洪钦国治疗原发性肾病综合征用药规律探讨
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摘要
收集洪钦国教授治疗原发性肾病综合征的门诊处方,采用"中医传承辅助平台"分析洪钦国教授治疗原发性肾病综合征的用药规律。结果共筛选出洪钦国教授治疗原发性肾病综合征的处方182首,涉及中药168味,使用频次在30次以上的中药有丹参、黄芪、山药等22味,可归为益气健脾、滋肾养阴、祛风解表、清热利湿及活血化瘀5类药。证型分布依次为气虚风水占33.5%,阴虚湿热占30.7%,瘀水互结占19.2%,阳虚水泛占16.4%。药物组合及关联规则分析结果显示高频药物组合多为益气健脾药与滋肾养阴、解表祛风、活血化瘀中药的组合(可归为玉屏风散合二至丸加解表、清热中药),聚类分析后得到4首候选新处方。结果以数据阐释了洪钦国教授临证治疗原发性肾病综合征的思路:治疗原则为"扶正、御邪、清热、活血",治法以益气养阴为主,佐以活血、解表、清热,药物组合多选择益气、养阴、活血、解表、清热中药。
The prescriptions prescribed by professor HONG Qin-Guo for the treatment of primary nephrotic syndrome(PNS)in the clinic were collected for the investigation of medication rules for PNS by using Traditional Chinese Medicine Inheritance Support Platform(TCMISP). A total of 182 prescriptions involving 168 herbs were enrolled into the analysis. There were 22 herbs(Radix Salviae Miltiorrhizae, Radix Astragali, Rhizoma Dioscoreae,etc.)with the frequency being and over 30,which can be classified into categories of replenishing Qi and invigorating spleen,nourishing kidney yin,expelling wind and releasing exterior,clearing heat and draining dampness, and activating blood and removing stasis. The distribution of syndrome types was shown as Qideficiency wind edema(33.5%),yin-deficiency damp heat(30.7%),blending of blood stasis with retained fluid(19.2%), and fluid retention due to yang deficiency(16.4%). The results of herbal combination and herbal association rule analysis showed that the frequently-used herbal combinations were usually composed of herbs for replenishing Qi and invigorating spleen together with the herbs for nourishing kidney yin, expelling wind and releasing exterior, and activating blood and removing stasis, which were the main compositions of Yupingfeng Powder plus Erzhi Pills combined with the herbs for relieving exterior and clearing heat. Four new candidate recipes were obtained by cluster analysis. The results reflected the thoughts of professor HONG Qin-Guo for the treatment of PNS after digital mining as follows:the therapeutic principles for PNS are supporting healthy Qi,eliminating pathogens,clearing heat and activating blood,the therapies are replenishing Qi and nourishing yin assisted by activating blood,relieving exterior and clearing heat,and the herbal combinations are usually composed of herbs for replenishing Qi,nourishing yin,activating blood,releasing exterior,and clearing heat.
The prescriptions prescribed by professor HONG Qin-Guo for the treatment of primary nephrotic syndrome(PNS)in the clinic were collected for the investigation of medication rules for PNS by using Traditional Chinese Medicine Inheritance Support Platform(TCMISP). A total of 182 prescriptions involving 168 herbs were enrolled into the analysis. There were 22 herbs(Radix Salviae Miltiorrhizae, Radix Astragali, Rhizoma Dioscoreae,etc.)with the frequency being and over 30,which can be classified into categories of replenishing Qi and invigorating spleen,nourishing kidney yin,expelling wind and releasing exterior,clearing heat and draining dampness, and activating blood and removing stasis. The distribution of syndrome types was shown as Qideficiency wind edema(33.5%),yin-deficiency damp heat(30.7%),blending of blood stasis with retained fluid(19.2%), and fluid retention due to yang deficiency(16.4%). The results of herbal combination and herbal association rule analysis showed that the frequently-used herbal combinations were usually composed of herbs for replenishing Qi and invigorating spleen together with the herbs for nourishing kidney yin, expelling wind and releasing exterior, and activating blood and removing stasis, which were the main compositions of Yupingfeng Powder plus Erzhi Pills combined with the herbs for relieving exterior and clearing heat. Four new candidate recipes were obtained by cluster analysis. The results reflected the thoughts of professor HONG Qin-Guo for the treatment of PNS after digital mining as follows:the therapeutic principles for PNS are supporting healthy Qi,eliminating pathogens,clearing heat and activating blood,the therapies are replenishing Qi and nourishing yin assisted by activating blood,relieving exterior and clearing heat,and the herbal combinations are usually composed of herbs for replenishing Qi,nourishing yin,activating blood,releasing exterior,and clearing heat.
引文
[1]王海燕.肾脏病学[M]. 3版.北京:人民卫生出版社,2008:940-960.
[2]周福德.原发性肾病综合征的免疫抑制治疗进展[J].临床药物治疗杂志,2015,13(1):5.
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[4]国家中医药管理局.中医病症诊断疗效标准[M].北京:中国医药科技出版社,2012:37-38.
[5]国家药典委员会.中华人民共和国药典(一部)[M].北京:中国医药科技出版社,2015.
[6]唐仕欢,申丹,卢朋,等.中医传承辅助平台应用评述[J].中华中医药杂志,2015,30(2):329.
[2]周福德.原发性肾病综合征的免疫抑制治疗进展[J].临床药物治疗杂志,2015,13(1):5.
[3]王永钧,鲁盈.肾病综合征的诊断、辨证分型及疗效评定(试行方案)[J].上海中医药杂志,2006,40(10):51.
[4]国家中医药管理局.中医病症诊断疗效标准[M].北京:中国医药科技出版社,2012:37-38.
[5]国家药典委员会.中华人民共和国药典(一部)[M].北京:中国医药科技出版社,2015.
[6]唐仕欢,申丹,卢朋,等.中医传承辅助平台应用评述[J].中华中医药杂志,2015,30(2):329.