肥胖的中医证型和方药规律分析  

Analysis of Syndromes of and Prescriptions Applied to Obesity in Chinese Medicine

作　　者：司富国 陈瑞[2] 司季青[3] 司富春[2] 

机构地区：[1]新郑市中医院,河南新郑451100 [2]河南中医药大学,河南郑州450046 [3]云南中医学院,云南昆明650500

出　　处：《河南中医》2016年第11期2032-2035,共4页Henan Traditional Chinese Medicine

基　　金：国家回国留学人员基金优秀项目[编号:(2007)170];河南省科技创新团队(编号:2010-29);河南省中医学博士后科研创新团队(编号:2012);河南中医药大学中医方证研究协同创新中心[编号:院政字(2014)150号]

摘　　要：目的:对1979年1月—2016年6月中国期刊全文数据库(CNKI)收录的中医药治疗肥胖文献,通过频数分析和聚类分析等数理统计方法总结肥胖的中医证型和方药组成规律,以期为临床治疗和科研提供参考。方法:运用SPSS 18.0统计软件结合中医传统理论对符合纳入标准的文献中的证型、症状、方剂和中药进行频数分析和聚类分析,总结出肥胖的中医证型、主要症状,分析证候要素和脏腑病位,得出相关证候分布规律和方药组成规律。结果:录入文献200篇,统计分析得肥胖证型24个,痰湿内盛、痰瘀互结、脾虚湿盛、脾肾阳虚、气滞血瘀、湿热蕴结为常见证型,共占68.01%。证候要素分实性(湿阻、痰盛、血瘀、气滞、热盛、肝郁、食积)及虚性(气虚、阴虚、阳虚)。频次较高的57个症状聚类得5大类证型:脾虚湿盛型,湿热蕴结、痰瘀互结型,脾肾阳虚型,痰湿内盛、胃热偏盛型,肝肾阴虚型,痰热内结、肝火上炎型。得方剂479首,其中成方214首,以补益剂、和解剂、祛湿剂、祛痰剂为主,自拟方所占比重较大,共265首,以化痰祛湿,补气健脾为主。涉及中药259味,按功能分为19大类,其中补虚药、利水渗湿药、活血化瘀药、清热药、理气药、解表药使用频次较多,占70.82%,药物归经主要为脾、肝、胃、肺、肾、心;对频次较高的中药进行聚类分析,得6个聚类方,分别适合阳虚水泛、湿热蕴结型肥胖,气滞血瘀型肥胖,脾虚湿盛、肝肾阴虚型肥胖,痰湿内盛、食滞痰瘀型肥胖,痰瘀互结型肥胖,脾虚型肥胖。结论:中医对肥胖的治疗有一定的优势,肥胖的中医辨证分型、组方用药规律以及药物的性味、归经等与肥胖的病因、病机密切相关,这些特点和规律可以为临床辨证论治提供有力的参考依据。Objective ： To conclude the syndromes of and prescriptions applied to obesity in Chinese medicine by mathematical sta- tistics method of frequenc＇y analysis and clustering analysis and provide references for clinical treatment and scientific： research based on the literatures on obesity treated with Chinese medicine included in CNK1 between January 1979 and June 2016. Meth- ods ： Frequency analysis and clustering analysis of the literatures accorded with the inclusive criteria were conducted on the syn- dromes, symptoms and prescriptions and Chinese medicine related to obesity with SPSSIS. 0 combined with theory, of traditional Chinese medicine. The TCM syndromes and main symptoms, the symptom factors and visceral location, and the distribution law and prescription-formulating law of the symptoms and signs were concluded. Results ： Among the 200 included literatures, there were 24 commonly seen syndromes of obesity, including internal exuberance of phlegm dampness, intermingling of phlegm and blood stasis, spleen deficiency and dampness exuberance, yang deficiency of the spleen and kidney, qi stagnation and blood sta- sis, accumulation of damp heat, accounting for 68.01%. The syndrome factors were divided into excess factors （damp obstruc- tion, exuberant phlegm, blood stasis, qi stagnation, excessive heat, liver depression, food stagnation） and deficiency factors （qi deficiency, yin deficiency and yang deficiency）. There were 57 symptoms clustering including 5 major syndromes： syndrome of spleen deficiency and dampness exuberance, accumulation of damp heat, intermingling of phlegm and blood stasis, yang deft- ciency of the spleen and kidney, internal exuberance of phlegm dampness, predominant stonach heat, yin deficiency of liver and kidney, intermingling phlegm and heat, and flaming up of liver fire. There were 479 prescriptions, among which 214 prescrip- tions were set prescriptions including mainly tonic prescriptiun, harmonizing prescription, dampness-removing prescription, phlegm-removin

关 键 词：肥胖 中医证型 方药规律 

分 类 号：R259.914.2[医药卫生—中西医结合]