基于临床科研信息共享系统的慢性乙型肝炎中药用药规律分析  

Analysis of Medication Rules of Chinese Herbs on Chronic Hepatitis B Treatment Based on Clinical Research Information Integration System

作　　者：郭明星[1] 李晓东[2] 盛国光[2] 吴辉坤[2] 李慧[2] 黄晶晶[2] 

机构地区：[1]武汉市中心医院中医科,武汉430014 [2]湖北省中医院肝病科,武汉430061

出　　处：《世界科学技术-中医药现代化》2016年第3期350-354,共5页Modernization of Traditional Chinese Medicine and Materia Medica-World Science and Technology

基　　金：国家中医药管理局中医临床研究基地科研专项课题(JDZX2012051):中医治疗慢性乙型肝炎真实世界效果比较研究;负责人:李晓东;国家"十二五"传染病重大专项子课题(2012ZX10005004-002):慢性乙型病毒性肝炎(HBe Ag阴性)患者中西医结合治疗方案优化研究;负责人:李晓东

摘　　要：目的:分析探讨基于临床科研信息共享系统的慢性乙型肝炎中药用药规律,提高临床疗效。方法:应用高度结构化电子病历系统,对2002-2013年慢性乙型肝炎住院患者的信息进行采集,利用复杂网络技术对中药用药部分进行数据挖掘与分析,探求慢性乙型肝炎的中药应用规律、性味归经分布规律、辨证用药演变规律。结果:1 1 200例慢性乙型肝炎住院患者所用中药188种,累计使用中药18 952频次,最常用的5味中药是茯苓、茵陈、白术、丹参、郁金;2中药药味以苦味药和甘味药为主,其次是辛味药;中药药性多为寒、温、平的中药;中药归经以归脾经、肝经的中药为主;3中药用药经历从"清热解毒药为主"到"解毒、活血、化痰药并重"再到"扶正药为主,兼有解毒、活血、化痰药"的过程。结论:性味归经分布规律显示慢性乙型肝炎"从肝脾论治"、"平调阴阳,以平为期"的辨证治疗思想;用药演变规律显示慢性乙型肝炎的辨证思想经历从"毒"到"毒痰瘀"再到"毒痰瘀虚"的转变,在辨证用药上逐步注重"扶正",阐释了"扶正解毒、祛瘀化痰"治疗思路的科学性。This study was aimed to investigate the medication rules of Chinese herbs on chronic hepatitis B treatment based on the Clinical Research Information Integration System and to improve the clinical efficacy. With a highly structured electronic medical records system, through the information collection and processing of chronic hepatitis B patients from 2002 to 2013, the complex network technology of data mining was applied. The medication rules, property, taste, channel tropism and distribution rules of Chinese herbs on chronic hepatitis B treatment were explored according to syndrome differentiation. The results showed that among 1,200 chronic hepatitis B cases, 188 kinds of Chinese herbs appeared 18,952 times. Among them, the most commonly used Chinese herbs were poria, virgate wormwood herb, atractylodes, salvia miltiorrhiza, curcuma aromatica. The main tastes were bitter and sweet, followed by the pungent taste. Properties of most Chinese herb were cold, warm and flat. The main channel tropisms were the spleen meridian and liver meridian. The medication experiences of Chinese herbs were from ＂heat-clearing and alexipharmic agent＂ to ＂alexipharmic, hemorheologic agent and apophlegmatisant＂, and then to ＂strengthening the body resistance agent, combined with alexipharmic, hemorheologic agent and apophlegmatisant＂. It was concluded that the property, taste, channel tropism and distribution rules showed that the syndrome differentiation and treatment of chronic hepatitis B were from ＂treatment of the liver and spleen＂, ＂yin-yang regulation＂. Medication experiences of Chinese herbs in chronic hepatitis B treatment were from ＂toxin＂ to ＂toxin-phlegm-stasis＂, and then ＂toxin-phlegm-stasis-deficiency＂. Medication based on syndrome differentiation should focus on ＂strengthening the body resistance＂. It interpreted the scientific treatment principle of ＂Fuzheng Jiedu Quyu Huatan＂.

关 键 词：临床科研信息共享系统 结构化电子病历 慢性乙型肝炎 用药规律 

分 类 号：R373.21[医药卫生—病原生物学]