中医药治疗2型糖尿病合并原发性高血压气阴两虚证用药规律探析

Medication rule of traditional Chinese medicine in treatment of type 2 diabetes comorbid with primary hypertension with syndrome of deficiency of both Qi and Yin

目的:探讨中医药治疗2型糖尿病合并原发性高血压(T2DH)气阴两虚证的用药规律。方法:收集2020年1月至2022年1月于湖南省中西医结合医院及湖南中医药大学第一附属医院就诊的T2DH气阴两虚证患者的病历资料,应用中医传承辅助平台(V3.0),采用频次计算、关联规则、聚类分析等方法进行数据挖掘。结果:纳入病例100例,患者男女比例均衡,以中老年人为主,临床表现多见口干、多饮、视物模糊,舌苔多见舌红、舌淡红、苔薄白、苔少,脉象以细弦脉、弦脉为主。筛选出处方100首,涉及药物208味,药性多寒,温、平次之,药味以甘味为主,多归肝、肺、肾经。置信度>0.8,得到14条关联性高的药物组合;对频次≥20次的药物进行聚类分析,得到核心药物组合5组,其中第5组最为靠近回归曲线。结论:T2DH的主要病机以气阴两虚为本,燥热为标,瘀血为患,治法主要采用益气养阴、清热泻火、活血化瘀,兼调理五脏。

Objective:To investigate the medication rule of traditional Chinese medicine(TCM)in the treatment of type 2 diabetes comorbid with primary hypertension(T2DH)with syndrome of deficiency of both Qi and Yin.Methods:Medical records were collected from the patients with T2DH with syndrome of deficiency of both Qi and Yin who attended The Hunan Provincial Hospital of Integrated Traditional Chinese and Western Medicine and The First Affiliated Hospital of Hunan University of Chinese Medicine from January 2020 to January 2022.With the help of Traditional Chinese Medicine Inheritance Support System(V3.0),the methods such as frequency calcu-lation,association rule analysis,and cluster analysis were used for data mining.Results:A total of 100 patients were included in analysis,with a balanced male-female ratio,and most of these patients were middle-aged and elderly individuals.Clinical manifestations mainly included dry mouth,polydipsia,and blurred vision;as for the coating on the tongue,the patients mostly had reddened tongue,light-reddish tongue,white and thin coating,or less coating on the tongue;pulse manifestation was mainly small and wiry pulse and wiry pulse.A total of 100 prescriptions were obtained,involving 208 TCM drugs,among which the drugs with a cold nature accounted for the highest proportion,followed by those with a warm or neutral nature;most drugs had a sweet taste and mainly entered the liver,spleen,and kidney meri dians.At a confidence of>0.8,14 drug combinations with a relatively high degree of association were obtained;a cluster analysis was performed for the drugs with a frequency of≥20 times,and 5 core drug combi-nations were obtained,among which the 5th group was the closest to the regression curve.Conclusion:The main pathogenesis of T2DH is deficiency of both Qi and Yin as the root cause,dryness-heat as the manifestation,and blood stasis as the disease,and the main treatment methods include Qi-benefiting and Yin-nourishing therapy,heat-clearing and fire-purging therapy,and blood-activating and stasis-resolving therapy,with consideration of the regulation of five viscera.