基于肝脾相关理论的乙型肝炎肝硬化辨证用药规律数据挖掘

Data mining for the medication rule of Traditional Chinese Medicine in chronic hepatitis B patients with cirrhosis based on the relevant theory of liver and spleen

目的:探讨从肝脾论治乙型肝炎肝硬化的中药复方用药规律。方法:对中国知网、万方医学网、维普中文期刊数据库等中文数据库2008至2019年关于从肝脾论治乙型肝炎肝硬化的文献进行检索,建立数据库,应用数据挖掘方法对其中药用药规律进行分析。结果:共纳入合格文献82篇,涉及处方82首,共164味中药。从肝脾论治乙型肝炎肝硬化常用的单味药包括柴胡、白术、丹参、鳖甲、黄芪、当归、茯苓。药物类别以益气健脾药、活血化瘀药和理气药为主。聚类分析发现3种配伍规律:益气健脾药常配伍活血化瘀药,佐以疏肝理气药;软坚散结药常配伍活血化瘀药;疏肝理气药常配伍活血柔肝药,佐以益气健脾药。常用药对及药组为丹参、白术和黄芪。结论:从肝脾论治乙型肝炎肝硬化常选用疏理肝气药、益气健脾药和活血化瘀药,但对于肝硬化的不同阶段,治疗用药的侧重点有所不同。

Objective:To explore the rule of traditional Chinese medicine(TCM)compound for treating chronic hepatitis B with cirrhosis based on relevant theory of liver and spleen.Methods:Chinese literatures such as China Knowledge Network,Wanfang Medical Network,and Weipu Chinese Journal Database were searched from 2008 to 2019 on the literature on the TCM treatment for chronic hepatitis B(CHB)related cirrhosis based on related theory of liver and spleen.The database was established and the data mining method was applied to analyze the medication rule.Results:A total of 82 qualified documents were included,involving 82 prescriptions and a total of 164 Chinese herbal medicines.The single-flavored drugs commonly used in the treatment of CHB-cirrhosis include:Bupleurum,Atractylodes,Salvia,Armor,Astragalus,Angelica and Poria.The drug category is mainly based on qi-tonifying medicinal,blood-activating and stasis-resolving medicinal and qi-regulating medicinal.Cluster analysis found that 3 kinds of compatibility rules:①qi-tonifying medicinal is often associated with bloodactivating and stasis-resolving medicinal,and a little qi-regulating medicinal;②soft stagnation medicine is often associated with blood-activating and stasis-resolving medicinal;③qi-regulating medicinal often compatible blood-activating and stasis-resolving medicinal,and a little qitonifying medicinal.The commonly used drug pairs and drug groups are Salvia miltiorrhiza,Atractylodes Rhizome and Astragalus.Conclusion:The treatment of CHB-cirrhosis based on the related theory of liver and spleen often uses qi-regulating medicinal,qi-tonifying medicinal and blood-activating and stasis-resolving medicinal,but for different stages of cirrhosis,the focus of treatment is different.