1004张中药饮片处方中细辛的使用情况及其治疗皮肤疾病的临床应用分析

Application of Asarum in 1004 Traditional Chinese Medicine Decoction Pieces and Its Clinical Application in the Treatment of Skin Diseases

目的:了解武汉市中西医结合医院(以下简称“该院”)中药饮片处方中细辛的用药规律,为中药饮片细辛在治疗皮肤疾病中的合理应用提供参考。方法:抽取2021年该院诊断为皮肤疾病、含有细辛的门诊中药饮片处方,采集处方中的信息,对用药情况进行频数分析和关联规则分析。结果:共纳入1004张中药饮片处方,主要来源于皮肤科、中医科。细辛以入汤剂煎服为主,使用剂量为2~15 g,超剂量使用的处方有580张(占57.77%)。频数分析结果显示,细辛超剂量使用程度为2~5倍,未发现不良反应;使用细辛频数较多的证型诊断为寒湿证、湿热浸淫证以及脾虚湿盛证。关联规则分析结果显示,与细辛由强到弱关联的药物依次有细辛、桂枝与当归,细辛、桂枝与附片,核心药对主要包括细辛与桂枝、当归、茯苓、甘草。结论:基于处方用药分析,中药细辛在治疗皮肤疾病的临床应用中,常与桂枝、当归、茯苓、甘草等配伍应用,起到增效减毒的作用,同时存在一定的超剂量使用情况。治疗皮肤疾病的临床应用研究为中药细辛的合理配伍及安全剂量范围提供了数据支持,有利于促进临床安全用药。

OBJECTIVE:To investigate the rules of asarum in the prescription of traditional Chinese medicine decoction pieces in Wuhan Hospital of Integrated Traditional Chinese and Western Medicine(hereinafter referred to as“the hospital”),so as to provide reference for the rational application of asarum in the treatment of skin diseases.METHODS:Outpatient traditional Chinese medicine decoction pieces prescriptions containing asarum diagnosed with skin diseases in the hospital in 2021 were extracted,and the prescription information was collected.Frequency analysis and association rule analysis were carried out for the application of asarum.RESULTS:A total of 1004 traditional Chinese medicine decoction pieces prescriptions were included,mainly from the department of dermatology and traditional Chinese medicine.Asarum was mainly used in traditional Chinese medicine decoction,with the dosage from 2 to 15 g.There were 580 prescriptions(57.77%)with off-label use of traditional Chinese medicine.Frequency analysis results showed that the degree of off-label use in Asarum were 2 to 5 times,and no adverse drug reactions were found.The syndrome types with high frequency of asarum were diagnosed as cold-dampness syndrome,dampness-heat syndrome,and spleen deficiency and dampness excess syndrome.Association rule analysis results showed that the core drugs strongly associated with asarum were asarum,osmanthus twig and angelica sinensis,asarum,osmanthus twig and attached pieces.The core drug pair mainly included asarum and cinnamomum twig,angelica sinensis,poria cocos and licorice.CONCLUSIONS:Based on the analysis of prescription drugs,asarum often used in combination with cinnamon twig,angelica sinensis,poria cocos and licorice to increase efficiency and reduce toxicity,and there is a certain off-label use of asarum in the clinical treatment of skin diseases.The clinical application of asarum in the treatment of skin diseases provides data support for the reasonable compatibility and safe dose range of traditional Chinese medicine,which is conducive to promoting clinical safe drug use.