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
目的探讨养心通脉Ⅱ号方治疗气阴两虚血瘀型慢性心力衰竭患者的临床疗效。方法将72例气阴两虚血瘀型慢性心力衰竭患者随机分为对照组36例和中药组36例,最终有70例患者完成试验(对照组和中药组各有1例患者脱落)。对照组予常规抗心衰治疗...目的探讨养心通脉Ⅱ号方治疗气阴两虚血瘀型慢性心力衰竭患者的临床疗效。方法将72例气阴两虚血瘀型慢性心力衰竭患者随机分为对照组36例和中药组36例,最终有70例患者完成试验(对照组和中药组各有1例患者脱落)。对照组予常规抗心衰治疗,中药组在对照组基础上,加用养心通脉Ⅱ号方治疗,连续治疗4周。对比两组患者治疗前后的中医症状积分及中医症状疗效。运用6分钟步行试验(6 minutes walk test,6MWT)及明尼苏达心力衰竭量表(Minnesota living with heart failure question-naire,MLHFQ)评估两组患者的运动耐量及生活质量。评定患者治疗前后的纽约心脏病学会(New York Heart Association,NYHA)心功能分级,计算NYHA心功能疗效标准;测定两组患者治疗前后N-末端B型钠尿肽前体(N-terminal-pro-brain natriuretic peptide,NT-proBNP)水平及左心射血分数(left ventricular ejection fraction,LVEF),评定患者心功能的变化。检测两组患者治疗前后一氧化氮(nitric oxide,NO)、内皮素-1(endothelin-1,ET-1)水平,以了解患者内皮功能的变化。结果治疗后,两组患者中医症状积分均低于治疗前(P<0.05),且中药组降低幅度更大(P<0.05)。中药组中医症状总有效率为91.42%,对照组的总有效率为80.88%,中药组明显高于对照组(P<0.05)。NYHA心功能疗效方面,中药组疗效(85.71%)明显高于对照组(68.57%),差异有统计学意义(P<0.05)。治疗后两组患者的6MWT高于治疗前,MLHFQ低于治疗前(P<0.05),且中药组的6MWT明显高于对照组,MLHFQ明显低于对照组(P<0.05)。治疗后两组LVEF、NO均高于治疗前(P<0.05),中药组较对照组升高更显著(P<0.05)。两组患者NT-proBNP、ET-1较治疗前降低(P<0.05),且中药组降低幅度更明显(P<0.05)。结论在常规西医治疗基础上加用养心通脉Ⅱ号方可显著提高气阴两虚血瘀型慢性心力衰竭患者的临床疗效,减轻心衰症状,改善运动耐力和生活质量,提高心功能,改善血管内皮功能,促进心衰患者康复。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.
文摘目的探讨养心通脉Ⅱ号方治疗气阴两虚血瘀型慢性心力衰竭患者的临床疗效。方法将72例气阴两虚血瘀型慢性心力衰竭患者随机分为对照组36例和中药组36例,最终有70例患者完成试验(对照组和中药组各有1例患者脱落)。对照组予常规抗心衰治疗,中药组在对照组基础上,加用养心通脉Ⅱ号方治疗,连续治疗4周。对比两组患者治疗前后的中医症状积分及中医症状疗效。运用6分钟步行试验(6 minutes walk test,6MWT)及明尼苏达心力衰竭量表(Minnesota living with heart failure question-naire,MLHFQ)评估两组患者的运动耐量及生活质量。评定患者治疗前后的纽约心脏病学会(New York Heart Association,NYHA)心功能分级,计算NYHA心功能疗效标准;测定两组患者治疗前后N-末端B型钠尿肽前体(N-terminal-pro-brain natriuretic peptide,NT-proBNP)水平及左心射血分数(left ventricular ejection fraction,LVEF),评定患者心功能的变化。检测两组患者治疗前后一氧化氮(nitric oxide,NO)、内皮素-1(endothelin-1,ET-1)水平,以了解患者内皮功能的变化。结果治疗后,两组患者中医症状积分均低于治疗前(P<0.05),且中药组降低幅度更大(P<0.05)。中药组中医症状总有效率为91.42%,对照组的总有效率为80.88%,中药组明显高于对照组(P<0.05)。NYHA心功能疗效方面,中药组疗效(85.71%)明显高于对照组(68.57%),差异有统计学意义(P<0.05)。治疗后两组患者的6MWT高于治疗前,MLHFQ低于治疗前(P<0.05),且中药组的6MWT明显高于对照组,MLHFQ明显低于对照组(P<0.05)。治疗后两组LVEF、NO均高于治疗前(P<0.05),中药组较对照组升高更显著(P<0.05)。两组患者NT-proBNP、ET-1较治疗前降低(P<0.05),且中药组降低幅度更明显(P<0.05)。结论在常规西医治疗基础上加用养心通脉Ⅱ号方可显著提高气阴两虚血瘀型慢性心力衰竭患者的临床疗效,减轻心衰症状,改善运动耐力和生活质量,提高心功能,改善血管内皮功能,促进心衰患者康复。
