中药灌肠治疗肝衰竭的用药规律分析

Analyze the Regularity of Chinese Medicine Enema Treatment of Liver Failure

目的:探讨中药灌肠治疗肝衰竭的用药规律,为临床组方用药和医学科研提供参考依据。方法:检索1990至2020年知网、维普、万方、PubMed数据库中所有中药灌肠治疗肝衰竭的文献,对合格文献的复方进行药物性味归经及剂量统计,应用SPSS Modeler及SPSS Statistics软件对复方进行关联规则分析、系统聚类分析。结果:共纳入文献93篇,中药复方83首,共涉及86味中药,药物频次总达589次,其中大黄、厚朴、赤芍、枳实、蒲公英、乌梅、茵陈频次≥28次;高频药物剂量分析中水牛角、赤芍、茵陈、牡蛎、大黄用量较大,厚朴、栀子的用量偏小。药效分类以清热药、泻下药、利水渗湿药为主,四气以寒性药物最多,其次为温性,不包括热性药物,五味以苦、辛、甘味药为主;归经十二正经均包括,以肝、胃、脾、大肠、肺经为主。通过关联规则分析得到核心药对16个组合,药对以大黄为核心药物;通过系统聚类得到4个新处方。结论:中药灌肠治疗肝衰竭以攻下、清热、利湿退黄为主要治法,药物性味多清温并用,高频药物所提炼出的4个新处方对肝衰竭不同证型各有侧重,从中医理论及药理作用方面分析对肝衰竭有治疗意义,可为临床中不同的证型的肝衰竭选方提供一定的参考。

Objective:To explore the rules of administration of traditional Chinese medicine enema in the treatment of liver failure,and to provide reference for clinical prescriptions and medical research.Methods:Search all the literatures on the treatment of liver failure with traditional Chinese medicine in the databases of CNKI,Weipu,Wanfang and PubMed from 1990 to 2020,and carry out the meridian distribution and dose statistics of the compound prescriptions in the qualified literature,and use SPSS Modeler and SPSS Statistics software to analyze The compound formula conducts association rule analysis and systematic cluster analysis.Results:A total of 93 literatures were included,including 83 Chinese herbal compound prescriptions,involving 86 traditional Chinese medicines.The frequency of the drugs reached 589 times.Among them,the frequency of rhubarb,magnolia officinalis,red peony root,citrus aurantium,dandelion,ebony,and Yinchen ≥ 28 times;high In the frequent drug dosage analysis,the dosage of buffalo horn,red peony root,Yinchen,oyster,and rhubarb was larger,while the dosage of Magnolia officinalis and Gardenia was smaller.The classification of drug effects is mainly based on heat-clearing drugs,laxative drugs,and diuretic and dampening drugs.The four qi is mainly cold drugs,followed by warm drugs,excluding heat drugs,and the five flavors are mainly bitter,pungent and sweet drugs;Both main meridians include the liver,stomach,spleen,large intestine,and lung meridians.Through association rule analysis,16 core drug pairs were obtained,with rhubarb as the core drug;4 new prescriptions were obtained through systematic clustering.Conclusion:Traditional Chinese medicine enema treatment of liver failure is mainly based on attacking,clearing away heat,removing dampness and relieving jaundice.The drug is used in combination with more nature and flavor,and the four new prescriptions extracted from high-frequency drugs have their own focus on different syndromes of liver failure.Analyzing the theory and pharmacological effects of traditional Chinese medicine has therapeutic significance for liver failure,and it can provide a certain reference for the selection of different types of liver failure in the clinic.