索拉非尼所致腹泻中医临床用药规律分析

Medication rule of traditional Chinese medicine on diarrhea caused by sorafenib

目的:基于数据挖掘探讨原发性肝癌患者使用索拉非尼所致腹泻的中医临床辩证及用药规律,进而探讨其用药特点,用于指导临床。方法:收集中国人民解放军第五医学中心(原解放军第302医院)住院原发性肝癌患者使用索拉非尼所致腹泻病例资料,建立临床用药的数据库,对数据进行频数分析、关联规则等分析。结果:对159例患者病例资料分析,其主证型从高到低依次为:湿热内蕴证、脾虚湿盛证、肝郁脾虚证、肝郁脾虚兼肝血瘀阻证、脾肾阳虚证,其中湿热内蕴证临床总有效率最高。药物使用频率居于前12位的药物分别为:半夏、黄芩、黄连、生地、香附、甘草、党参、薏苡仁、黄芪、干姜、川芎、吴茱萸,以“清热解毒、健脾利湿、温阳健脾”药物为主。结论:原发性肝癌患者使用索拉非尼所致腹泻,最常见的临床证型为湿热内蕴证,清热、利湿、健脾、理气、化瘀、温阳”为中医治疗索拉非尼所致腹泻的主要治则。

Objective:To explore the clinical dialectics and medication regularity of TCM in Diarrhea caused by sorafenib,which may guide the treatment.Methods:The clinical research part,collecting cases material from the fifth medical center of the Chinese people's liberation army(former PLA 302 hospital),established the clinical drugs database,used frequency analysis and association rules to research the medication characteristics.Results:Analyzing the case data of 159 patients in hospital,the TCM syndrome type proportional from high to low in turn is Damp-heat syndrome,damp-heat deficiency of spleen syndrome,liver-stagnation of spleen deficiency syndrome,liver-stagnation of spleen deficiency with liver-blood stasis syndrome,spleen-kidney Yang deficiency syndrome.The therapy effect of Damp-heat syndrome has been considered with the highest treatment efficacy.The first 12 agent medicines were pinellia ternata,scutellaria baicalensis,rhizoma coptidis,radix cyperi,liquorice,codonopsis pilosula,coix seed,astragalus membranaceus,dried ginger,ligusticum chuanxiong,evodia officinalis.Conclusion:The most common clinical syndrome type is Damp-heat syndrome."clearing heat,benefiting dampness,invigorating spleen,regulating qi,removing blood stasis and warming Yang"are the main principles of traditional Chinese medicine in treating Diarrhea caused by sorafenib.