基于名医验案探讨卵巢早衰用药规律

Exploration the medication rules of premature ovarian failure based on the proven records of famous doctors

目的通过收集名中医治疗卵巢功能早衰(POF)病例,分析其组方规律,为临床治疗提供选方用药和思路借鉴。方法计算机检索中国知网(CNKI)数据库中POF的名医验案,以主题词为“卵巢早衰”检索CNKI数据库自建库至2020年2月所收录文献,以药物使用频次、性味归经、及Apriori关联规则结果为观察指标进行统计分析。结果共纳入文献103篇,筛选出112个中药复方,涉及165味中药。词频最高的药物是熟地、菟丝子、当归、淫羊藿、枸杞等。使用药物在四气中所占比重由大到小依次为温、平、寒、凉、热。使用药物在五味中所占比重由大到小依次为甘、苦、辛、酸、涩、咸、淡。药物使用归经频次由多到少依次为:肝、肾、脾、肺、心。Apriori关联规则计算结果显示规则支持最高为:熟地、当归配伍以及熟地、当归、菟丝子配伍。结论本病病因多为肾虚为主,兼夹肝郁、瘀血阻滞,病属虚实夹杂,以虚为主。治法当以补肾填精为基本治则,以调补气血、养血疏肝为重要治法。

Objective To collect cases of premature ovarian failure(POF)treated by famous traditional Chinese medicine doctors,and to analyze the rules of formulating prescriptions,to provide reference for the selection of prescriptions and ideas for clinical treatment.Methods A computer search of proven records of famous doctors in treating POF included in the China National Knowledge Infrastructure(CNKI)database,with the subject term“premature ovarian failure”searched for documents collected from the establishment of the database until February 2020.Statistical analysis based on the frequency of drug use,nature and flavour,channel tropism of the drugs and the results of Apriori association rules as observation indicators.Results A total of 103 papers and 112 prescriptions were included,and 165 herbs were involved.The herbs listed in usage frequency from high to low were Radix Rehmanniae Preparata,Semen Cuscutae,Radix Angelicae Sinensis,Herba Epimendii,Fructus Lycii.Four nature of drugs listed from high to low were warm,clam,cold,cool,hot.The proportion of five flavors from high to low were sweet,bitter,pungent,sour,astringent,salty,tasteless.The frequency of drug used in descending order were liver,kidney,spleen,lung,heart.Apriori association rules showed that the highest rule support were Radix Rehmanniae Preparata combined with Radix Angelicae Sinensis,Radix Rehmanniae Preparata combined with Radix Angelicae Sinensis and Semen Cuscutae.Conclusion The mainly etiology of POF are deficiency of kidney and sometimes with stagnation of liver and blood stasis.The disease is intermingled deficiency and excess,mainly deficiency.The treatment principles are strengthening and nourishing marrow and essence,and combined with benefiting qi and nourishing blood,and dispersing stagnated liver qi.