目的:运用数据挖掘方法,研究中药复方治疗糖尿病肾脏病(DKD)气阴两虚兼血瘀证的用药规律,为临床遣方用药提供依据。方法:检索中国知网、维普、万方、中国生物医学文献数据库近10年收录的中药复方治疗DKD气阴两虚兼血瘀证的临床研究文献...目的:运用数据挖掘方法,研究中药复方治疗糖尿病肾脏病(DKD)气阴两虚兼血瘀证的用药规律,为临床遣方用药提供依据。方法:检索中国知网、维普、万方、中国生物医学文献数据库近10年收录的中药复方治疗DKD气阴两虚兼血瘀证的临床研究文献,对检索文献进行筛选,提取合格文献中方药信息构建数据库,进行频次分析、关联规则分析和系统聚类分析。结果:共纳入163篇合格文献,包含163首有效处方,涉及170味中药,中药总频次为1874次。其中,使用频次 > 20次的高频中药有26味,排名前5位的中药分别是黄芪、丹参、山茱萸、山药和生地黄。高频中药共涉及8种功效类别,使用频率靠前的为补虚药、活血化瘀药、收涩药、清热药、利水渗湿药。高频中药性味归经分析表明,药性以平、温、寒为主;药味以甘、苦、辛为主;归经以肝、脾、肾、肺为主。关联规则分析表明,“山茱萸→黄芪”、“黄芪、山药→山茱萸”和“茯苓、山药、山茱萸→黄芪”分别为2种、3种和4种药物关联规则中支持度最高的组合。系统聚类分析显示,聚为4类时最佳。结论:中药复方治疗DKD气阴两虚兼血瘀证以益气养阴、活血通络为基本大法,重在健脾益肺、补益肝肾;用药以甘补、苦坚、辛行,寒温平调;提炼出“黄芪、山茱萸、山药”为核心药物组合,黄芪葛根汤、补阳还五汤、参芪地黄汤、水陆二仙丹为常用处方。Objective: Using the method of data mining, this paper studies the medication rule of traditional Chinese medicine compound in the treatment of diabetic kidney disease (DKD) with Qi-Yin deficiency and blood stasis syndrome, and provides the basis for clinical prescription. Methods: The clinical research literatures of traditional Chinese medicine compound for the treatment of DKD with qi-yin deficiency and blood stasis syndrome collected by CNKI, VIP, Wanfang Data and CBM database in recent 10 years were retrieved. The retrieved literatures were screened, and the prescription information in the qualified literature was extracted to construct the database for frequency analysis, association rule analysis and systematic clustering analysis. Results: A total of 163 eligible literatures were included, including 163 effective prescriptions, involving 170 traditional Chinese medicines. The total frequency of traditional Chinese medicines was 1874 times, and 26 high-frequency traditional Chinese medicines with a frequency > 20 times were obtained. Among them, the top 5 traditional Chinese medicines with the highest frequency were Astragalus membranaceus, Salvia miltiorrhiza, Cornus officinalis, Chinese yam and Rehmannia glutinosa. The high-frequency traditional Chinese medicine involves a total of 8 efficacy categories, and the most frequently used are tonic drugs, blood-activating and stasis-resolving drugs, astringent drugs, heat-clearing drugs, and damp-draining diuretics. According to the analysis of the property, taste and meridian tropism of high-frequency traditional Chinese medicine, the medicinal properties are mainly flat, warm and cold;the medicinal tastes are mainly sweet, bitter and spicy;the medicinal meridian tropisms are mainly liver, spleen, kidney and lung. Association rule analysis showed that “Cornus officinalis → Astragalus membranaceus”, “Astragalus membranaceus, Chinese yam → Cornus officinalis” and “Poria cocos, Chinese yam, Cornus officinalis → Astragalus membranaceus” were the most supported combinations of 2, 3 and 4 drug association rules, respectively. The systematic clustering analysis showed that it was the best when clustered into 4 categories. Conclusion: The traditional Chinese medicine compound treatment of DKD with Qi-Yin