中药治疗COPD合并呼吸衰竭痰湿阻肺证方药规律信息学研究

Prescription Rules of Chinese Medicine in the Treatment of COPD Complicated with Respiratory Failure of Tanshizufei(痰湿阻肺)Syndrome Based on R Language

目的:基于R语言数据挖掘平台探讨中药治疗COPD合并RF痰湿阻肺证的方药规律。方法:计算机检索8个数据库,按照预先设定的纳入、排除标准筛选自建库起至2022年2月期间收录的中医药治疗COPD合并RF痰湿阻肺证的文献,采用Excel软件提取纳入文献信息,运用R语言对中药频次、频率、中药剂量、关联度、聚类等进行挖掘分析,并结合方药频次、频率,分析中药治疗COPD合并RF痰湿阻肺证的用药规律。结果:本研究共检索到文献1357篇,最终纳入文献37篇。共纳入中药37味,累计频次196次,其中频次>5的中药共5味,累计频次142次,占比72.45%,依次为茯苓(30,15.31%)、橘红(30,15.31%)、陈皮(29,14.80%)、厚朴(28,14.29%)、姜半夏(25,12.76%)。37味中药可分为13类,前5类频率从高到低依次为理气药(64,32.65%)、化痰止咳平喘药(40,20.41%)、化湿药(33,16.84%)、利水渗湿药(32,16.33%)、补益药(13,6.63%)。其中化痰止咳平喘药以温化寒痰药(34,17.35%)、止咳平喘药(4,2.04%)为主;补益药以补气药(11,5.61%)为主。药性偏温、平、微寒,药味偏辛、苦、甘;主归肺、脾、胃经。共涉及方剂6首,累计频次38次,其中频率最高的方剂为燥湿化痰方(30,78.95%),其次为二陈汤(4,10.53%)。关联规则与聚类分析形成以茯苓、橘红、陈皮、厚朴、姜半夏为基础的核心药物组方。结论:中药治疗COPD合并RF痰湿阻肺证以茯苓、橘红、陈皮、厚朴、姜半夏为核心药物组方,以燥湿化痰、理气止咳为主要治则,在此基础上加入益气健脾和中、宽胸散结的中药,可取得较好的临床疗效。未来可进一步规范COPD合并RF中医证候诊断标准的制定,进一步增加以辨证为前提精准施治的相关研究,为本病的中医辨证施治提供参考。

Objective:To explore the prescription rules of Chinese medicine in the treatment of chronic obstructive pulmonary disease(COPD) complicated with respiratory failure(RF) of Tanshizufei(痰湿阻肺) syndrome based on the R language data mining platform. Methods:Eight databases, including China National Knowledge Infrastructure(CNKI),Wanfang Data, China Science and Technology Journal Database(VIP),Chinese BioMedical Literature Database(CBM),PubMed, Cochrane Library, Embase, and Web of Science were searched for research articles on traditional Chinese medicine(TCM) in the treatment of COPD complicated with RF of Tanshizufei syndrome according to the preset inclusion and exclusion criteria from database inception to February 2022. Excel was used to extract information, and R language was used to mine and analyze the times of usage, frequency, dosage, correlation degree, clustering, and other aspects of Chinese medicine, and the medication rules of Chinese medicine in the treatment of COPD combined with RF of Tanshizufei syndrome were analyzed in combination with times of usage and frequency of prescriptions. Results:A total of 1 357 articles were retrieved in this study, and 37 articles were finally included. Thirty-seven drugs were included, with cumulative times of usage of 196. Among them, there were five drugs with times of usage greater than 5,with cumulative times of usage of 142,accounting for 72.45%,which were Fuling(茯苓)(30,15.31%),Juhong(橘红)(30,15.31%),Chenpi(陈皮)(29,14.80%),Houpo(厚朴)(28,14.29%),and Jiangbanxia(姜半夏)(25,12.76%). Thirty-seven drugs could be divided into 13 categories. In terms of frequency, the top 5 categories were drugs effective in Liqi(理气)(64,32.65%),Huatan(化痰),Zhike(止咳),and Pingchuan(平喘)(40,20.41%),Huashi(化湿)(33,16.84%),Lishui(利水) and Shenshi(渗湿)(32,16.33%),and Buyi(补益)(13,6.63%). Among them, the main drugs for Huatan, Zhike, and Pingchuan were those for Wenhuahantan(温化寒痰)(34,17.35%) and Zhike and Pingchuan(4,2.04%),and Buyi drugs were mainly Buqi(补气) drugs(11,5.61%). In terms of Xing(性),drugs were mainly Wen(温),Ping(平),and slightly Han(寒),and in terms of Wei(味),drugs were mainly Xin(辛),Ku(苦),and Gan(甘). In terms of Guijing(归经),drugs mainly acted on the Fei(肺),Pi(脾),and Wei(胃). Six prescriptions were involved, with cumulative times of usage of 38. The prescription with the highest frequency was Zaoshi(燥湿) Huatan Prescription(30,78.95%),followed by Erchen Decoction(二陈汤)(4,10.53%). Association rules and cluster analysis revealed the core drug combinations based on Fuling, Juhong, Chenpi, Houpo, and Jiangbanxia. Conclusion:In the treatment of COPD complicated with RF of Tanshizufei syndrome, Fuling, Juhong, Chenpi, Houpo, and Jiangbanxia are the core drugs, and the main treatment principles are Zaoshi, Huatan, Liqi, and Zhike. On this basis, drugs efficient in Yiqi(益气),Jianpi(健脾),Hezhong(和中),Kuanxiong(宽胸),and Sanjie(散结) are added to achieve better clinical curative effect. In the future, the formulation of TCM syndrome diagnosis and diagnosis standards for COPD complicated with RF can be further standardized, and relevant research on accurate treatment based on Bianzheng(辨证) can be further strengthened, so as to provide references for TCM Bianzheng and treatment of this disease.