中药治疗糖尿病黄斑水肿临床用药特征探讨  

Administrative features of Chinese medicinals in treatment of diabetic macular edema

作　　者：胡元春[1] 接传红[1] 吴正正[1] 蔡文静 王建伟[1] Hu Yuanchun;Jie Chuanhong;Wu Zhengzheng;Cai Wenjing;Wang Jianwei(Eye Hospital, China Academy of Chinese Medical Sciences, Beijing 100040, China)

机构地区：[1]中国中医科学院眼科医院,北京100040

出　　处：《北京中医药大学学报》2018年第5期434-440,共7页Journal of Beijing University of Traditional Chinese Medicine

基　　金：首都卫生发展科研专项重点攻关资助项目(No.2016-1-4181);中国中医科学院自主选题资助项目(No.ZZ0808008)~~

摘　　要：目的探讨中药治疗糖尿病黄斑水肿(DME)临床用药规律,分析糖尿病黄斑水肿中药辨证施治特点。方法全面收集国内外期刊公开发表的中药汤剂治疗糖尿病黄斑水肿的文献,使用Excel 2007建立药物数据库,采用IBM SPSS Statistics 20进行基础数据分析、频数统计分析,采用IBM SPSS Modeler 14.1软件中的Apriori算法建立关联分析模型,进行中药处方的数据挖掘,分析中药治疗DME核心药物、核心药对、核心用药组合,探索中药处方规律。结果本研究共纳入54篇文献,540频次药物使用,99种药物。药物使用频次前10位的单味药物为茯苓、泽泻、黄芪、当归、川芎、猪苓、生地黄、白术、丹参、车前子。共19种证候,分三大类:痰瘀阻滞类、脾虚水停类、气血阴阳亏虚类。2项关联规则前4位为黄芪→茯苓,泽泻→茯苓,当归→川芎,当归→茯苓;3项关联规则前3位为川芎、当归→茯苓,当归、茯苓→泽泻,泽泻、黄芪→茯苓;4项关联规则前3位为川芎、当归、茯苓→泽泻,当归、黄芪、茯苓→川芎,当归、黄芪、茯苓→泽泻。结论分析得出以补气利水为主,活血补血为辅的核心药物使用特征;DME中医病机为气血阴阳亏虚以致水湿内停,日久痰瘀互结,阻滞目络。Objective To analyze the law of medicinals and discuss rules of clinical administration of Chinese medicinals and features of pattern differentiation and treatment in treatment of diabetic macular edema（DME）. Methods The literature using TCM decoctions for treating DEM published at home and abroad were collected,analyzed and studied by applying modern computer data mining technology The core medicinals,core couplet medicinals and core medicinal combinations were analyzed,and the presicriptvons law was explored. Results A total of 54 articles were included in this study involving 99 kinds of medicinals with a total frequency of 540 counts. The top ten frequent single medicinals were Fuling（Indian Bread, Poria）, Zexie（Oriental Waterplantain Rhizome, Rhizoma Alismatis）, Huangqi（Milkvetch Root,Radix Astragali seu Hedysari）,Danggui（Chinese Angelica,Radix Angelicae Sinensis）,Chuanxiong（Sichuan Lovage Rhizome,Rhizoma Ligustici Chuanxiong）,Zhuling（Chuling,Polyporus）,Shengdihuang（Unprocessed Rehmannia Root,Radix Rehmanniae Recens）,Baizhu（White Atractylodes Rhizome,Rhizoma Atractylodis Macrocephalae）,Danshen（Salvia Root,Radix Salviae Miltiorrhizae）,and Cheqianzi（Plantain Seed,Semen Plantaginis）. There were 19 types of TCM patterns,which were divided into 3 categories： phlegm-stasis obstruction,spleen deficiency and water retention,and qi-blood and yin-yang deficiency. The top four couplet medicinals according to association rules were Fuling-Huangqi,Fuling-Zexie,Chuanxiong-Danggui,Fuling-Danggui. The top three-medicinal combinations according to association rules were Fuling-Chuanxiong-Danggui,Zexie-Danggui-Fuling,and Fuling-Zexie-Huangqi. The top three four-medicinal combinations according to association rules were Zexie-Chuanxiong-Danggui-Fuling,Chuanxiong-Danggui＋ Huangqi＋ Fuling,and Zexie-Danggui-Huangqi-Fuling. Conclusion DME was treated mainly with medicinals with effects of tonifying qi and inducing dieresis,and with medicinals with effects of activating blood and en

关 键 词：中医药 数据挖掘 糖尿病黄斑水肿 用药特点 

分 类 号：R255.4[医药卫生—中医内科学]