中医治疗肾阳虚不孕症用药规律的现代文献挖掘

Modern Literature Mining of Medication Rules for Chinese Medicine Treatment of Kidney Yang Deficiency Type of Infertility

【目的】探讨现代文献中不孕症肾阳虚证的中药用药规律。【方法】检索中国知网(CNKI)、万方数据库(Wanfang Data)、维普中文科技期刊数据(VIP)3个数据库中近20年来中医治疗不孕症肾阳虚证的文献,建立不孕症方药数据库,采用中医传承计算平台(V3.0)进行相应的中药用药频次分析、性味归经分析、中药功效分析、核心药物分析、组方关联分析与聚类分析等。【结果】共纳入205首复方,涉及中药308味,总用药频次为2456次。单味中药用药频次最高的为当归,其次为菟丝子、香附、川芎、白芍、枸杞子、丹参等。治疗不孕症肾阳虚证多采用温性药及甘味药;药味主要归肝经,其次为肾经、脾经、心经、肺经等。中药功效频次统计分析显示共涉及16种功效,频次排前3位的为补虚类、活血化瘀类、理气类。共涉及核心药物9味,强关联药物组合16个,由此进一步推演出核心候选方共3首。【结论】临床治疗不孕症肾阳虚证应重视肝、肾、脾的调理;可大量选用补阴之药,以滋补阴血,再佐以补肾阳之药;可采用滋肾阴、补肾阳、养肝血、活血化瘀、疏肝理气等药物治疗。应善于"阴中求阳",选用滋肾阴、补肾阳、养肝血、活血化瘀、疏肝理气往往能取得较好的疗效。

Objective To investigate the medication rules for Chinese medicine treatment of kidney yang deficiency type of infertility.Methods The three databases of China Knowledge Network(CNKI),Wanfang,and VIP were retrieved to screen out the literature of Chinese medicine treatment of kidney yang deficiency type of infertility in recent 20 years.Database of prescriptions for infertility was established,and then the analysis of the herbal medication frequency,herbal properties and flavors and meridian tropism,herbal actions,core herbs and herbal association rules as well as the clustering analysis was carried out on Traditional Chinese Medicine Inheritance Support System(V3.0).Results A total of 205 compound prescriptions were included,involving 308 herbs,with a total frequency of 2456 times.Radix Angelicae Sinensis had the highest medication frequency,and then followed by Semen Cuscutae,Rhizoma Cyperi,Rhizoma Chuanxiong,Radix Paeoniae Alba,Fructus Lycii and Radix Salviae Miltiorrhizae.Warm and sweet herbs were mostly used for the treatment of kidney yang deficiency of infertility,and the herbs were mainly attributed to the liver meridian,followed by the kidney,spleen,heart and lung meridians.The frequency analysis of the herbal actions showed that the included herbs can be classified into16 categories,and the top 3 categories were herbs for replenishing deficiency,herbs for activating blood and resolving stasis,and herbs for regulating qi.A total of 9 core herbs were obtained,and 3 core candidate formulas were derived from 16 strongly-associated herbal combinations.Conclusion For the clinical treatment of infertility with kidney yang deficiency syndrome,more attention should paid on the regulation of the liver,kidney and spleen;a large number of yin tonics can be used to nourish yin and blood,and kidney-yang tonics can be used as the adjuvant herbs;the primary herbs for the treatment of infertility are herbs for nourishing kidney yin,replenishing kidney yang,nourishing liver blood,activating blood and resolving stasis,and soothing liver and regulating qi.Following the principle of replenishing yang from nourishing yin,the application of therapies for nourishing kidney yin,replenishing kidney yang,nourishing liver blood,invigorating blood and resolving stasis,and soothing liver and regulating qi can achieve satisfactory efficacy.