基于中医传承计算平台探讨中枢性性早熟中医诊治规律

Analysis on the Traditional Chinese Medicine Diagnosis and Treatment Rules of Central Precocious Puberty Based on the Traditional Chinese Medicine Inheritance Computing Platform System

目的:基于中医传承计算平台(TCMICS)探讨中枢性性早熟(CPP)中医诊治规律,为临床治疗提供参考。方法:计算机检索中国知网、万方数据知识服务平台、维普数据库、中国生物医学文献服务系统等数据库中建库以来至2023年2月所收录的中药内服治疗CPP的临床研究文献,手工检索现代名家医案书籍(出版时间为2004—2021年),提取中药处方,采用Excel软件创建中药治疗CPP处方数据表,借助中医传承计算平台V3.0挖掘诊治规律。结果:纳入现代医案82则,涉及方剂210首,中药216味。82则医案中CPP病位证素以肝为主,涉及脾、胞宫、肾;病性证素以阴虚、热、气滞、痰为多。CPP常见证型为阴虚火旺证、肝郁化火证、痰热内盛证、痰湿内阻证、脾虚痰湿证;频数最高药物依次为知母、黄柏、牡丹皮、生地黄、柴胡等;功效以清热类、补虚类、利水渗湿类、理气类、化痰止咳平喘类为主;四气主要以寒性、平性、温性为主;五味以苦味、甘味、辛味为多;归经频数以肝经为首,肾经、肺经、脾经次之;核心药对有“知母,黄柏”“知母,生地黄”“黄柏,牡丹皮”“知母,牡丹皮”“黄柏,生地黄”;聚类分析得出3个核心组方,组方1为白芍、柴胡、当归、牡丹皮、甘草,组方2为柴胡、浙贝母、白芍、夏枯草、茯苓,组方3为知母、黄柏、牡丹皮、生地黄、夏枯草。结论:CPP的中医药治疗宜补虚泻实,扶正祛邪,肝脾肾同调,尤其要注重调畅肝气。

Objective:To explore and analyze the diagnosis and treatment rules of traditional Chinese medicine in the treatment of central precocious puberty(CPP)based on the Traditional Chinese Medicine Inheritance Computing Platform System(TCMICS),and to provide reference for clinical treatment.Methods:The clinical research literature on the treatment of CPP by oral administration of traditional Chinese medicine(TCM)were retrievedd by computer through CNKI,Wanfang Data Knowledge Service Plaform,VIP database,and Chinese Biomedical Literature Service System from the establishment of the database to February 2023,and the modern medical records books of famous authors(published from 2004 to 2021)were manually retrieved to extract TCM prescriptions.Excel software was used to create the prescription data table for Chinese medicine treatment of CPP,and the diagnosis and treatment rules were mined with the help of the TCMICS V3.0.Results:A total of 82 modern medical cases were included,involving 210 prescriptions and 216 flavors of Chinese medicines.Among 82 medical cases of CPP,the syndrome elements of disease location were mainly liver,involving the spleen,uterus,and kidneys.The pathological syndrome is mainly characterized by Yin deficiency,heat,Qi stagnation,and phlegm.The common syndromes types of CPP included Yin deficiency and excessive fire syndrome,liver depression and fire transformation syndrome,phlegm heat internal excess syndrome,phlegm dampness internal obstruction syndrome,and spleen deficiency phlegm dampness syndrome.The drugs with the highest frequency were Zhimu(Anemarrhenae Rhizoma),Huangbai(Phellodendri Cortex),Mudanpi(Moutan Cortex),Shengdihuang(Rehmanniae Radix Exsiccata seu Recens),Chaihu(Bupleuri Radix),and etc.The main effects included clearing heat,tonifying deficiency,promoting diuresis and dampness,regulating Qi,resolving phlegm,relieving cough,and relieving asthma.The four Qi were mainly cold,mild,and warm.The five flavors were mainly bitter,sweet and spicy.The frequency of meridian tropism was mainly based on the liver meridian,followed by the kidney meridian,lung meridian,and spleen meridian.The core medicine pairs included"Zhimu(Anemarrhenae Rhizoma),Huangbai(Phellodendri Cortex)","Zhimu(Anemarrhenae Rhizoma),Shengdihuang(Rehmanniae Radix Exsiccata seu Recens)","Huangbai(Phellodendri Cortex),Mudanpi(Moutan Cortex)","Zhimu(Anemarrhenae Rhizoma),Mudanpi(Moutan Cortex)","Huangbai(Phellodendri Cortex),Shengdi-huang(Rehmanniae Radix Exsiccata seu Recens)":Cluster analysis revealed three core prescriptions,prescription 1 consisting of Baishao(Paeoniae Radix Alba),Chaihu(Bupleuri Radix),Danggui(Angelicae Sinensis Radix),Mudanpi(Moutan Cortex),and Gancao(Glycyrrhizae Radix),prescription 2 consisting of Chaihu(Bupleuri Radix),Zhebeimu(Fritillariae Thunbergi Bulbus),Baishao(Paeoniae Radix Alba),Xiakucao(Prunellae Spica),and Fuling(Poria),and prescription 3 consisting of Zhimu(Anemarrhenae Rhizoma),Huangbai(Phellodendri Cortex),Mu-danpi(Moutan Cortex),Shengdihuang(Rehmanniae Radix Exsiccata seu Recens),and Xiakucao(Prunellae Spica).Conclusion:The TCM treatment for CPP is suitable for tonifying deficiency and purging excess,support right and dispel evil,regulating the liver,spleen,and kidney in harmony,especially focusing on regulating liver Qi.