疏肝清热法治疗粉刺性乳痈的用药规律研究  

Study on medication rule of soothing liver and clearing heat in treatment of comedomastitis

作　　者：陈豪[1] 杨铭[2] 陈红风[3] CHEN Hao;YANG Ming;CHEN Hongfeng(Department of Mammary Gland of Integrated Traditional Chinese and Westem Medicine,Longhua Hospital,Shanghai University of Traditional Chinese Medicine,Shanghai 200032,China;Office of GCP,Longhua Hospital,Shanghai University of Traditional Chinese Medicine,Shanghai 200032,China;Breast Department of Traditional Chinese Medicine,Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 200032,China)

机构地区：[1]上海中医药大学附属龙华医院中西医结合乳腺科,上海200032 [2]上海中医药大学附属龙华医院药物临床试验机构办公室,上海200032 [3]上海中医药大学附属龙华医院中医乳腺科,上海200032

出　　处：《上海中医药杂志》2022年第8期22-26,共5页Shanghai Journal of Traditional Chinese Medicine

基　　金：国家中医药管理局全国中医学术流派传承工作室第二轮建设项目(国中医药人教函[2019]62号);第七批全国老中医药专家学术经验继承工作项目(国中医药人教函[2022]76号)

摘　　要：目的通过数据挖掘技术研究分析疏肝清热法治疗粉刺性乳痈的中药用药规律。方法收集2019年1月至2021年12月上海中医药大学附属龙华医院门诊粉刺性乳痈患者(肝经郁热证)的就诊记录和处方,运用中药网络药理学分析系统(TCMNPAS)进行数据挖掘分析(BK算法、复杂系统熵网络)。结果①共收录分析处方28530张,涉及中药526味,累计用药频次416463次。②使用频率超过20%的有24味中药,使用频次超过10000(>35%)的有9味中药(蒲公英、柴胡、皂角刺、生山楂、当归、芥子、莪术、黄芩、丹参)。③中心度前30位的中药,主要为蒲公英、柴胡、皂角刺等。关联度值前30位的核心药对有白术-茯苓、黄芩-柴胡、天葵子-土茯苓等。④分析后发现4组潜在“核心方”,其中置信度最高的为“皂角刺,黄芩,蒲公英,当归,柴胡,莪术,芥子,浙贝母,甘草,金银花”。结论疏肝清热法是中医药治疗粉刺性乳痈的经典内治法则之一,药用柴胡、陈皮、郁金、蒲公英、黄芩、白花蛇舌草、甘草、夏枯草、忍冬藤、土茯苓等疏肝清热,根据患者病情,在疏肝清热内治法则的基础上可配合使用当归、莪术、丹参等活血化瘀,芥子、鹿角、肉桂、炮姜等温阳散结,浙贝母、白术、陈皮、半夏等化痰散结,皂角刺、黄芪等消肿托毒。Objective To study and analyze the medication rule of soothing the liver and clearing heat in the treatment of comedomastitis by data mining technology.Methods Medical records and prescriptions of the patients with comedomastitis(syndrome of heat stagnation in liver meridian)were collected in Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine from January 2019 to December 2021,and data mining analysis(BK algorithm,complex system entropy network)was performed using TCMNPAS,a TCM network pharmacology analysis system.Results①A total of 28530 prescriptions were analyzed,involving 526 traditional Chinese herbal medicines,with a cumulative frequency of 416463 times.②There were 24 traditional Chinese herbal medicines with a frequency of more than 20%,and 9 traditional Chinese herbal medicines with a frequency of more than 10000(>35%)including Chinese herbal medicines such as(Taraxaci Herba,Bupleuri Radix,Gleditsiae Spina,raw Crataegi Fructus,Angelicae Sinensis Radix,Sinapis Semen,Curcumae Rhizoma,Scutellariae Radix,Salviae Miltiorrhizae Radix Et Rhizoma).③The top 30 traditional Chinese medicines were mainly Taraxaci Herba,Bupleuri Radix,Gleditsiae Spina,and so on.The top 30 core drug pairs of correlation value were Atractylodis Macrocephalae Rhizoma-Poria,Scutellariae Radix-Bupleuri Radix,Semiaquilegiae Radix-Smilacis Glabrae Rhizoma,and so on.④After analysis,four groups of potential“core prescriptions”were found,among which the one with the highest confidence was Gleditsiae Spina,Scutellariae Radix,Taraxaci Herba,Angelicae Sinensis Radix,Bupleuri Radix,Curcumae Rhizoma,Sinapis Semen,Fritillariae Thunbergii Bulbus,Glycyrrhizae Radix Et Rhizoma and Lonicerae Japonicae Flos.Conclusions The method of soothing the liver and clearing heat is one of the classic internal treatment rules of TCM for comedomastitis,which often includs the Chinese herbal medicines such as Bupleuri Radix,Citri Reticulatae Pericarpium,Curcumae Radix,Taraxaci Herba,Scutellariae Radix,Oldenlandia,Glycyrrhiza

关 键 词：粉刺性乳痈 浆细胞性乳腺炎 疏肝清热 数据挖掘 用药规律 中药研究 

分 类 号：R269[医药卫生—中西医结合]