以偏头痛为例分析中医临床实践指南中常用方药的遴选原则  

Selection principles and analysis of common prescriptions in clinical practice guidelines of traditional Chinese medicine--case example of migraine

作　　者：付国静 鲁喦[3] 张允岭 廖星[2] 梁晓 魏竞竞 贾敏[3] 陈倩 雷林 FU Guo-jing;LU Yan;ZHANG Yun-ling;LIAO Xing;LIANG Xiao;WEI Jing-jing;JIA Min;CHEN Qian;LEI Lin(Graduate School,Beijing University of Chinese Medicine,Beijing 100029,China;Center for Evidence-based Chinese Medicine,Institute of BasicResearch in Clinical Medicine,China Academy of Chinese Medical Sciences,Beijing 100700,China;Xiyuan Hospital,China Academy of Chinese Medical Sciences,Beijing 100091,China)

机构地区：[1]北京中医药大学研究生院,北京100029 [2]中国中医科学院中医临床基础医学研究所循证医学基础研究室,北京100700 [3]中国中医科学院西苑医院,北京100091

出　　处：《中国中药杂志》2020年第21期5103-5109,共7页China Journal of Chinese Materia Medica

基　　金：国家自然科学基金项目(81774159);中医药诊疗标准化关键技术研究项目(Z0479);国家中医药管理局中医药传承与创新“百千万”人才工程(岐黄学者项目-国家中医药领军人才支持计划)(国中医药人教发[2018]12号);中央级公益性科研院所基本科研业务费专项(ZZ13-024-3);首都卫生发展科研专项(首发2020-2-4173)。

摘　　要：该研究把现有资料多途径检索常用方药,作为中医临床实践指南中常用方药的遴选原则,以《偏头痛中医临床实践指南》中常用方药的遴选为例,检索《国家基本药物目录》《国家基本医疗保险、工伤保险和生育保险药品目录》《中国药典》以及3本中医内科学教材、2本临床实践指南中治疗偏头痛的方药,同时检索中国知网(CNKI)、万方数据库、维普数据库(VIP)自1990—2019年所收录的与名家经验相关的文献,并收集前期临床实践指南问卷调研中32个专家常用方药,归纳分析纳入方药的中医临床适用证型及用药规律。结果显示,《国家基本药物目录》《国家基本医疗保险、工伤保险和生育保险药品目录》《中国药典》共得到12个中成药;指南得到8个方药;教材得到9个方药;名家经验得到3个方药;前期问卷调研结果中得到4个临床专家常用方药。综合以上检索结果,最终得到24个方药。分析纳入方药治疗偏头痛的临床适用证型以外风证、瘀阻脑络证、肝阳化风证为主,其中川芎、白芷为出现频率最多的中药,川芎-白芷为治疗偏头痛最常见的药对。该研究通过检索教材、名家经验等数据资料,较为系统地梳理了治疗偏头痛常用的方药,为临床实践指南中医药遴选部分提供了依据。In this study,common prescriptions were retrieved from existing data in multiple ways to determine the selection principle of common formulas in traditional Chinese medicine(TCM)clinical practice guidelines.Taking the selection of common prescriptions in the clinical practice guidelines of TCM for migraine as an example,we searched common prescriptions for migraines from National Essential Medicine List,the National Drug Catalog for Basic Medical Insurance,Work-related Injury Insurance,and Maternity Insurance,Chinese Pharmacopoeia,three teaching materials and two clinical practice guidelines,and we also electronically searched CNKI,VIP,WanFang about famous clinical experience for migraine published from 1990 to 2019.At the same time,32 prescriptions commonly used by experts in the clinical questionnaire survey were collected to summarize and analyze the TCM clinically applicable syndrome types and medication rules of the included prescriptions and medicines.From the National Essential Medicine List,the National Drug Catalog for Basic Medical Insurance,Work-related Injury Insurance,and Maternity Insurance,Chinese Pharmacopoeia,we got 12 Chinese patent medicines.From the teaching materials,we got 9 prescriptions.From the clinical practice guidelines,we got 8 prescriptions.We got 3 prescriptions from the experience of famous experts and got 4 prescriptions from experts in the clinical questionnaire survey.A total of 24 prescriptions were included from the above results.External wind syndrome,syndrome of blood stasis and brain blocking,and syndrome of liver Yang transforming into wind were the common syndrome types in the treatment of migraine.Chuanxiong Rhizoma and Angelicae Dahuricae Radix were the most common Chinese herbs in the prescriptions.Chuanxiong Rhizoma-Angelicae Dahuricae Radix was the most common drug pair for the treatment of migraine.By retrieving the data such as the famous clinical experience and teaching materials,we systematically summarized the prescriptions in the treatment of migraine in this s

关 键 词：偏头痛 中医药 名家经验 中医证型 中医临床实践指南 

分 类 号：R277.7[医药卫生—中医学]