中医药治疗肝郁气滞型便秘型肠易激综合征的用药规律分析

Analysis of the medication rules for the treatment of liver depression and Qi stagnation type constipation-predominant irritable bowel syndrome in traditional Chinese medicine

目的通过分析总结肝郁气滞型便秘型肠易激综合征(IBS-C)中药治疗的配伍规律,以期为今后的临床治疗及新型中成药的开发提供参考。方法通过应用中医传承辅助平台系统,检索中国知网、万方、维普数据库建库至2022年4月的文献,查找中文期刊数据库中关于口服中药治疗肝郁气滞型IBS-C的处方,提取相关方药信息,录入表格并整理,运用软件的频数分析、关联规则分析、聚类分析方法分析组方用药规律。结果最终筛选出口服中药治疗肝郁气滞型IBS-C的方剂23首,涉及中药62味,分析得出,中药应用总频次为241次,频次≥2的有35味中药,使用频次居前10位的中药依次为白芍、甘草、柴胡、白术、枳壳、槟榔、木香、枳实、乌药、厚朴;药物种类以补虚药和理气药为主;药性以温为主;五味以苦为主;归经以脾经为主。基于关联规则的中药组合有28个,聚类分析分为3类,提取核心方3个及新方2个。结论肝郁气滞型IBS-C临床上多遵循健脾疏肝、理气润肠的原则。核心方及新方分析提示疏肝理气为治疗大法,益气、养阴、活血亦可灵活应用于临床病因复杂多元化的患者。用药多寒温并用,常用苦、辛、甘味,调理脏腑,顺应机体。

Objective By analyzing and summarizing the compatibility rules of traditional Chinese medicine(TCM)treatment for liver Qi stagnation constipated irritable bowel syndrome(IBS-C),hope to provide reference for future clinical treatment and development of new proprietary Chinese medicine.Methods Through the application of TCM inheritance assistance platform system,the literature of CNKI,Wanfang and VIP database from the establishment of the database to April 2022 was searched to find the prescription of oral Chinese medicine for the treatment of liver depression and Qi stagnation IBS-C in the Chinese journal database.The relevant prescription information was extracted,entered into the table and sorted out,and the frequency analysis,association rule analysis and cluster analysis methods of software were used to analyze the rule of prescription group medication.Results Finally,23 prescriptions for IBS-C,including 62 TCM medicines,the analysis showed that the total frequency of TCM application was 241 times,there were 35 TCM in frequency 2,the top 10 used Chinese medicines were white paeony root,licorice root,radix bupleuri,white atractylodes rhizome,fructus aurantii,betel nut,costustoot,immature bitter orange,the root of three-nerved spicebush,mangnolia officinalis.The types of drugs were mainly tonic deficiency drugs and qi-regulating drugs,the drug was mainly warm;The five flavors were mainly bitter,the main channel tropism was the spleen channel.There were 28 TCM combinations based on the association rules,and the cluster analysis was divided into 3 categories,with 3 core prescriptions and 2 new prescriptions extracted.Conclusion Clinically,IBS-C mainly follows the principles of invigorating spleen and soothing liver,regulating Qi and moistening intestine.The analysis of core formula and new formula suggested that soothing liver and regulating Qi is a great treatment method,supplementing Qi,nourishing Yin and promoting blood circulation can also be flexibly applied to patients with complex and diversified clinical etiology.Use cold and warm drugs,commonly used bitter,pungent,sweet taste,conditioning viscera,comply with the body.