石淋复方治法和用药规律分析

Therapeutic Principles and Medication Regularity of Chinese Medicine for Treatment of Urolithiasis

目的:运用数据挖掘和文献研究的方法研究中医治疗石淋复方的治法及用药规律。方法:检索中国期刊全文数据库(CNKI),自有记录以来至2020年11月10日期间收录的中医复方治疗石淋的临床研究,提取纳入文献中的治法、处方,统计治法频数,以及复方使用药物的频数、功效分布,并运用关联规则和聚类分析探究高频药的用药规律。结果:共纳入文献247篇,处方247首。(1)247首处方共使用209味中药。使用频数较高的中药有金钱草、鸡内金、海金沙、牛膝、石苇、车前子、滑石等。使用频数较高的中药功效类别主要以利水渗湿、活血化瘀为主,其次为补虚、理气、攻下。鸡内金、威灵仙、琥珀可作为对证专药。(2)关联规则分析药物配伍,以金钱草、鸡内金、海金沙三药间的两两组合或三者共用最为普遍,其次为金钱草分别与牛膝、石苇、车前子的配伍。(3)高频药聚类分析可将药物聚为4类。(4)247首处方共使用31类治法,使用频数较高的治法为清热利湿、化瘀利水、补益肾气。结论:(1)利水渗湿是石淋的核心治法;(2)活血化瘀是石淋的重要治法;(3)补益是石淋的潜在治法;(4)石淋用药具有专科特点。

Objective: To explore the therapeutic principles and medication regularity of Chinese medicine for the treatment of urolithiasis based on data mining and literature research. Method: Chinese National Knowledge Infrastructure(CNKI)was searched for the clinical research papers on Chinese medicinal compounds for the treatment of urolithiasis published from database inception to November 10,2020.Therapeutic methods and Chinese medicinal compounds were extracted from the included papers,and the frequencies of therapeutic methods and the drugs in the Chinese medicinal compounds,as well as the efficacies were analyzed. The medication regularity of high-frequency drugs was explored by association rule analysis and cluster analysis. Result: A total of 247 papers and 247 Chinese medicinal compounds were included,and 209 drugs were involved. Those with high frequencies included Lysimachiae Herba,Galli Gigerii Endothelium Corneum,Lygodii Spora,Achyranthis Bidentatae Radix,Pyrrosiae Folium,Plantaginis Semen,and Talcum. The drugs with the highest frequency were effective in promoting urination,draining dampness,and activating blood to resolve stasis,followed by those in tonifying deficiency,regulating Qi,and purgation. Galli Gigerii Endothelium Corneum,Clematidis Radix et Rhizoma,and Succinum were used as specialized drugs targeting the syndrome. Association rule analysis showed that Lysimachiae Herba,Galli Gigerii Endothelium Corneum,and Lygodii Spora were commonly used in pairwise or ternary combination,followed by the pairwise combinations of Lysimachiae Herba with Achyranthis Bidentatae Radix,Pyrrosiae Folium,and Plantaginis Semen. Highfrequency drugs were clustered into four categories by clustering analysis. Thirty-one therapeutic principles were employed in the 247 Chinese medicinal compounds. The ones with the highest frequency were clearing heat and eliminating dampness,resolving stasis and promoting urination,and tonifying kidney and replenishing qi.Conclusion: For the treatment of urolithiasis,promoting urination and draining dampness is the core therapeutic principle,and activating blood to resolve stasis is the important therapeutic principle,while tonifying is the potential therapeutic principle. The medication for urolithiasis is featured by specialized drugs targeting the syndrome.