基于文献挖掘治疗腰椎管狭窄症方药功效和证型规律

Literature-based Mining of Prescription Efficacy and Pattern of Evidence in the Treatment of Lumbar Spinal Stenosis

目的探讨近30年文献中内服中药治疗腰椎管狭窄症的方药功效和中医证型规律,为临床辨证论治和遣方用药提供参考依据。方法通过检索万方、维普、知网三大中文数据库近30年已发表的中药内服治疗腰椎管狭窄症的临床相关文献,通过统一的纳入标准和排除标准,合并重复文献,整理、归纳和分析中药内服治疗腰椎管狭窄症的方剂功效和中医证型规律。结果317篇有效文献中共有436个方剂,统计的方剂功效共有12个,总使用频次为1374次。所列的中医证型共有14个,总使用频次为1759次。结论中药内服治疗腰椎管狭窄症的中医证型分为三大类:虚证(肝肾亏虚)、实证(气滞血瘀、寒湿痹阻、痰湿痹阻、湿热瘀阻、风寒痹阻、痰瘀互结、风湿痹阻)、虚实夹杂证(气虚血瘀、肾虚血瘀);中医治法分为三大类:补法(补益肝肾)、泻法(活血化瘀、温经散寒、祛湿化痰、清热除湿、祛风散寒、祛瘀化痰、祛风除湿)、补泻兼施法(补气活血、补肾活血)。

OBJECTIVE To investigate the efficacy of prescriptions and TCM syndrome patterns in the literature of lumbar spinal stenosis in recent 30 years,so as to provide reference for clinical medication.METHODS By searching the pubilished clinical literature about the treatment of lumbar spinal stenosis with traditional Chinese medicine in the past 30 years through the three Chinese literature databases of CNKI,Wanfang,and Weipu.Using uniform inclusion and exclusion criteria and combining duplicate literature,the efficacy of oral prescriptions and the pattern of TCM syndromes of lumbar spinal stenosis were sorted out,summarized and analyzed.RESULTS There were 436 prescriptions in 317 effective literatures,12 prescriptions were statistically effective,and the total frequency was 1374 times.There were 14 TCM syndrome types listed,and the total frequency of use was 1759 times.CONCLUSION TCM Syndromes of lumbar spinal stenosis were mainly divided into three categories:deficiency syndrome(liver and kidney deficiency type),excess syndrome(qi stagnation and blood stasis syndrome,cold dampness obstruction syndrome,phlegm dampness obstruction syndrome,dampness and heat stasis syndrome,wind cold obstruction syndrome,phlegm and blood stasis syndrome,rheumatism obstruction syndrome),deficiency and excess syndrome(qi deficiency and blood stasis syndrome,kidney deficiency and blood stasis type).The treatment was mainly:tonifying method(tonifying liver and kidney),purging method(promoting blood circulation and removing blood stasis,warming meridians and dispersing cold,resolving phlegm and dampness,clearing heat and removing dampness,dispersing cold and removing dampness,promoting blood circulation and resolving phlegm,dispelling wind and removing dampness),and reinforcing and reducing methods(invigorating qi and activating blood,tonifying kidney and activating blood circulation).