deficiency and blood stasis syndrome is based on supplementing Qi and nourishing Yin, activating blood and unblocking collaterals, which focuses on strengthening the spleen, lungs, liver and kidney. The medicinal tastes are mainly sweet, bitter and spicy, with the balance of cold and heat. “Astragalus membranaceus, Cornus officinalis and Chinese yam” were extracted as the core drug combination, and Huangqi Gegen Decoction, Buyang Huanwu Decoction, Shenqi Dihuang Decoction, Shuilu Erxian Dan as commonly used prescriptions.展开更多
目的研究益气养阴复脉通络颗粒治疗2型糖尿病下肢血管病变(Lower-extremity arterial Disease,LEAD)气阴两虚兼血瘀证患者的临床疗效及对糖脂代谢、炎症因子与血管内皮功能的影响。方法采用随机数字表法将186例LEAD患者分为对照组和观察...目的研究益气养阴复脉通络颗粒治疗2型糖尿病下肢血管病变(Lower-extremity arterial Disease,LEAD)气阴两虚兼血瘀证患者的临床疗效及对糖脂代谢、炎症因子与血管内皮功能的影响。方法采用随机数字表法将186例LEAD患者分为对照组和观察者,各93例。两组患者均给予降糖、降压及降脂基础治疗;观察组在此基础上采用院内制剂益气养阴复脉通络颗粒治疗,疗程均为24周。监测治疗前后空腹血糖(FPG)、餐后2 h血糖(2 h PG)、糖化血红蛋白(HbAlc)、总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白(LDL-C)、收缩压(SBP)及舒张压(DBP)水平变化;观察治疗前后踝肱指数(ABI)、趾肱指数(TBI)、足背动脉血管内径、血流量及峰值流速指标变化;统计治疗前后中医症状积分与多伦多临床神经病评分(TCSS);检测血清中肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、同型半胱氨酸(Hcy)、超敏C反应蛋白(hs-CRP)、血管内皮生长因子(VEGF)及内皮素-1(ET-1)水平。结果对照组有7例患者脱离治疗方案,完成符合方案为86例;两组患者FPG、2 h PG、HbAlc、TC、TG、LDL-C、SBP及DBP水平均低于治疗前,且观察组低于对照组(P<0.05);两组患者ABI和TBI指数均高于治疗前,且观察组高于对照组(P<0.05);两组患者足背动脉血管内经、血流量及峰值流速改善均优于治疗前,且观察组优于对照组(P<0.05);两组患者中医症状积分与TCSS量表各维度评分均低于治疗前,且观察组低于对照组(P<0.05);两组患者血清中TNF-α、IL-6、Hcy、hs-CRP、VEGF及ET-1水平均低于治疗前,且观察组低于对照组(P<0.05);观察组临床总有效率91.40%高于对照组总有效率77.91%(P<0.05)。结论采用益气养阴复脉通络颗粒治疗可以显著减轻LEAD患者临床症状、改善患者下肢血管功能及血流动力学情况,延缓LEAD进展,其作用机制可能与调节患者糖脂代谢、抑制炎症反应、改善血管内皮功能有关。展开更多
文摘目的:运用数据挖掘方法,研究中药复方治疗糖尿病肾脏病(DKD)气阴两虚兼血瘀证的用药规律,为临床遣方用药提供依据。方法:检索中国知网、维普、万方、中国生物医学文献数据库近10年收录的中药复方治疗DKD气阴两虚兼血瘀证的临床研究文献,对检索文献进行筛选,提取合格文献中方药信息构建数据库,进行频次分析、关联规则分析和系统聚类分析。结果:共纳入163篇合格文献,包含163首有效处方,涉及170味中药,中药总频次为1874次。其中,使用频次 > 20次的高频中药有26味,排名前5位的中药分别是黄芪、丹参、山茱萸、山药和生地黄。高频中药共涉及8种功效类别,使用频率靠前的为补虚药、活血化瘀药、收涩药、清热药、利水渗湿药。高频中药性味归经分析表明,药性以平、温、寒为主;药味以甘、苦、辛为主;归经以肝、脾、肾、肺为主。关联规则分析表明,“山茱萸→黄芪”、“黄芪、山药→山茱萸”和“茯苓、山药、山茱萸→黄芪”分别为2种、3种和4种药物关联规则中支持度最高的组合。系统聚类分析显示,聚为4类时最佳。结论:中药复方治疗DKD气阴两虚兼血瘀证以益气养阴、活血通络为基本大法,重在健脾益肺、补益肝肾;用药以甘补、苦坚、辛行,寒温平调;提炼出“黄芪、山茱萸、山药”为核心药物组合,黄芪葛根汤、补阳还五汤、参芪地黄汤、水陆二仙丹为常用处方。Objective: Using the method of data mining, this paper studies the medication rule of traditional Chinese medicine compound in the treatment of diabetic kidney disease (DKD) with Qi-Yin deficiency and blood stasis syndrome, and provides the basis for clinical prescription. Methods: The clinical research literatures of traditional Chinese medicine compound for the treatment of DKD with qi-yin deficiency and blood stasis syndrome collected by CNKI, VIP, Wanfang Data and CBM database in recent 10 years were retrieved. The retrieved literatures were screened, and the prescription information in the qualified literature was extracted to construct the database for frequency analysis, association rule analysis and systematic clustering analysis. Results: A total of 163 eligible literatures