中医药治疗大肠癌术后胃肠道不良反应用药规律研究

Study on medication rule of TCM medicine in treating gastrointestinal adverse reactions after colorectal cancer operation

目的:分析中医药治疗大肠癌术后胃肠道不良反应的用药规律。方法:检索并筛选中国知识资源总库(CNKI)中医药治疗大肠癌术后胃肠道不良反应的相关文献,提取文献中作者、疾病、证型和中药组成信息,进行频次统计、聚类分析、关联分析和网络图分析。结果:共纳入文献50篇,筛选方剂63首,涉及药物150味,共813条数据。证型频次统计中居前三位的为脾虚湿盛证、脾肾两虚证和湿热蕴结证;中药频次统计中用药频次≥15次的中药共13味,用药频次≥10的中药共23味;聚类分析中聚为5类效果最好;在二项中药关联分析中得到14条规则,三项中药关联分析中得到19条规则,分证型二项中药关联分析中脾虚湿盛证、脾肾两虚证、湿热蕴结证分别得到了10条、7条、13条规则。结论:中医药治疗大肠癌术后胃肠道不良反应以健脾祛湿为主,兼顾清热解毒和温补脾肾,根据证型不同可选用不同的药物组合治疗。

Objective:To analyze the medication rule of TCM medicine in the treatment of gastrointestinal adverse reactions after colorectal cancer operation.Methods:Literature related to adverse reactions of gastrointestinal tract after colorectal cancer treatment with TCM medicine in CNKI was retrieved and screened.Information of authors,diseases,syndrome types and composition of TCM medicine was extracted from the literature.Frequency statistics,cluster analysis,association analysis and network graph analysis were performed.Results:A total of 50 studies were included,63 prescriptions were screened,involving 150 flavors of drugs,and 813 items were included.In the frequency statistics of syndrome types,the top three were spleen deficiency and dampness-heat accumulation syndrome,spleen-kidney deficiency syndrome and dampness-heat accumulation syndrome.In the statistics of frequency of TCM,there were 13 TCM medicinals with not less than 15 times of medication,and 23 TCM medicinals with not less than 10 times of medication.Clustering analysis showed that the results were best in 5 categories.Fourteen rules were obtained from the two-item association analysis of TCM medicine,and 19 rules were obtained from the three-item association analysis of TCM medicine.In the twoitem association analysis of TCM medicine,10,7 and 13 rules were obtained from the two-item association analysis of TCM medicine,respectively,for spleen deficiency and dampness-accumulation syndrome,spleen-kidney deficiency syndrome and dampness-heat accumulation syndrome.Conclusion:In the treatment of postoperative gastrointestinal adverse reactions of colorectal cancer with TCM medicine,it is mainly to strengthen spleen for clearing damp,give consideration to clearing heat and detoxifying,and warming spleen and kidney.Different drug combinations can be used according to different syndromes.