中医药治疗发热用药规律

On Medication Rule of TCM in the Treatment of Fever

目的:分析中医药治疗发热的用药规律。方法:以"发热"为检索词、以"中医"或"中药"为主题词,检索中国知网、万方数据、维普网等数据库2005年1月至2020年2月中医药治疗发热的临床研究文献,筛选后建立数据库,运用频数统计、关联规则分析、聚类分析的方法,总结发热的症状特征、用药规律。结果:共纳入符合标准的文献142篇,包括症状118种,处方165首,中药186味。高频症状前5位分别为:发热、恶寒、头痛、咳嗽、口干;高频舌象前5位分别为:舌偏红、舌淡红、舌尖红、舌黯红、舌红绛;高频苔象前5位分别为:苔薄白、苔薄黄、苔黄腻、苔白、苔白腻;高频脉象前5位分别为:脉浮数、脉滑数、脉浮紧、脉细数、脉弦细;高频药物前5位分别为:甘草、柴胡、黄芩、连翘、杏仁;常用组合为金银花-连翘、麻黄-杏仁-甘草等;聚类分析将药物分为4类。结论:中医将发热分为外感发热和内伤发热,治疗外感发热以疏风解表药物为主,治疗内伤发热属虚者以益气、养血、滋阴、温阳为主,兼以清热;属实者以解郁、活血、除湿、清热为主。

Objective:To analyze the medication law of TCM in the treatment of fever.Methods:With"fever"as the key word and"TCM"or"Chinese medicinals"as the subject word,we searched CNKI,Wanfang Data,VIP.com and other databases for clinical research literature on TCM treatment of fever from January 2005 to February 2020.After screening,the database was established,and the symptom characteristics and medication rule of fever were summarized by frequency statistics,association rule analysis and cluster analysis.Results:A total of 142 articles were included,involving 118 kinds of symptoms,165 formulas and 186 Chinese medicinals.The top five high frequency symptoms were fever,aversion to cold,headache,cough and dry mouth.The first five high frequency tongue manifestation were:red tongue,light red tongue,red tongue tip,dark red tongue,crimson tongue.The first five high frequency coating manifestation were thin and white coating,thin and yellow coating,yellow and greasy coating,white and greasy coating.The first five high frequency pulse manifestation were as follows:floating and quick pulse,slippery and quick pulse,floating and tight pulse,thin and quick pulse,string and thin pulse.The top five high frequency Chinese medicinals were Gancao(Radix et Rhizoma Glycyrrhizae),Chaihu(Radix Bupleuri),Huangqin(Radix Scutellariae),Lianqiao(Fructus Forsythiae)and Xingren(Semen Armeniacae Amarum).The commonly-used combination included Jinyinhua(Flos Lonicerae Japonicae)-Lianqiao(Fructus Forsythiae),Mahuang(Herba Ephedrae)-Xingren(Semen Armeniacae Amarum)-Gancao(Radix et Rhizoma Glycyrrhizae),etc.The Chinese medicinals were divided into four kinds by cluster analysis.Conclusion:According to TCM,fever can be divided into external-contraction fever,and internal damage fever.For external-contraction fever,the treatment should focus on dispersing wind and relieving exterior.For internal damage fever with deficiency,the treatment should focus on tonifying qi,nourishing blood and yin,and warming yang,combined with clearing heat.For internal damage fever with excess,the treatment should focus on relieving depression,activating blood circulation,removing dampness and clearing away heat.