基于中医“四季脾旺不受邪”理论探讨老年慢性阻塞性肺疾病的用药规律  

Discussion on Medication Rule of Senile Chronic Obstructive Pulmonary Disease Based on The Theory of"Four Seasons Spleen Flourishing Without Pathogenic Factors"

作　　者：狄冠麟[1] 朱振刚[1] 郑延龙[1] DI Guan-lin;ZHU Zhen-gang;ZHENG Yan-long(The First Affiliated Hospital of Tianjin University of Traditional Chinese Medicine,Tianjin 300380,China)

机构地区：[1]天津中医药大学第一附属医院呼吸科,天津300380

出　　处：《中国中医基础医学杂志》2021年第5期782-785,共4页JOURNAL OF BASIC CHINESE MEDICINE

基　　金：天津市卫生和计划生育委员会课题项目(2018029)-基于RABEX-5-VEGF通路探讨“固本解毒祛瘀”药在NSCLS中的作用研究。

摘　　要：目的:探讨基于中医“四季脾旺不受邪”理论在老年慢性阻塞性肺疾病(COPD)的用药规律。方法:选择老年COPD患者常用药物处方300张,分析其用药规律,指导临床患者用药,并对结果进行分析与总结。同时基于中医“四季脾旺不受邪”理论,分析老年COPD的用药规律并完成树状图的绘制,用药规律分析时主要针对药物使用频率相对较高的药物进行合理分类。结果:300张处方涉及中药165味1805频次,使用频数>15次药物合计42味。对使用频数较高的药物进行分为四类:第一类主要以黄精、麦冬、五味子、白术、黄芪、山萸肉、紫河车为主,第二类主要以贝母、杏仁、大黄、知母、牛蒡子、枳壳、苏子、苏梗为主,第三类以白芍、羚羊角、丹皮、三七、天麻等为主,第四类以半夏、郁金、黄芩为主。结论:老年COPD久病气虚,本虚标实,虚实夹杂,基于中医四季脾旺不受邪理论治疗更加重视清肺泻热、活血化瘀,用药方面能实现脾、肺、肾同治,能获得良好的预后,可指导临床用药。Objective:To explore the rule of drug use in elderly patients with chronic obstructive pulmonary disease(COPD)based on the theory of“four seasons spleen invigorating without pathogenic factors”.Methods:300 commonly used drug prescriptions of elderly patients with COPD were selected to analyze their medication rules,guide clinical patients to use drugs,and summarize the results;at the same time,based on the theory of“four seasons spleen is not affected by evil”,the medication rules of elderly patients with COPD were analyzed,and the tree diagram was drawn.In the analysis of drug use law,the drugs with relatively high frequency of drug use should be reasonably classified.Results:300 prescriptions involved 165 kinds of traditional Chinese medicine,1805 times,and 42 kinds of drugs were used more than 15 times.The drugs with high frequency of use can be divided into four categories:the first category is mainly polygonatum,Ophiopogon japonicus,Schisandra chinensis,Atractylodes macrocephala,Astragalus membranaceus,Cornus officinalis and Ziheche;the second category is mainly Fritillaria,almond,rhubarb,Anemarrhena asphodeloides,Arctium lappa,Fructus aurantii,Perilla frutescens and scutellaria;the third category is mainly Paeoniae Alba,cornu antelope,Cortex Moutan,Panax notoginseng and Gastrodia elata;the fourth category is pinellia,Curcuma,Rhizoma flavesce It is mainly composed of Scutellaria.Conclusion:Senile COPD has a long history of Qi deficiency,deficiency in origin and excess in sign,deficiency and excess intermingled.Based on the theory of four seasons spleen excess without pathogenic factors,more attention should be paid to clearing lung and purging heat,promoting blood circulation and removing blood stasis.In terms of medication,it can achieve the same treatment of spleen,lung and kidney,obtain a good prognosis,and guide clinical medication.

关 键 词：中医“四季脾旺不受邪”理论 老年慢性阻塞性肺疾病 用药规律 临床经验 

分 类 号：R563[医药卫生—呼吸系统]