基于中医临床文献分析糖尿病周围神经病变的用药规律

Analysis on Medication Rules of Traditional Chinese Medicine for Treatment of Diabetic Peripheral Neuropathy Based on Clinical Literature

目的:研究中医治疗糖尿病周围神经病变(DPN)的临床用药规律。方法:收集2008-2019年中国知网(CNKI),万方数据库,中国生物医学文献服务系统(SinoMed)和维普数据库中发表的主题为"糖尿病周围神经病变"与"中医"的文献以及PubMeb数据库中检索词为(diabetic peripheral neuropathy)AND TCM的文献,筛选后建立数据库,采用频次统计、关联规则和构建复杂网络的数据统计方法,分析中医临床用药的功效、频次、性味归经、常用药对及核心处方等规律。结果:纳入治疗DPN的文献461篇,涉及中药275种,总使用频次6361次。频数统计结果显示出现频次最高的中药为黄芪;各类药物功效中以活血祛瘀药使用最多,其次为补气药;药物性味以甘味、温性为主;药物归经以入肝经药物居多。关联规则分析得到支持度最高的药对为当归-黄芪,复杂网络分析得到的核心中药为黄芪、当归、川芎、鸡血藤、桂枝、红花、地龙、赤芍、丹参、桃仁。结论:该研究较为全面地分析了中医临床治疗DPN的用药规律,发现补气血兼活血祛瘀、通络止痛是该病的主要治疗手段,这一发现可为DPN的中医临床用药和中药新药开发提供参考。

Objective:To investigate the medication rules of traditional Chinese medicine(TCM)for the treatment of diabetic peripheral neuropathy(DPN). Method: The literature published in China Knowledge Resource Integrated Database(CNKI), Wanfang Database, China Biomedical Literature Service System(SinoMed),VIP Database and PubMeb from 2008 to 2019 were retrieved by setting the topics of diabetic peripheral neuropathy and TCM. After screening,a database was established to analyze the medication rules(efficacy,frequency,flavor and meridian tropism,common couplet medicinals and core medicines)of TCM by frequency statistics,association rules and data statistical methods of constructing complex networks. Result:A total of 461 papers for treatment of DPN were included in this study,including 275 kinds of TCM and a total frequency of 6 361 times. Astragali Radix had the highest frequency. Among all kinds of medicinal materials,activating blood circulation and removing stasis was the most commonly used medicine,followed by Qiinvigorating medicine. Flavor of medicines was mainly sugariness and warm,and most of their meridian tropism was liver meridian. After the analysis by association rules,the couplet medicinals with the highest support was Astragali Radix-Angelicae Sinensis Radix. The core medicines obtained by complex network analysis were Astragali Radix,Angelicae Sinensis Radix,Chuanxiong Rhizoma,Spatholobi Caulis,Cinnamomi Ramulus,Carthami Flos,Pheretima,Paeoniae Radix Rubra,Salviae Miltiorrhizae Radix et Rhizoma and Persicae Semen.Conclusion:This study comprehensively analyzes the medication rules of TCM clinical treatment of DPN. The main treatment methods of TCM for DPN are invigorating Qi and blood,activating blood circulation and removing stasis,activating meridians to stop pain,which can provide guidance for the TCM clinical use and new Chinese medicines research and development of DPN.