were included, including 163 effective prescriptions, involving 170 traditional Chinese medicines. The total frequency of traditional Chinese medicines was 1874 times, and 26 high-frequency traditional Chinese medicines with a frequency > 20 times were obtained. Among them, the top 5 traditional Chinese medicines with the highest frequency were Astragalus membranaceus, Salvia miltiorrhiza, Cornus officinalis, Chinese yam and Rehmannia glutinosa. The high-frequency traditional Chinese medicine involves a total of 8 efficacy categories, and the most frequently used are tonic drugs, blood-activating and stasis-resolving drugs, astringent drugs, heat-clearing drugs, and damp-draining diuretics. According to the analysis of the property, taste and meridian tropism of high-frequency traditional Chinese medicine, the medicinal properties are mainly flat, warm and cold;the medicinal tastes are mainly sweet, bitter and spicy;the medicinal meridian tropisms are mainly liver, spleen, kidney and lung. Association rule analysis showed that “Cornus officinalis → Astragalus membranaceus”, “Astragalus membranaceus, Chinese yam → Cornus officinalis” and “Poria cocos, Chinese yam, Cornus officinalis → Astragalus membranaceus” were the most supported combinations of 2, 3 and 4 drug association rules, respectively. The systematic clustering analysis showed that it was the best when clustered into 4 categories. Conclusion: The traditional Chinese medicine compound treatment of DKD with Qi-Yin deficiency and blood stasis syndrome is based on supplementing Qi and nourishing Yin, activating blood and unblocking collaterals, which focuses on strengthening the spleen, lungs, liver and kidney. The medicinal tastes are mainly sweet, bitter and spicy, with the balance of cold and heat. “Astragalus membranaceus, Cornus officinalis and Chinese yam” were extracted as the core drug combination, and Huangqi Gegen Decoction, Buyang Huanwu Decoction, Shenqi Dihuang Decoction, Shuilu Erxian Dan as commonly used prescriptions.
文摘目的研究益气养阴复脉通络颗粒治疗2型糖尿病下肢血管病变(Lower-extremity arterial Disease,LEAD)气阴两虚兼血瘀证患者的临床疗效及对糖脂代谢、炎症因子与血管内皮功能的影响。方法采用随机数字表法将186例LEAD患者分为对照组和观察者,各93例。两组患者均给予降糖、降压及降脂基础治疗;观察组在此基础上采用院内制剂益气养阴复脉通络颗粒治疗,疗程均为24周。监测治疗前后空腹血糖(FPG)、餐后2 h血糖(2 h PG)、糖化血红蛋白(HbAlc)、总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白(LDL-C)、收缩压(SBP)及舒张压(DBP)水平变化;观察治疗前后踝肱指数(ABI)、趾肱指数(TBI)、足背动脉血管内径、血流量及峰值流速指标变化;统计治疗前后中医症状积分与多伦多临床神经病评分(TCSS);检测血清中肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、同型半胱氨酸(Hcy)、超敏C反应蛋白(hs-CRP)、血管内皮生长因子(VEGF)及内皮素-1(ET-1)水平。结果对照组有7例患者脱离治疗方案,完成符合方案为86例;两组患者FPG、2 h PG、HbAlc、TC、TG、LDL-C、SBP及DBP水平均低于治疗前,且观察组低于对照组(P<0.05);两组患者ABI和TBI指数均高于治疗前,且观察组高于对照组(P<0.05);两组患者足背动脉血管内经、血流量及峰值流速改善均优于治疗前,且观察组优于对照组(P<0.05);两组患者中医症状积分与TCSS量表各维度评分均低于治疗前,且观察组低于对照组(P<0.05);两组患者血清中TNF-α、IL-6、Hcy、hs-CRP、VEGF及ET-1水平均低于治疗前,且观察组低于对照组(P<0.05);观察组临床总有效率91.40%高于对照组总有效率77.91%(P<0.05)。结论采用益气养阴复脉通络颗粒治疗可以显著减轻LEAD患者临床症状、改善患者下肢血管功能及血流动力学情况,延缓LEAD进展,其作用机制可能与调节患者糖脂代谢、抑制炎症反应、改善血管内皮功能有关。
