COVID-19诊疗信息、中医证型分布及组方用药规律的文献研究

Literature Research on COVID-19 Diagnosis and Treatment Information Collection,TCM Syndrome Distribution and Prescription Medication Rules

目的利用数据挖掘技术深入探究新型冠状病毒感染(COVID-19,简称新冠感染)患者的诊断、中医证型分布以及药物使用规律,以期为中医药治疗新冠感染提供有效的参考依据。方法通过搜索,可以获取来自国家卫生健康委员会和全国各地的《新型冠状病毒肺炎诊疗方案》内涉及的中医证型和中医药防治方案,以及中国生物医学文献服务系统、知网、维普、万方数据库收录的治疗新冠感染相关文献共249份。对文献通过筛选、整理和去重并建立中药复方数据库、诊疗信息数据库、证型数据库,运用频数分析、频率分析进行探究。结果新冠感染患者常见的症状频数较高的为咳嗽、咽干咽痛、发热、纳差、乏力;大多数患者呈淡红舌、红舌,脉象为滑脉、滑数脉;中医证型频数较高的有湿毒郁肺证、湿热蕴肺证、肺脾气虚证、寒湿郁肺证、气阴两伤证、兼夹瘀血证。此外,共纳入491首治疗新冠感染中药复方,涉及中药227味,得到高频中药共64个,药物类别以清热药、补益药、解表药、化痰止咳平喘药、化湿药为主;药性以温、平、寒为主,药味以甘、辛、苦为主,归经中归肺、脾、胃经中药居多;聚类分析结果根据中药性能将治疗新冠感染的高频药物聚为8类较好。结论中医药治疗新型冠状病毒感染用药具有以下特点:补益药用药次数较多体现攻邪不忘扶正;解表、清热、攻下、化湿、利湿、渗湿药物俱全体现多种逐邪之法;药类以清热药、补益药、化湿药、化痰止咳平喘药、解表药为主,彰显新冠感染基本治法为清热化湿、止咳平喘、补养气阴。可为指导临床用药及研发新药提供一定的参考与借鉴。

Objective The purpose of this study is to use data mining technology to deeply explore the diagnosis,TCM syndrome distribution and drug use rules of corona virus disease 2019(COVID-19)patients,in order to provide an effective reference for the treatment of COVID-19 with traditional Chinese medicine.Methods Through the search,we can obtain the TCM syndrome types and TCM prevention and treatment schemes involved in Diagnosis and Treatment Plan for COVID-19 from the National Health Commission and all over the country,as well as the Chinese Biomedical Literature Service System,CNKI,VIP and Wanfang database.A total of 249 literatures related to the treatment of COVID-19 were included.Through screening,sorting and deduplication of the literature,and the database of traditional Chinese medicine compound prescriptions,diagnosis and treatment information databases were set up,and syndrome types databases,frequency analysis and frequency analysis were used to analyze the results.Results The common symptoms of patients with COVID-19 in this study were cough,dry throat and sore throat,fever,anorexia and fatigue.Most patients showed pink tongue,red tongue,pulse for slippery pulse,slippery pulse;the high frequency of TCM syndromes were damp and toxin stagnation in lung syndrome,damp-heat accumulation in lung syndrome,lung and spleen Qi deficiency syndrome,cold and dampness stagnation in lung syndrome,Qi and Yin injury syndrome and blood stasis syndrome.In addition,a total of 491 Chinese medical compound prescriptions for the treatment of COVID-19 were included,involving 227 Chinese drugs,and a total of 64 high-frequency Chinese drugs were obtained.The drug categories were mainly heat-clearing drugs,tonic drugs,relieving the exterior drugs,reliving cough and asthma drugs and eliminating dampness drugs;the medicinal properties were mainly warm,flat and cold,and the tastes were mainly sweet,pungent and bitter.Most of the Chinese drugs belonged to the lung,spleen and stomach meridians.The results of cluster analysis clustered the high-frequency drugs for the treatment of COVID-19 into 8 categories according to the performance of traditional Chinese medicine.Conclusion The medication of traditional Chinese medicine in the treatment of COVID-19 has the following characteristics:the number of tonic drugs is more,reflecting attacking evil without forgetting to support vital Qi;relieving the exterior,clearing heat,purging,resolving dampness,removing dampness and eliminating dampness drugs all reflect a variety of methods of expelling evils;the drugs are mainly heat-clearing drugs,tonic drugs,dampness-eliminating drugs,phlegm-resolving,cough-relieving and asthma-relieving drugs and the exterior-relieving drugs.The basic treatment methods are clearing heat and eliminating dampness,relieving cough and asthma and nourishing Qi and Yin.This study can provide some reference for guiding clinical medication and developing new drugs.