基于文献分析抑郁症的证型分布及用药规律

Analysis of depression syndrome distribution and medication rules based on the literature

目的:运用文献计量学分析的方法,探讨抑郁症在中医治疗中的证型分布情况及用药规律。方法:采用“主题”为检索项,“抑郁症”“证型”“证素”“中药”“中医”为检索词在中国知网、维普、万方三个中文数据库中检索2011年6月30日―2022年6月30日的与中医药治疗抑郁症相关的文献。借助WPS软件建立中医治疗抑郁症整体证型及临床用药数据库,运用Excel进行频数分析,运用SPSS 23.0软件进行聚类分析。结果:共纳入符合标准的文献127篇;涉及证型67种;涉及的病位要素7个,病性要素14个;涉及的方剂共215方,药物类别17种,使用的药物共计160味,出现频次共计2 619次。(1)涉及的证型67种,其中常见的证型为肝郁气滞证、肝郁脾虚证、心脾两虚证,共占41.05%。(2)在涉及的病位要素方面以肝为主,其次为脾、心;在病性要素方面以气滞为主,其次为气虚、阳虚。(3)涉及的药物共计160味,按功效分为17类,补虚药占28.75%,安神药占11.76%,理气药占11.53%。(4)中医治疗抑郁症所用的中药药性主要以温、平为主,药味以甘、苦、辛为主,归经上以脾经为主。结论:抑郁症的病因病机复杂,多为虚实夹杂,病性要素主要为气滞、阳虚和气虚,病位要素以肝为主,但从临床治疗的用药规律分析可知临床治疗抑郁症以补虚为主,归经上以脾经为主。

Objective:To explore the depression syndrome distribution and medication rules in TCM treatment by using the method of bibliometric analysis.Methods:With“Theme”as the search term,“Depression”,“Syndrome type”,“Syndrome elements”,“TCM”and“Chinese medicine”as the search words,the literature related to TCM treatment of depression from June 30,2011 to June 30,2022 was searched in three Chinese databases:CNKI,VIP and Wanfang.WPS software was used to establish the overall syndrome type and clinical drug database of TCM treatment of depression,Excel was used for frequency analysis,and SPSS23.0 software was used for cluster analysis.Results:A total of 127 literatures meeting the criteria were included.There were 67 types of syndrome involved.There were 7 elements of disease location and 14 pathogenic factors involved.There were 215 prescriptions involved,17 types of drugs,160 flavors of drugs were used,with a total frequency of 2,619 times.(1)There were 67 types of syndrome involved,among which the common types were liver-qi stagnation syndrome,liver-qi spleen deficiency syndrome and heart-spleen deficiency syndrome,accounting for 41.05%.(2)In terms of elements of disease location involved,the liver was predominant,which was followed by the spleen and heart.In terms of pathogenic elements,Qi(气)stagnation was predominant,which was followed by Qi deficiency and Yang(阳)deficiency.(3)The total number of Chinese medicine involved was 160 flavors,which were divided into 17 categories according to their efficacy,with deficiency tonifying drugs accounting for 28.75%,tranquilizing drugs accounting for 11.76%,and Qi-regulating drugs accounting for 11.53%.(4)The medicinal properties of traditional Chinese medicine used in the treatment of depression were mainly warm and mild,the taste of medicine was mainly sweet,bitter and pungent,and the spleen meridian was mainly used in the treatment of depression.Conclusion:The etiology and pathogenesis of depression are complex,which is mostly mixed with deficiency and excess,the pathogenic factors are mainly Qi stagnation,Yang deficiency and Qi deficiency,and the elements of disease location are dominated by the liver,but from the analysis of the medication rules in clinical treatment,it can be seen that the clinical treatment of depression is dominated by the supplementation of deficiency,and the attribution of meridian to spleen meridian is dominated.