便秘型肠易激综合征证型及用药规律分析

Analysis of Syndrome Type and Medication Regularity of Irritable Bowel Syndrome with Constipation Type

目的:探讨便秘型肠易激综合征(IBS-C)常见证型及处方用药规律,为临床研究及治疗提供参考。方法:以中国知网(CNKI)、维普期刊资源整合服务平台(VIP)、万方数据知识服务平台(WF)为检索源,检索中医药治疗IBS-C的临床研究类文献,检索日期为建库至2020年11月1日,运用古今医案云平台软件对IBS-C证型、用药等信息进行频次及复杂网络分析。结果:纳入文献135篇,证型21种,病例数5845例,方剂135首,中药139味。处方中药多性味温、平、寒、苦、甘,归脾、肺、胃、肝经;高频中药为白术、白芍、枳实、柴胡、甘草等;IBS-C原文献各证型按《中医内科学》便秘辨治可分为热秘、气秘、气虚秘、阴虚秘、阳虚秘,其中,热秘中胃肠积热证、肠道湿热证多见,气秘中肝郁脾虚证、肝郁气滞证多见,气虚秘中脾胃虚弱证、脾肺气虚证多见,阴虚秘中阴虚肠燥证最多,阳虚秘以脾肾阳虚证为主。常用治法有泻热通便、疏肝健脾、塞因塞用、增水行舟及温阳通便等。结论:IBS-C常见证型有5个,主要治疗方法有疏肝健脾、清热益阴等。

Objective:To explore the common syndrome type and the medication regularity of irritable bowel syndrome with constipation type(IBS-C),in order to provide reference for clinical research and treatment.Methods:China National Knowledge Infrastructure(CNKI),Weipu Journal Resource Integration Service Platform(VIP)and Wanfang Database Knowledge Service Platform(WF)were used as the search sources.The clinical research papers on the treatment of IBS-C with traditional Chinese medicine were retrieved,and the retrieval date was from the establishment of the database to November 1st,2020,and the frequency and complex network analysis of IBS-C syndrome type,medication and other information were analyzed using the Ancient and Modern Medical Record Cloud Platform Software.Results:Total 135 papers were included,with 21 syndrome types,5845 cases,135 formulas,and 139 Chinese medicinals.Chinese medicinals in formulas were warm,neutral,cold,bitter,sweet,and enters the spleen,lung,stomach,and liver meridians.The high-frequency Chinese medicinals included Baizhu(Atractylodes),Baishao(Paeoniae Radix Alba),Zhishi(Aurantii Fructus Immaturus),Chaihu(Bupleuri Radix)and Gancao(Glycyrrhizae Radix et Rhizhoma),etc..According to the Internal Medicine of Traditional Chinese Medicine,each syndrome type of IBS-C in papers may be divided into heat constipation,qi constipation,qi deficiency constipation,yin deficiency constipation and yang deficiency constipation.Syndrome of accumulated heat in stomach and intestine and syndrome of dampness-heat in intestine commonly appear in heat constipation.Syndrome of liver depression and spleen deficiency and syndrome of liver depression and qi stagnation commonly appear in qi constipation.Spleen and stomach deficiency syndrome and qi deficiency syndrome of spleen and lung commonly appear in qi deficiency constipation.Syndrome of yin deficiency and intestinal dryness mainly appears in yin deficiency constipation and yang deficiency syndrome of spleen and kidney mainly appears in yang deficiency constipation.The commonly used treatment methods included purging heat and relaxing bowels,soothing liver and invigorating spleen,treating obstructive syndrome with tonics,moistening intestines to relieve constipation and warming yang to relieve constipation,etc..Conclusion:Using complex networks and other analysis methods,we obtained five common syndrome types of IBS-C and therapeutic methods of soothing liver and invigorating spleen,clearing heat and replenishing yin,etc..