中药治疗绝经后骨质疏松症肝肾阴虚证组方用药规律分析

Medication Rules of Chinese Medicine in Treating Postmenopausal Osteoporosis with Liver-Kidney Yin Deficiency Syndrome

目的探讨中药治疗绝经后骨质疏松症(PMOP)肝肾阴虚证的组方用药规律。方法检索CNKI、万方、维普、CBM、Web of Science数据库中,中药治疗PMOP的随机对照试验相关文献,提取治法及方剂组成,采用可视化工具Cite Space,分别对治法、组方用药进行频次、关联、聚类分析,并分析基础方、剂型。结果共纳入中文文献55篇。治疗PMOP肝肾阴虚证的主要基础方为左归丸、六味地黄丸,剂型以汤剂为主。主要治法包括滋补肝肾、补血、健脾益气、温补肾阳、补肾固精、活血化瘀、强筋壮骨等,其中温补肾阳的中介中心性最高;主要治法共形成4个聚类。常用的药物有熟地黄、山茱萸、枸杞子、山药、牛膝、茯苓、菟丝子、鹿角胶等,关联强度较高的有熟地黄、山茱萸、山药、茯苓、泽泻、牡丹皮,其中中介中心性较高的药物有枸杞子、千斤拔、续断、熟地黄、鹿角胶等;常用药物共形成6个聚类。结论治疗PMOP肝肾阴虚证的核心治法是滋补肝肾,并佐以温补肾阳之品,主要方剂是左归丸、六味地黄丸,枸杞子是最常配伍的药物;若出现虚烦不眠,可配伍清虚热药物,以及除烦功效的淡豆豉;根据具体情况,可配合健脾益气、活血化瘀、祛风除湿、强筋壮骨之品。

Objective To understand the medication rules of Chinese medicine in the treatment of postmenopausal osteoporosis(PMOP)with liver-kidney yin deficiency syndrome.Methods China National Knowledge Infrastructure(CNKI),Wanfang,VIP database,China Biology Medicine disc(CBMdisc),and Web of Science databases were searched for randomized controlled trials related to the treatment of PMOP with Chinese medicine.The treatment and prescription composition were extracted.The frequency,correlation and cluster analysis of the treatment and composition were carried out by using the visualization tool CiteSpace,and the basic prescriptions and dosage forms were analyzed.Results Fifty-five Chinese papers were included.The main basic prescriptions for the treatment of PMoP with liver-kidney yin deficiency syndrome were Zuogui Pills and Liuwei Dihuang Pills,and the dosage form was mainly decoction.The main treatment methods included nourishing liver and kidney,tonifying blood,invigorating spleen and replenishing qi,warming kidney yang,tonifying kidney and consolidating essence,promoting blood circulation and removing blood stasis,and strengthening muscles and bones.Among them,the intermediary centrality of warming kidney yang was the highest.The main treatment methods formed 4 clusters.Commonly used drugs were Rehmanniae Radix Praeparata,Corni Fructus,Lyci Fructus,Dioscoreae Rhizoma,Achyranthis Bidentatae Radix,Poria,Cuscutae Semen,and Cervi Cornus Colla.Drugs with high correlation strength were Rehmanniae Radix Praeparata,Corni Fructus,Dioscoreae Rhizoma,Poria,Alismatis Rhizoma,and Moutan Cortex,among which drugs with high intermediary centrality were Lyci Fructus,Flemingia prostrata,Dipsaci Radix,Rehmanniae Radix Praeparata,and Cervi Cornus Colla.The commonly used drugs formed 6 clusters.Conclusion The core treatment method for PMOP with liver-kidney yin deficiency syndrome is to nourish liver and kidney,and assisted with warming and tonifying kidney yang.The main prescriptions are Zuogui Pills and Liuwei Dihuang Pills,and Lyci Fructus is the most commonly used drug.If there is deficiency and insomnia,it can be combined with drugs for clearing deficiency and heat,as well as Sojae Semen Praeparatum with anti-annoyance effect.According to the specific situation,it can be combined with products of invigorating spleen and replenishing qi,promoting blood circulation and removing blood stasis,dispelling wind and removing dampness,and strengthening muscles and bones.