梁晓春教授治疗糖尿病微血管病变的用药经验

Professor Liang Xiaochun’s experience in the treatment of diabetic microvascular complications

目的探讨梁晓春教授治疗糖尿病微血管病变用药经验。方法采用回顾性真实世界研究方法,以北京协和医院信息系统电子病历为载体,采集梁晓春教授2021年1月至2022年12月门诊治疗糖尿病微血管病变患者的临床信息,构建数据库并将其录入中医传承计算平台(V 3.5),运用关联规则、聚类分析等方法分析病案处方的用药频次、性味归经、常用药物组合,总结梁晓春教授治疗糖尿病微血管病变的治则治法和用药规律。结果共整理梁晓春教授治疗糖尿病微血管病变的验方301则,中药211味。使用次数最多的药物为桑白皮、菟丝子、鸭跖草、女贞子、鬼箭羽、倒扣草等。性味多甘寒,归经多属于肝、脾、肾经。用药关联分析得出最核心的药物组合为:菟丝子-女贞子、菟丝子-倒扣草、菟丝子-鸭跖草、菟丝子-桑白皮、女贞子-倒扣草、倒扣草-土茯苓、女贞子-桑白皮、女贞子-鸭跖草。聚类分析得出4个核心处方为:女贞子-菟丝子-桑白皮-鸭跖草-鬼箭羽-倒扣草、鸭跖草-桑白皮-葛根-丹参-菟丝子-女贞子、女贞子-鸭跖草-菟丝子-桑白皮-川芎-鸡血藤、桑白皮-菟丝子-荷叶-鸭跖草-女贞子-川芎。结论梁晓春教授治疗糖尿病微血管病变以活血化瘀、祛痰泄浊、补虚扶正为主要治疗原则。

Objective To investigate the medication rule of Professor Liang Xiaochun in the treatment of diabetic microvascular complications.Methods A retrospective real-world study method was used,with the electronic medical records from the hospital information system of Peking Union Medical College Hospital as the carrier.Clinical information of patients treated for diabetic microvascular complications by Professor Liang Xiaochun from January 2021 to December 2022 was collected to construct a database,which was then entered into the Traditional Chinese Medicine Inheritance Platform(V 3.5).Techniques such as association rule mining and cluster analysis were used to analyze the frequency of medication usage,the nature,flavour,and channel tropism of the medicines,and common drug combinations,the treatment principles and medication patterns of Professor Liang Xiaochun for diabetic microvascular complications were summarized.Results A total of 301 effective prescriptions for treating diabetic microvascular complications by Professor Liang Xiaochun were collated,involving 211 Chinese herbal medicines.The most frequently used medicines were Mori Cortex,Cuscutae Semen,Commelina communis,Fructus Ligustri Lucidi,Euonymus alatus,Achyranthes aspera,etc.The four natures were mostly cold,and the five flavours were mostly sweetness.The channel tropism belonged to the liver,spleen,and kidney.The core combinations of medicines identified through correlation analysis were Cuscutae Semen-Fructus Ligustri Lucidi,Cuscutae Semen-Achyranthes aspera,Cuscutae Semen-Commelina communis,Cuscutae Semen-Mori Cortex,Fructus Ligustri Lucidi-Achyranthes aspera,Achyranthes aspera-Smilacis Glabrae Rhixoma,Fructus Ligustri Lucidi-Mori Cortex,Fructus Ligustri Lucidi-Commelina communis.The four core prescriptions were obtained by cluster analysis:Fructus Ligustri Lucidi-Cuscutae Semen-Mori Cortex-Commelina communis-Euonymus alatus-Achyranthes aspera,Commelina communis-Mori Cortex-Radix Puerariae-Salvia miltiorrhiza-Cuscutae Semen-Fructus Ligustri Lucidi,Fructus Ligustri Lucidi-Commelina communis-Cuscutae Semen-Mori Cortex-Chuanxiong Rhizoma-Spatholobus Suberectus Dunn,Mori Cortex-Cuscutae Semen-Folium Nelumbinis-Commelina communis-Fructus Ligustri Lucidi-Chuanxiong Rhizoma.Conclusion Professor Liang Xiaochun treats diabetic microvascular complications with the main therapeutic principles of invigorating blood circulation to remove blood stasis,clearing away phlegm to eliminate turbidity,and supplementing deficiencies to support the body’s vital energy.