基于真实世界研究探讨中医药治疗抑郁症的临床用药规律

Research on Regularity of Depression Treatment in Traditional Chinese Medicine Based on Real World Research Rule

目的基于真实世界研究探讨抑郁症治疗的临床中药用药规律。方法采集来源于广安门医院副主任及以上医师门诊抑郁症患者中药处方,利用广安门医院名老中医研究室的“中医科研信息共享系统数据分析挖掘平台”进行中药用药规律的数据挖掘。结果常用单味中药为茯苓、制远志、炒酸枣仁、柴胡、石菖蒲、甘草、当归等。药性结果显示以平性为主,五味中以甘味为主,苦、辛味次之,主要归肝经,其次为心、脾。中药分类以补虚药为主,其中补气药为最常用,其次为养心安神药、理气药。通过复杂网络分析法得到本次研究的核心处方为茯苓、制远志、炒酸枣仁、石菖蒲、柴胡、当归、丹参、郁金;并利用复杂网络分析法得出除去肝胆湿热型外的其余5个证型的用药结果。运用点式互信息法,得出常用药对为制巴戟天-人参、赤芍-人参、麸炒枳实-人参等。结论采用真实世界研究方法、利用大数据技术从中医临床信息中挖掘抑郁症的用药规律,为中医治疗抑郁症提供了临床参考。

Objective Based on real world research rules,to study the regularity of depression treatment with traditional Chinese medicine.Methods It collected the clinical prescriptions of traditional Chinese medicine of the outpatients treated by associate chief physician and chief physician of Guang'anmen Hospital,the studies were carried out by using“data analysis and mining platform of scientific research information sharing system of traditional Chinese medicine”which was created by Guang'anmen Hospital.Results Fuling(Poria),processed Yuanzhi(Radix Polygalae),baked Suanzaoren(sour jujube kernel),Chaihu(Bupleurum),Shichangpu(Acorus tatarinowii),Gancao(Glycyrrhiza uralensis),Danggui(Angelica)and so on were the common single Chinese medicine.The drug property was mainly mild.Among the five tastes,sweet taste is the most commonly used,the second is bitter and next is pungent.To the meridian distribution,the proportion of liver meridian is the largest,followed by heart and spleen meridians.Tonifying and replenishing drugs were mainly used.Qi tonifying drugs were used most frequently,the next were heart-nourishing and tranquilizing drugs and then were Qi regulating drugs.Through the complex network analysis method,it got the core prescription of depression treatment which was composed of Fuling(Poria),processed Yuanzhi(Polygalae Radix),fired Suanzaoren(Ziziphi Spinosae Semen),Shicangpu(Acori Tatarinowii Rhizoma),Chaihu(Bupleuri Radix),Danggui(Angelicae Sinensis Radix),Danshen(Salviae Miltiorrhizae Radix Et Rhizoma)and Yujin(Curcumae Radix).Meanwhile,it got the prescriptions of the five syndrome types except damp-heat in liver and gallbladder by the complex network analysis method.By using the method of point-mutual information,it concluded the common drug pairs were Bajitian(Morindae Officinalis Radix)-Renshen(Ginseng Radix Et Rhizoma),Chishao(Paeoniae Radix Rubra)-Renshen(Ginseng Radix Et Rhizoma)and bran-fried Zhishi(Aurantii Fructus Immaturus)-Renshen(Ginseng Radix Et Rhizoma).Conclusion With the help of real world research methods and big-data technology,it got some drug laws of depression treatment by the analysis of clinical information of traditional Chinese medicine that provided clinical references for the treatment of depression.