中医药治疗乙型肝炎肝硬化用药规律的文献研究  

Literature research on TCM medication law of HBV-related hepatocirrhosis

作　　者：杨先照[1,2] 江锋[2,3] 茹淑瑛[2,4] 张鹏[2,3] 李莹[2,3] 张露丹[2,3] 叶永安[2,3] 

机构地区：[1]北京中医药大学东直门医院感染科,北京100700 [2]北京中医药大学肝病研究所,北京100700 [3]北京中医药大学东直门医院脾胃病科,北京100700 [4]北京中医药大学东直门医院东区脾胃病科,北京101100

出　　处：《中国医药导报》2017年第18期157-160,180,共5页China Medical Herald

基　　金：国家自然科学基金资助项目(81603555);国家"十二五"科技重大专项项目(2012ZX10005010-002-005);北京市自然科学基金资助项目(7174319)

摘　　要：目的基于既往临床研究文献资料来分析中医药治疗乙型肝炎肝硬化的用药规律。方法通过系统检索Pub Med、中国生物医学文献数据库、中国知网、万方数据知识服务平台、维普网5个电子数据库,纳入从建库至2016年9月有关中医药治疗乙型肝炎肝硬化的临床研究文献。建立中医药治疗乙型肝炎肝硬化的方药数据库,统计每味药物使用频次,同时对所有药物的功效、性、味进行分类分析。结果纳入研究的文献共118篇,涉及中药复方121首,药物204味,共计1356药次。研究中所涉及的204味药物中使用频数>30次的药物共11味,按频次排前5位的依次为黄芪、丹参、鳖甲、白术、柴胡。所涉及的204味药物按功效不同可分为19类,使用频率最高的前5位依次为补虚药、活血化瘀药、清热药、利水渗湿药、理气药,药物累计使用频率达80.23%;而在所有药物的药性频数统计中,使用频率最高的前3位依次为寒、温、平,寒性药物使用频率达37.75%;药味频数统计中,使用频率最高的前3位依次为苦、甘、辛,苦味药物使用频率达32.40%。结论中医药治疗乙型肝炎肝硬化总的治则是将扶正和祛邪相结合,在具体治法上,以益气健脾养阴为基础,辨证施以活血化瘀、清热解毒、利水祛湿和疏肝理气。Objective To analyze the traditional Chinese medicine（TCM） medication law of HBV-related hepatocirrhosis based on the past clinical research literatures. Methods The clinical research literatures on TCM for HBV-related hepatocirrhosis from inception to September 2016 was searched in Pub Med, Chinese biomedical literature database（CBM）, China National Knowledge Infrastructure（CNKI）, Wan Fang Data, VIP network. A database of TCM decoctions for HBV-related hepatocirrhosis was established. The frequency of medication was analyzed. The effect, nature and flavor of herbs were descriptively analyzed. Results A total of 118 articles were included. There were 121 prescriptions,204 herbs and 1356 herb frequency involved. There were 11 herbs with a frequency greater than 30. The top 5 were Radix Astragali, Radix Salviae Miltiorrhizae, Carapax Trionycis, Rhizoma Atractylodis Macrocephalae and Radix Bupleuri. The 204 herbs could be divided into 19 categories according to the effect. The top 5 were deficiency-supplementing herb, blood-quickening stasis-transforming herb, heat-clearing herb, dampness-removing herb and qi-regulating herb, with a total frequency of80.23%. In the frequency of herb nature, the top 3were cold, warm and calm. The total frequency of cold herbs and slightly cold herbs was 37.75%. In the frequency of herb flavor, the top 3 were bitter, sweet and pungent. The frequency of bitter herbs was 32.40%. Conclusion The general rule of TCM in the treatment of HBV-related hepatocirrhosis is strengthening the body resistance and eliminating pathogenic factors. In the specific principle,on the basis of qi-boosting spleen-supplementing yin-nourishing therapy, blood-quickening stasis-transforming therapy, heat-clearing toxin-resolving therapy, dampness-clearing therapy and liver-coursing qi-rectifying therapy are often used in treating HBV-related hepatocirrhosis.

关 键 词：中医药 慢性乙型肝炎 肝硬化 用药规律 文献研究 

分 类 号：R657.31[医药卫生—外科学]