艾滋病合并肝硬化腹腔积液的名老中医用药规律研究  

Regularities of Prescribing Therapy for AIDS Combined with Ascites Due to Cirrhosis by an Elderly Famous TCM Doctor Named LI Fa-zhi

作　　者：王丹妮[1,2,3] 陈莉华 吴瑞红[1] 许前磊 张晓伟[1,2,3] 张丽 孙苗娜[1] 邬欣怡 郭会军[1,2,3] WANG Dan-ni;CHEN LI-hua;WU Rui-hong;XU Qian-lei;ZHANG Xiao-wei;ZHANG Li;SUN Miao-na;WU Xin-yi;GUO Hui-jun(AIDS Clinical Research Center,The First Affiliated Hospital of Henan University of TCM,Zhengzhou 450000,China;Key Research Division of AIDS,State Administration of Traditional Chinese Medicine of the People's Republic of China,Zhengzhou 450000,China;Henan Key Laboratory of Viral Diseases Control with TCM,Zhengzhou 450000,China)

机构地区：[1]河南中医药大学第一附属医院艾滋病临床研究中心,河南省郑州市450000 [2]国家中医药管理局艾滋病重点研究室,河南省郑州市450000 [3]河南省病毒性疾病重点实验室,河南省郑州市450000

出　　处：《中国全科医学》2018年第4期486-490,共5页Chinese General Practice

基　　金：国家科技重大专项(2012ZX10005010-001-002);国家自然科学基金资助项目(81102575);国家中医药管理局基地专项(JDZX2015164);河南省特色学科中医学学科建设项目(STS-ZYX-2017017);2015年河南中医学院中医药与经济社会发展研究中心科研项目(2015JDYB15);2016年河南中医学院科技创新人才项目(2016XCXRC03)

摘　　要：目的探讨名老中医李发枝教授治疗艾滋病合并肝硬化腹腔积液的用药规律。方法从"名老中医临床信息采集系统"数据库中选取2007年10月—2014年9月接受名老中医李发枝教授治疗的艾滋病合并肝硬化腹腔积液患者259例,剔除19例治疗无效患者,最终纳入患者240例,共计794例次。采用中医临床复杂网络分析系统(Liquorice软件)进行描述性统计分析和复杂网络分析。结果李发枝教授治疗艾滋病合并肝硬化腹腔积液使用频次较高的3种药物分别为白术(770次)、黄芪(761次)、泽泻(707次);药物配伍频度较高的3项分别为白术-黄芪(747)、茯苓-泽泻(698)、当归-泽泻(696)。核心药物为白术、黄芪、茯苓等补气健脾利水之品,当归、川芎等活血之品,白芍、柴胡、紫苏叶等敛肝疏肝行气之品,泽泻、防己、木瓜、大腹皮、茯苓皮、冬瓜皮等利水消肿之品。核心处方为当归芍药散合防己黄芪汤、鸡鸣散加减。结论李发枝教授治疗艾滋病合并肝硬化腹腔积液以疏肝健脾理气、利水消肿为要,兼顾血之瘀、气之虚、气之滞。Objective To investigate the regularities of prescribing therapy for AIDS combined with ascites due to cirrhosis by LI Fa-zhi,an aged famous TCM doctor.Methods According to the inclusion and exclusion criteria,from Elderly Famous TCM Doctors'Clinical Diagnosis and Treatment Data Collection System,we selected 259 cases of AIDS combined with ascites due to cirrhosis treated by professor LI Fa-zhi from October 2007 to September 2014 and finally enrolled 240 cases(totaled 794 visits)after excluding 19 cases without response.Complex Network Analysis System for Clinical TCM-treated Cases(Liquorice software)was used for descriptive statistical analysis and complex network analysis.Results For AIDS combined with ascites due to cirrhosis treated by LI Fa-zhi,the three drugs used most frequently were Atractylodes(770 times),Astragalus membranaceus(761 times)and Alisma(707 times);the three combinations used most commonly were Atractylodes-Astragalus membranaceus(747 times),Poria cocos-Alisma(698 times)and Angelica-Alisma(696 times);the core drugs used for invigorating qi and spleen and promoting dieresis,for activating blood circulation,for astringing liver,soothing liver and promoting the circulation of qi,for inducing diuresis to reduce edema,were Atractylodes,Astragalus membranaceus and Poria cocos,Angelica and Ligusticum wallichii,White peony root,Bupleurum,and Folia perillae acutae,Alisma,Radix stephaniae tetrandrae,Fructus chaenomelis lagenariae,Pericarpium arecae,Indian bread exodermis and Epicarpium benincasae,respectively;the core prescriptions were Dangguishaoyao powder with Fangjihuangqi decoction,Modified Jiming powder,respectively.Conclusion LI Fa-zhi treats this disease mainly by soothing liver,invigorating the spleen,regulating qi,inducing diuresis for removing edema,as well as removing blood stasis,nourishing qi and eradicating qi stagnation.

关 键 词：获得性免疫缺陷综合征 肝硬化腹腔积液 李发枝 复杂网络分析 中药疗法 

分 类 号：R512.91[医药卫生—内科学] R657.31[医药卫生—临床医学]