基于中医传承辅助平台分析彭江云辨治痛风的用药规律

Analysis on Drug Use Rules of PENG Jiangyun in Syndrome Differentiation and Treatment of Gout Based on Traditional Chinese Medicine Inheritance Assistance Platform

目的通过收集、整理彭江云教授门诊的痛风患者病案,基于中医传承辅助平台V2.5,系统分析、总结彭江云教授辨治痛风的思路及遣方用药经验。方法纳入对象为2017年1月—2018年12月于云南省中医医院彭江云教授门诊就诊的痛风患者,以拍照、抄写等形式记录符合纳入标准的病案信息,基于中医传承辅助平台对其辨治痛风进行相关数据分析和统计。结果对符合纳入标准的273条数据进行分析,得出常见病机为:湿热蕴结、寒湿阻痹、脾虚湿盛、肝肾亏虚;常见病理因素有:湿、热、痰、瘀,病性本虚标实,虚实夹杂;常用药物为:独活、海桐皮、海风藤、生薏苡仁等。结论彭江云教授将痛风常分为5种证候,分别是湿热蕴结证、寒湿阻痹证、脾虚湿盛证、痰瘀痹阻证(未纳入数据源)和肝肾亏虚证。证不同则治则相异,治疗分别有以清热利湿、祛风通络、益气养阴;温经散寒、通络止痛;健脾化痰、渗湿通络;补益肝肾、通络止痛;基于复杂聚熵类分析,得出9个新处方,新方通过系统计算得出,仍需实践于临床以检验其有效性和安全性。

Objective By collecting and sorting out the medical records of gout patients in professor PENG Jiangyun’s outpatient department,this study systematically analyzed and summarized professor PENG Jiangyun’s ideas of syndrome differentiation and treatment of gout and his experience on prescription medication based on the traditional Chinese medicine inheritance assistance platform V2.5.Methods The included subjects were gout patients who went to the clinic of professor PENG Jiangyun of Yunnan Hospital of Traditional Chinese Medicine from January 2017 to December 2018.The medical records that met the inclusion criteria were recorded by taking photos and copying,and relevant data analysis and statistics were carried out on syndrome differentiation and treatment based on the traditional Chinese medicine inheritance assistance platform.Results According to the analysis of 273 pieces of data that met the inclusion criteria,the common pathogenesis was dampness and heat accumulation,cold and dampness obstruction,spleen deficiency and dampness excess,liver and kidney deficiency.The common pathological factors were dampness,heat,phlegm,blood stasis,pathogenic deficiency and excess,deficiency and excess.The commonly-used drugs were Duhuo( Angelicae Pubescentis Radix),Haitongpi( Aralia Chinensis Cortex),Haifengteng( Piperis Kadsurae Caulis),Yiyiren( Coicis Semen) and so on.Conclusion According to professor PENG Jiangyun,gout is usually divided into five syndromes,which are dampness and heat accumulation syndrome,cold and dampness obstruction syndrome,spleen deficiency and dampness excess syndrome,phlegm and blood stasis obstruction syndrome( not included in the data source) and liver and kidney deficiency syndrome.Different syndromes should use different treatments,which respectively were clearing heat and eliminating dampness,dispelling wind and dredging collaterals,nourishing Qi and Yin;warming meridians and dispelling cold,dredging collaterals and relieving pain;strengthening the spleen and resolving phlegm,drying dampness and dredging collaterals;tonifying liver and kidney,dredging collaterals and relieving pain.Based on the complex cluster entropy analysis,9 new prescriptions were obtained,and the new prescriptions were obtained through systematic calculation,which still needed to be put into clinical practice to test their effectiveness and safety.