主要功效,由金银花、板蓝根、玄参和黄芩等组成。分析提示寻常型银屑病最常见的证型是血热瘀滞证和血热毒盛证,治疗以凉血解毒、活血化瘀为主,用药以生地黄、牡丹皮、赤芍、土茯苓、金银花、板蓝根、玄参和黄芩等为主,临床需随证加减,灵活应用。

The clinical reports of Chinese medicine treatment for psoriasis vulgaris issued in the databases of CNKI,Wanfang Data,and VIP were retrieved. Frequency analysis and Ward’s hierarchical clustering analysis were adopted to explore the distribution of syndromes and the rule of Chinese medicine medication in the treatment of psoriasis vulgaris. The results showed that 256 reports were obtained,and the reports involved 52 syndrome types, 24 syndrome elements, 214 recipes and 223 herbs. The commonly-seen syndrome types in psoriasis vulgaris were stagnation of blood heat and blood stasis syndrome,blood heat with excessive toxin syndrome,yin deficiency and blood dryness syndrome. The herbs with the medication frequency being or over 30 can be classified into 2 clustered recipes by R-cluster analysis. Clustered recipe 1 mainly has the actions of cooling blood for detoxification, and activating blood to remove stasis, and is mainly composed of Radix Rehmanniae, Cortex Moutan, Radix Paeoniae Rubra, and Rhizoma Smilacis Glabrae. Clustered recipe 2 mainly has the actions of clearing heat for detoxification,and cooling blood and nourishing yin,and is mainly composed of Flos Lonicerae,Radix Isatidis, Radix Scrophulariae, and Radix Scutellariae. The analysis results indicated that stagnation of blood heat and blood stasis syndrome and blood heat with excessive toxin syndrome are the mostly common syndrome types in psoriasis vulgaris,the primary therapies for psoriasis vulgaris are the methods of cooling blood for detoxification,and activating blood to remove stasis,and the commonly-used herbs are Radix Rehmanniae,Cortex Moutan, Radix Paeoniae Rubra, Rhizoma Smilacis Glabrae, Flos Lonicerae, Radix Isatidis, Radix Scrophulariae, and Radix Scutellariae. Flexible medication in the clinic should be based on the syndrome differentiation.