中药治疗多囊卵巢综合征辨证与组方规律分析

Analysis on Regularities of Syndrome Differentiation and Prescription in Treatment of Polycystic Ovary Syndrome with Chinese Medicinals

目的:运用集合可视化分析系统探析中药治疗多囊卵巢综合征辨证与组方规律。方法:检索2018年1月至2020年1月中国知网数据库、万方数据知识服务平台和维普医药信息资源系统收录的中药治疗多囊卵巢综合征临床研究文献,根据纳入与排除标准对文献进行筛选,提取纳入文献中的辨证与组方信息。运用集合可视化分析系统3.0与Apriori算法分析中药治疗多囊卵巢综合征的辨证规律和不同证型的组方规律。设定Apriori算法的支持度为0.15、置信度为0.15,每个规则至少由2个元素构成。结果:共纳入950篇文献,包含155个复合证型和934首中药方剂,通过对复合证型进行归纳,最终得到10个基础证型,对应2296首基础方剂。肝肾阴虚证、血瘀证、肾阳虚证和痰湿证是多囊卵巢综合征最为常见且联系最为紧密的证型,当归、菟丝子、熟地黄、茯苓、香附、丹参等补益肝肾、健脾化痰、活血化瘀之品是临床治疗多囊卵巢综合征最常用的药物。血瘀证、肝肾阴虚证、肾阳虚证、痰湿证四个证型组方规律具有一定的相似性,均用到熟地黄、当归、菟丝子、茯苓、香附、淫羊藿、丹参等药物。结论:本虚标实是多囊卵巢综合征的主要病机特点,本虚为肝脾肾虚,标实可由血瘀、痰湿、湿热、气滞、肝火、阴虚火旺导致,中药治疗多囊卵巢综合征的组方体现出虚实同治、扶正与祛邪相结合的特点。

Objective:To explore the regularities of syndrome differentiation and prescription in treatment of polycystic ovary syndrome with Chinese medicinals by using the set visualization analysis system.Methods:The clinical study articles relevant with polycystic ovary syndrome treated with Chinese medicinals published from January 2018 to January 2020 were searched from CNKI,WanFang and VIP databases.The search results were filtered according to the inclusive and exclusive criteria.The information of syndrome differentiation and prescription in the included articles were extracted.The Set Visualization Analysis System 3.0 and Apriori algorithm were used to analyze the syndrome differentiation regularities in treatment of polycystic ovary syndrome and the prescription regularities of different syndrome types.The Apriori algorithm had a support of 0.15 and a confidence of 0.15,and each rule was composed of at least two elements.Results:A total of 950 articles were included,containing 155 compound syndrome types and 934 Chinese medicinal prescriptions.By summarizing the compound syndrome types,10 basic syndrome types were finally obtained,corresponding to 2296 basic prescriptions.Yin deficiency of liver and kidney,blood stasis,deficiency of kidney yang and phlegm dampness were the most common and closely related syndromes in polycystic ovary syndrome.Danggui(Angelica Sinensis),Tusizi(Cuscuta Chinensis),Shudihuang(Rehmannia Glutinosa),Fuling(Poria Cocos),Xiangfu(Cyperus Rotundus L),Danshen(Salvia Miltiorrhiza),etc.were the most frequently used herbs in clinical treatment of polycystic ovary syndrome which have the functions of benefiting liver and kidney,tonifying spleen and resolving phlegm,promoting blood circulation and removing blood stasis.The prescription regularities of different syndrome types such as blood stasis,yin deficiency of liver and kidney,deficiency of kidney yang and phlegm dampness share certain similarities,and they all use Shudihuang(Rehmannia Glutinosa),Danggui(Angelica Sinensis),Tusizi(Cuscuta Chinensis),Fuling(Poria Cocos),Xiangfu(Cyperus Rotundus L),Yinyanghuo(Epimedium Brevicornu Maxim),Danshen(Salvia miltiorrhiza)and other medicinals.Conclusions:Deficiency in origin and excess in superficiality is the main characteristics of the pathogenesis of polycystic ovary syndrome,with deficiency of liver,spleen and kidney as the root and blood stasis,phlegm dampness,dampness heat,qi stagnation,liver fire and yin deficiency with effulgent fire as the branch.Therefore,treatments of polycystic ovary syndrome with Chinese medicinals embodies the features of treating deficiency and excess together,and strengthening the body resistance to suppress pathogenic factors.