室性早搏中医证候及用药规律文献分析

Literature analysis on TCM syndrome and drug-use rules in ventricular premature beat

目的基于文献分析室性早搏中医证候及用药规律。方法以"室性早搏"作为关键词检索中国期刊全文数据库(CNKI) 2007年1月1日至2017年6月10日中医药口服治疗室性早搏的临床研究文献,建立数据库,应用Frequency法对中医证候、药物功效、性、味、归经分别进行频数统计。结果筛选出符合标准的文献61篇,涉及中医证候17种,方剂61首,药物87味。室性早搏的中医证型主要以虚证(53. 62%)和实证(27. 53%)为主;辨证方法主要采用气血津液辨证(59. 42%),辅助以病因辨证(27. 53%)、脏腑辨证(13. 04%); 87味中药中使用频次≥10次的中药共有27种,使用频次前5位中药分别是甘草、丹参、麦冬、酸枣仁、桂枝; 87种中药按功效可分为20种,使用频次最高的是补气药(18. 76%),其次是安神药(16. 66%)、活血化瘀药(11. 11%)、补血药(9. 00%)、补阴药(8. 10%)、理气药(6. 45%),这6类中药的累计频率达70. 12%;药性出现频率最高的是温(39. 47%),温、平、寒3类药物累积频率达到98. 13%;药味出现频率排在首位的是甘味(42. 88%),甘、苦、辛3类药物累积频率达到87. 28%。药性归经排在首位的是心经(20. 30%),心经、脾经、肺经、肝经、胃经5类药物累积频率达到78. 39%。结论室性早搏中医证型主要以虚证和实证为主,辨证主要采用气血津液辨证,治疗以补气养阴、养心安神、活血化瘀为基本治则,临床常用补气、安神、活血化瘀、补血、滋阴等药物。

Objective To analyze TCM syndromes and drug-use in treatment of ventricular premature best(VPB)based on literature study.Methods Taking'ventricular premature beat'as key word,the relevant clinical trials of VPB treated with oral administration of Chinese herbal drugs were retrieved from CNKI from January 1,2007 to June 10,2017.The database was set up.Using Frequency method,the data including TCM syndrome,drug effects,property,flavor and meridian tropism were analyzed statistically.Results A total of 61 eligible articles were collected,with 17 TCM syndromes,61 formulas and 86 kinds of herbal drugs included.The main syndromes of VPB in TCM are deficiency syndrome(53.62%)and excess syndrome(27.53%).Regarding the methods of syndrome differentiation,the differentiation based on qi,blood and body fluid is predominiated(59.42%),assisted by differentiation according to etiology(27.62%)and zangfu organs(13.04%).Regarding the use frequency,of 87 kinds of herbal drugs,27 kinds of herbal drugs are≥10 times.The top 5 with the highest use frequency are glycyrrhiza,root of red-rooted salvia,radix ophiopogonis,spina date seed and cassia twig.Along with drug effects,87 kinds of drugs are classified into 20 types,in which,the drugs with the highest use frequency include tonic herb(18.76%),tranquilizer(16.66%),herb for activating blood circulation and resolving stasis(11.11%),herb for tonifying blood(9.00%),herb for yin replenishment(8.10%)and herb for regulating qi(6.45%).The cumulative frequency is up to 70.12%among these 6 categories.Regarding herb property,warm property is of the highest frequency(39.47%)and the cumulative frequency is up to 98.13%for warm,neutral and cold properties.Regarding herb flavor,sweet flavor is of the highest frequency(42.88%)and the cumulative frequency is up to 87.28%for sweet,bitter and pungent flavors.Regarding meridian tropism,heart meridian is predominant(20.30%)and the cumulative frequency is up to 78.39%for heart,spleen,lung,liver and stomach meridians.Conclusion The dominant TCM syndromes of VPB are deficiency syndrome and excess syndrome.The dominant differentiation is based on qi,blood and body fluid.The basic principles of treatment are tonifying qi and nourishing yin,nourishing blood and calming down mind,activating blood and resolving stasis.The common herbs in clinical treatment are for qi tonification,tranquilization,activating blood circulation and resolving stasis,tonifying blood and nourishing yin,etc.