中医药治疗肺结核的用药规律研究

Medication Rules of Traditional Chinese Medicine in Treating Pulmonary Tuberculosis

目的 探究肺结核病采用中医药治疗的用药规律。方法 检索中国知网、万方、维普三大数据库1956—2022年中医药治疗肺结核病的相关文献报道,全面系统整理治疗肺结核的中药处方,使用Microsoft Excel对中药进行种类、四气五味等相关指标分析,IBM SPSS Modeler Subscription 1.0进行关联规则及网络视图分析,研究治疗肺结核的中药处方用药规律。结果 临床中通常以补虚药、清热药、化痰止咳平喘药、止血药为主,药物归经为肺经、脾经、肝经、心经、肾经、三焦经;而四气五味以寒温、甘苦辛为主;中药与肺结核症状、舌象、脉象进行关联规则分析结果显示,置信度最高的药物为麦冬、甘草。结论 化痰、平喘、补虚、止血等药物为临床治疗肺结核的常用药物,常用药方为百合固金汤,可根据每一位患者的具体情况实施辨证治疗,保证与肺结核病病机相吻合,可为肺结核的中医药治疗提供参考依据。

Objective To mine the medication rules of traditional Chinese medicine(TCM) in treating pulmonary tuberculosis.Methods The articles about the TCM treatment of pulmonary tuberculosis were retrieved from China National Knowledge Infrastructure,Wanfang Data,and VIP with the time interval from 1956 to 2022.The TCM prescriptions for treating pulmonary tuberculosis were comprehensively extracted from the articles.Microsoft Excel was used to analyze the medicinal categories,qi,flavor,and other information of the Chinese medicines used in the prescriptions.IBM SPSS Modeler Subscription 1.0 was used to analyze the association rules and network views,based on which the medication rules of TCM for treating pulmonary tuberculosis were mined.Results In clinical practice,pulmonary tuberculosis was usually treated with tonifying,heat-clearing,phlegmresolving and cough-and dyspnea-relieving,and hemostatic medicines,which showed tropism to the lung,spleen,liver,heart,kidney,and triple energizer meridians.The medicines with cold and warm natures and sweet,bitter,and pungent tastes were commonly used.The results of the association rule analysis of Chinese medicines with symptoms,tongue manifestations,and pulse manifestations showed that the medicines with high confidence were Ophiopogonis Radix and Glycyrrhizae Radix et Rhizoma.Conclusion Phlegm-resolving,dyspnea-relieving,tonifying,and hemostatic medicines were commonly used for treating pulmonary tuberculosis.The commonly used prescription was Baihe Gujin Decoction.The patients should be treated based on syndrome differentiation,which can ensure that the treatment method corresponds to the pathogenesis of pulmonary tuberculosis.The findings of this study provide reference for the TCM treatment of pulmonary tuberculosis.