前列腺增生症中医治则治法、常用方药文献研究

Literature Research on Traditional Chinese Medicine Therapeutic Principles and Methods and Common Prescriptions of Benign Prostatic Hyperplasia

目的:基于名医名家临证经验,明确前列腺增生症(BPH)中医治则治法以及常用方药的分布规律。方法:系统检索1997年1月1日至2018年12月31日,中国知网、中国生物医学、维普、万方数据库中名医名家诊治BPH相关文献,建立文献分析数据库,整合、分析中医治则治法及遣方用药相关内容,采用SPSS 20. 0软件进行统计,获得BPH中医治则治法及常用方剂和药物分布规律。结果:本研究共纳入合格文献109篇,涉及名医名家66位,得到BPH治则共9种,主要有'标本兼治''攻补兼施''调理阴阳'等;治法共55种,主要有'活血化瘀''清热利湿''温补肾阳''软坚散结''补益肾气'等;且BPH多从肾、脾、肺论治。通过归纳整理得到BPH常用的经方共有38个,使用较多的为'桂枝茯苓丸''滋肾通关丸''补中益气汤''八正散''济生肾气丸'等;常用药物共有217味,以'黄芪''熟地黄''白术''甘草''当归'等补虚药,'牛膝''桃仁''穿山甲''王不留行''丹参'等活血化瘀药,'茯苓''泽泻''车前子'等利水渗湿药为主。结论:BPH的治疗以'标本兼治、攻补兼施'为主要治则,常用'活血化瘀''清热利湿''温补肾阳'等治法,并进行相应的遣方用药。

Objective:Define traditional Chinese medicine(TCM)therapeutic principles and methods and common prescriptions of benign prostatic hyperplasia(BPH)based on clinical experience of famous doctors.Method:China National Knowledge Infrastructure,China Biology Medicine disc,China Science and Technology Journal Database,Wanfang database were systematically retrieved for literatures of famous doctors in diagnosis and treatment of BPH from January 1,1997 to December 31,2018.A literature analysis database was established for integration and analysis of relevant content of TCM therapeutic principles and methods and prescriptions.SPSS20.0 software was used for statistics to obtain TCM therapeutic principles and methods,common prescriptions and drug distribution regularity of BPH.Result:A total of 109 qualified literatures were included in this study,involving 66 famous doctors and experts,and 9 kinds of BPH therapeutic principles were obtained,including'treatment of both symptoms and root cause of disease','tonification and purgation in combination','coordination of Yin and Yang'.There are 55 kinds of therapies,including'promoting blood circulation for removing blood stasis','clearing heat and promoting dampness','warming and recuperating kidney Yang','softening and resolving hard mass'and'invigorating kidney Qi'.And BPH was mostly diagnosed and treated based on kidney,spleen and lung.Through collection and summarization,totally 38 formulas commonly used in treating BPH obtained.The most commonly used ones were'Guizhi Fuling Wan','Zishen Tongguan Wan','Buzhong Yiqi Tang','Bazheng Tang'and'Jisheng Shenqi Wan'.There were 217 commonly used herbs,mainly including'Astragali Radix','Rehmanniae Radix Praeparata','Atractylodis Macrocephalae Rhizoma','Glycyrrhizae Radix et Rhizoma','Angelicae Sinensis Radix','Radix Achyranthis Bidentatae','Peach Kernel','Pangolin Scales','Vaccariae Semen','Salviae Miltiorrhizae Radix et Rhizoma','Poria','Rhizoma Alismatis'and'Plantain Seed'.Conclusion:The treatment of BPH is based on the principles of'treatment of both symptoms and root cause of disease,and tonification and purgation in combination'.The commonly used therapies include prescription for'promoting blood circulation for removing blood stasis','clearing heat and promoting dampness'and'warming and recuperating kidney Yang'.The corresponding prescriptions shall be based on symptoms.