洪钦国治疗原发性肾病综合征用药规律探讨  

Exploration of Medication Rules of Professor HONG Qin-Guo in Treating Primary Nephrotic Syndrome

作　　者：张恩[1] 兰聪颖 洪钦国[1] ZHANG En;LAN Cong-Yin;HONG Qin-Guo(The First Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangzhou 510405 Guangdong,China;Guangzhou University of Chinese Medicine,Guangzhou 510405 Guangdong,China)

机构地区：[1]广州中医药大学第一附属医院,广东广州510405 [2]广州中医药大学,广东广州510405

出　　处：《广州中医药大学学报》2019年第4期592-596,共5页Journal of Guangzhou University of Traditional Chinese Medicine

基　　金：全国名老中医药专家洪钦国名医工作室建设基金资助项目(国中医药人教发〔2014〕20号)

摘　　要：收集洪钦国教授治疗原发性肾病综合征的门诊处方,采用"中医传承辅助平台"分析洪钦国教授治疗原发性肾病综合征的用药规律。结果共筛选出洪钦国教授治疗原发性肾病综合征的处方182首,涉及中药168味,使用频次在30次以上的中药有丹参、黄芪、山药等22味,可归为益气健脾、滋肾养阴、祛风解表、清热利湿及活血化瘀5类药。证型分布依次为气虚风水占33.5%,阴虚湿热占30.7%,瘀水互结占19.2%,阳虚水泛占16.4%。药物组合及关联规则分析结果显示高频药物组合多为益气健脾药与滋肾养阴、解表祛风、活血化瘀中药的组合(可归为玉屏风散合二至丸加解表、清热中药),聚类分析后得到4首候选新处方。结果以数据阐释了洪钦国教授临证治疗原发性肾病综合征的思路:治疗原则为"扶正、御邪、清热、活血",治法以益气养阴为主,佐以活血、解表、清热,药物组合多选择益气、养阴、活血、解表、清热中药。The prescriptions prescribed by professor HONG Qin-Guo for the treatment of primary nephrotic syndrome(PNS)in the clinic were collected for the investigation of medication rules for PNS by using Traditional Chinese Medicine Inheritance Support Platform(TCMISP).A total of 182 prescriptions involving 168 herbs were enrolled into the analysis.There were 22 herbs(Radix Salviae Miltiorrhizae,Radix Astragali,Rhizoma Dioscoreae,etc.)with the frequency being and over 30,which can be classified into categories of replenishing Qi and invigorating spleen,nourishing kidney yin,expelling wind and releasing exterior,clearing heat and draining dampness,and activating blood and removing stasis.The distribution of syndrome types was shown as Qideficiency wind edema(33.5%),yin-deficiency damp heat(30.7%),blending of blood stasis with retained fluid(19.2%),and fluid retention due to yang deficiency(16.4%).The results of herbal combination and herbal association rule analysis showed that the frequently-used herbal combinations were usually composed of herbs for replenishing Qi and invigorating spleen together with the herbs for nourishing kidney yin,expelling wind and releasing exterior,and activating blood and removing stasis,which were the main compositions of Yupingfeng Powder plus Erzhi Pills combined with the herbs for relieving exterior and clearing heat.Four new candidate recipes were obtained by cluster analysis.The results reflected the thoughts of professor HONG Qin-Guo for the treatment of PNS after digital mining as follows:the therapeutic principles for PNS are supporting healthy Qi,eliminating pathogens,clearing heat and activating blood,the therapies are replenishing Qi and nourishing yin assisted by activating blood,relieving exterior and clearing heat,and the herbal combinations are usually composed of herbs for replenishing Qi,nourishing yin,activating blood,releasing exterior,and clearing heat.

关 键 词：原发性肾病综合征 益气养阴 活血 清热 解表 玉屏风散 二至丸 中医传承辅助平台 洪钦国 

分 类 号：R256.51[医药卫生—中医内科学]