中医药治疗射血分数保留心力衰竭的核心处方及类方分析

Analysis on Core Prescriptions and Categorized Prescriptions in TCM for the Treatment of Heart Failure with Preserved Ejection Fraction

目的分析中医药治疗射血分数保留心力衰竭(HFpEF)的核心处方及类方的用药规律,为HFpEF临床遣药组方提供参考。方法检索中国知识资源总库(CNKI)、中国学术期刊数据库(Wanfang Data)、中文科技期刊数据库(VIP)、中国生物医学文献数据库(CBM)、PubMed、Web of Science、Embase、Cochrane Library建库至2023年11月1日收录的中医药治疗HFpEF临床研究文献,采用复杂网络、处方相似性网络、社团划分等数据挖掘方法,探讨HFpEF的处方用药规律。结果共纳入中医药治疗HFpEF临床研究文献142篇,包含146首处方,涉及中药162味;使用频次较高的中药以黄芪、丹参、茯苓为代表;利用复杂网络分析得到治疗HFpEF的核心处方及常用药物配伍,核心处方由黄芪、茯苓、丹参、甘草、川芎、桂枝、葶苈子、白术、赤芍、麦冬、当归组成;进一步基于处方相似性网络和社团划分方法,得到对应于HFpEF分期及证型的3个主要社团类方集合基础方,发现HFpEF病程发展的分期诊疗用药规律。结论益气活血、温阳利水为HFpEF的治疗大法;采用数据挖掘技术分析HFpEF核心处方及类方,可为HFpEF中医诊疗规律及用药经验总结提供依据。

Objective To analyze the medication law of core prescriptions and categorized prescriptions of TCM for the treatment of heart failure with preserved ejection fraction(HFpEF);To provide references for clinical prescriptions of HFpEF.Methods The clinical research literature on TCM for HFpEF was retrieved from CNKI,Wanfang Data,VIP,CBM,PubMed,Web of Science,Embase and Cochrane Library from establishment of the databases to November 1,2023.Data mining methods,such as complex network,prescription similarity network and community detection method were used to explore the prescription medication law of HFpEF.Results Totally 142 articles related to TCM treatment of HFpEF were included,containing 146 prescriptions and involving 162 kinds of Chinese materia medica.The most frequently used drugs were represented by Astragali Radix,Salviae Miltiorrhizae Radix et Rhizoma and Poria.The core prescription and the commonly used modified law of HFpEF treatment were obtained by complex network analysis.The core prescription consisted of Astragali Radix,Poria,Salviae Miltiorrhizae Radix et Rhizoma,Glycyrrhizae Radix et Rhizoma,Chuanxiong Rhizoma,Cinnamomi Ramulus,Descurainiae Semen Lepidii Semen,Atractylodis Macrocephalae Rhizoma,Paeoniae Radix Rubra,Ophiopogonis Radix and Angelicae Sinensis Radix.Further based on the prescription similarity network and community detection method,the basic prescriptions of the 3 major community of categorized prescription corresponding to the HFpEF staging and syndrome types were obtained,and the staged diagnosis and treatment medication law with the development of the HFpEF disease course were found.Conclusion Invigorating qi and activating blood circulation,warming yang and promoting diuresis are the main therapeutic principles of HFpEF.Data mining technology provides a feasible method for the analysis of core prescriptions and categorized prescriptions for HFpEF,which can provide a basis for the diagnosis and treatment law and medication experience of HFpEF in TCM.