基于古今医案云平台的中医药治疗慢性心力衰竭用药规律研究

Study on the medication rule of traditional Chinese medicine in the treatment of chronic heart failure based on ancient and modern medical record cloud platform

目的 基于古今医案云平台研究现代中医药治疗慢性心力衰竭的用药规律,为临床治疗慢性心力衰竭提供用药参考。方法 通过检索CNKI、万方、维普等数据库收集慢性心力衰竭现代文献的有效验案,经过数据筛选、清洗、标准化处理,并建立标准化医案数据库,利用古今医案云平台进行频次统计、关联分析、聚类分析、复杂网络分析等数据分析方法,分析中医药治疗慢性心力衰竭的用药频次、四气、五味、归经、核心处方等用药规律,并进行可视化展示。结果 本研究共纳入处方243首,涉及药物219味,其中使用频次较高的药物为黄芪、茯苓、丹参、桂枝、葶苈子、白术等;药物四气多以温、平为主;五味以甘味为主,辛味、苦味次之;药物归经多入肺经、脾经、心经;使用频次较高的药物组合包括黄芪-丹参、黄芪-茯苓、黄芪-葶苈子、白术-茯苓、丹参-茯苓等。结论 中医药治疗慢性心力衰竭多用益气、利水、活血之药,虚实兼顾,标本同治。

Objective To study the medication rule of traditional Chinese medicine(TCM) in the treatment of chronic heart failure(CHF) based on ancient and modern medical record cloud platform, and provide medication reference for clinical treatment of CHF. Methods The effective cases of modern literature on CHF were collected by searching CNKI, Wanfang, VIP and other databases by computer. After data screening, cleaning and standardized processing, a standardized medical case database was established. Data analysis such as frequency statistics, correlation analysis, cluster analysis and complex network analysis were carried out based on the cloud platform of ancient and modern medical records. The medication frequency, four qi, five flavors, meridian tropism and core prescription of TCM for CHF were analyzed. Results A total of 243 prescriptions were included in this study, involving 219 flavors of drugs, of which the drugs used more frequently were Astragalus membranaceus,Poria cocos, Salvia miltiorrhiza, Ramulus cinnamomi, Semen lepidii, Atractylodes macrocephala, etc. The four Qi of drugs were mainly warm and flat. The five flavors of medicine were mainly sweet, followed by pungent and bitter. The meridian of drugs mostly entered the lung meridian, spleen meridian and heart meridian. The frequently used drug combinations included Astragalus-miltiorrhiza, Astragalus-Poria cocos, Astragalus-Semen lepidii,Atractylodes macrocephala-Poria cocos, Salvia miltiorrhiza-Poria cocos, etc. Conclusion TCM is often used to treat CHF, of which the medicines of benefiting Qi, clearing damp, promoting blood circulation are mostly used.Both deficiency and excess are taken into account, and both symptoms and root causes are treated together.