快速性心律失常的中医证候分布及中药使用规律文献研究  

Distribution of Traditional Chinese Medicine Pattens and Composition Rule of Chinese Herbal Medicine for Treatment of Tachyarrhythmia:A Literature Study

作　　者：曹新福 周明学[1,2] 李享[1] 刘红旭[1] 来晓磊[1] 韩垚[1] CAO Xinfu;ZHOU Mingxue;LI Xiang;LIU Hongxu;LAI Xiaolei;Han Yao(Beijing Hospital of Traditional Chinese Medicine,Capital Medical University,Beijing,100010;Beijing Institute of Traditional Chinese Medicine)

机构地区：[1]首都医科大学附属北京中医医院,北京市100010 [2]北京市中医研究所

出　　处：《中医杂志》2021年第3期271-276,共6页Journal of Traditional Chinese Medicine

基　　金：北京市医院管理局重点医学专业发展计划(ZYLX201817);国家中医药管理局中医药循证能力建设项目(2019XZZX-XXG001)。

摘　　要：目的基于数据挖掘技术总结快速性心律失常的中医证候分布特点及中药遣方用药规律。方法检索中国期刊全文数据库、维普中文科技期刊数据库、万方数据知识服务平台自建库至2020年6月1日期间收录的涉及中医药治疗快速性心律失常的临床观察或临床随机对照研究文献,统计纳入文献的中医证型、证素分布及药物使用频次、功效分类,并对高频使用药物进行关联规则及系统聚类分析。结果共纳入文献127篇,涉及患者5684例,涵盖中医证型21种,出现频次前3位的证型依次为气阴两虚夹瘀(1009)、气阴两虚(984)、心阳亏虚(662);共提取出9个病性证素和5个病位证素,其中病性证素频次前3位依次为气虚(3347)、阴虚(2441)、血瘀(2330)。共使用处方132首,涉及药物110味,使用频次较高的前5位药物依次为甘草(71)、丹参(64)、麦冬(58)、五味子(48)、党参(41);30味高频药物关联规则分析显示,支持度最高的前3位药对为五味子-甘草、丹参-甘草、五味子-麦冬,置信度最高的前3位药对为麦冬-生地黄、牡蛎-龙骨、甘草-龙骨;聚类分析结果显示,30味高频中药可聚为11类。结论快速性心律失常以虚实夹杂证为多,常见气阴两虚夹瘀证;病性证素以虚性居多,常见气虚、阴虚,实性证素主要为血瘀。用药以益气养阴、活血化瘀、安神定惊为基本大法,并兼顾温阳补血、理气化痰、清热凉血等治法。Objective To explore the distribution of traditional Chinese medicine(TCM)pattens of tachyarrhythmia,and the composition rule of Chinese herbal medicine(CHM)for treatment of tachyarrhythmia,based on data mining technologies.Methods Electronic databases including CNKI,VIP,and Wanfang were searched from the inception date till June 1 st,2020,for clinical observational studies and randomized control trials assessing CHM for tachyarrhythmia.Data on TCM pattens,patten elements,frequency of herbs,and herbal functions were collected.Association rule mining and systematic clustering analysis were performed for the high-frequency herbs.Results Totally,127 studies involving 5684 participants were included.Twenty-one TCM pattens were covered,and the three most common pattens were qi-yin deficiency with stasis patten(1009),qi and yin deficiency patten(984),and heart yang depletion patten(662).Nine patten elements related to nature of disease were found,of which qi deficiency(3347),yin deficiency(2441),and blood stasis(2330)were the top three in frequency.There were five patten elements found to be related to disease location.One hundred and thirty-two recipes involving 110 herbs were used,of which Gancao(Radix et Rhizoma Glycyrrhizae)(71)was the most frequently used herb,followed by Danshen(Radix et Rhizoma Salviae Miltiorrhizae)(64),Maidong(Radix Ophiopogonis)(58),Wuweizi(Fructus Schisandrae Chinensis)(48),and Dangshen(Radix Codonopsis)(41).Association analysis of 30 high-frequency herbs showed that Wuweizi-Gancao,Danshen-Gancao,Wuweizi-Maidong were the top three herbal pairs of highest degree of support;in terms of the degree of confidence,Maidong-Shengdihuang(Radix Rehmanniae Recens),Muli(Concha Ostreae)-Longgu(Os Draconis),Gancao-Longgu were the top three highest.Through clustering analysis,30 high-frequency herbs were grouped into 11 clusters.Conclusion Deficiency-excess complex is the main pathogenesis of tachyarrhythmia,which is mainly manifested as qi-yin deficiency and stasis patten.Deficiency patten elements,mainly

关 键 词：快速性心律失常 中医证候 证素 用药规律 关联规则 系统聚类 

分 类 号：R259[医药卫生—中西医结合] G353.1[医药卫生—中医内科学]