基于文献分析探讨中医药治疗乙型肝炎肝硬化腹水的用药特点

Research on TCM medication characteristics for treatment of HBV-related cirrhosis ascites based on literature analysis

目的:基于文献分析探讨中医药治疗乙型肝炎肝硬化腹水的用药特点。方法:检索1963年1月1日至2021年1月1日中国学术期刊全文数据库、万方数据知识服务平台、维普网数据库及PubMed、EMBASE、Cochrane Library数据库治疗肝硬化腹水的中医文献报道,提取文献中的药物组成,根据不同病因进行分组比较,并进行统计和评价。结果:纳入文献119篇,中药复方126个;其中治疗乙型肝炎肝硬化腹水的复方占比34.12%。上述复方所含药物按功效可分为17类,频率前5位分别为补虚药、利水渗湿药、活血化瘀药、清热药、理气药,累计占比72.82%。清热药及具有清热解毒功效的药物在治疗乙型肝炎肝硬化腹水中的应用频率更高,其占比高于未明确提及病因的肝硬化腹水。结论:乙型肝炎肝硬化腹水以湿热之邪稽留人体为因,以气虚为主,以水停为著,治法上以益气健脾、利水渗湿为基础,针对病因治疗以清热解毒,辨病机对应施治。

Objective:To explore the medication characteristics of TCM in the treatment of HBV-related cirrhosis ascites based on literature analysis.Methods:Search the Chinese academic journals fulL-text database,Wanfang data knowledge service platform,VIP,PubMed,EMBASE and Cochrane Library database for the treatment of cirrhosis ascites from Jan 1963 to Jan 2021.The medicine composition in the literature was extracted,grouped and compared according to different etiologies,and analyzed.Results:A total of 119 articles and 126 Chinese herbal compound prescriptions were included in this study.Among them,it was clear that HBV infection was the underlying cause,accounting for 34.12%.The drugs included in the compound prescriptions can be divided into 17 categories according to their efficacy,and the top 5 in frequency are Tonics,Damp-draining Diuretic,Blood-activating and Stasis-resolving herb,Heat-clearing herb and Qi-regulating herb with a total frequency of 72.82%.The proportion of Heat-clearing herb and drugs with heat-clearing and Toxicity-removing are higher than the proportion of cirrhosis ascites without a clear cause.Conclusion:HBV-related cirrhosis ascites is caused by the evil of Dampness and Heat staying in the human body,mainly due to Qi deficiency and Water stopping.The treatment method is based on replenishing Qi and strengthening the spleen,damp draining and water,and clearing heat and detoxification to treat the cause of the disease.Differentiating the mechanism of the disease and responding to treatment.