儿童原发性局灶节段性肾小球硬化症的中医证型分布及用药规律  

TCM Syndrome Types Distribution and Medication Principles of Primary Focal Segmental Glomerulosclerosis in Children

作　　者：陈乃清 温晓莹[1,2] 张丽娇 李亚美 李燕羽[3] 刘爱华 杨慧仪 曾维嘉 裴俊娟 黄清明[1,2] CHEN Naiqing;WEN Xiaoying;ZHANG Lijiao;LI Yamei;LI Yanyu;LIU Aihua;YANG Huiyi;ZENG Weijia;PEI Junjuan;HUANG Qingming(The Second Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangzhou Guangdong China 510120;Luoxiaorong Famous Doctor Studio,Guangdong Provincial Hospital of Traditional Chinese Medicine,Guangzhou Guangdong China 510120;Guangzhou University of Chinese Medicine,Guangzhou Guangdong China 510006)

机构地区：[1]广州中医药大学第二附属医院,广东广州510120 [2]广东省中医院罗笑容名医工作室,广东广州510120 [3]广州中医药大学,广东广州510006

出　　处：《中医学报》2021年第11期2459-2464,共6页Acta Chinese Medicine

基　　金：国家中医药管理局科研项目(14GG2X02);广东省中医药局专项资助项目(20191161)。

摘　　要：目的:分析原发性局灶节段性肾小球硬化症(focal segmental glomerulosclerosis,FSGS)患儿的中医证型、方剂及中药使用规律。方法:选取FSGS住院患儿,建立包含证型、方剂、中药等中医数据库,运用频数分析、聚类分析、关联分析以及中医传承辅助平台(V2.5)等数据挖掘方法对本病的中医证型、方剂及中药使用规律进行分析。结果:筛选出20例FSGS病案符合纳入标准,均为本证合并标证。本证主要以脾肾阳虚、脾肾气虚为主,标证排在前5位的是血瘀、水湿、风邪、湿热、湿浊。本证数量与病程时间相关(P<0.05),标证数量与住院时间相关(P<0.05)。20例FSGS患儿住院期间用方299首,129味药,3433次用药频次,37个主方,其中祛湿剂共13首方剂,补益剂共11首方剂,解表剂共6首方剂,其余1~2首。129味中药主要由补虚药、解表药、利水渗湿药、化痰止咳平喘药、理气药、温里药和清热药组成;性味以甘、辛、苦为主,药性多温、平、寒;归经以肺经、脾经为主。对药物进行关联规则分析,得到频数在60次以上的药对共17组,药组置信度大于0.8的11条。结论:儿童FSGS中医证型具有多样复杂的特点,病位主要在脾、肾,病性为本虚标实,需重视标本兼治,标证选方以祛湿剂最多,如五皮饮、五苓散、麻黄连翘赤小豆汤等;本证多以四君子汤、真武汤为主方。最核心的中药为白术、茯苓、玉米须、白芍、甘草等。Objective:To analyze the TCM syndrome types,prescriptions,and usage principles of TCM in children with primary focal segmental glomerulosclerosis(FSGS).Methods:Select FSGS hospitalized children,establish a TCM database containing syndrome types,prescriptions,Chinese medicines,etc.,and use data mining methods such as frequency analysis,cluster analysis,association analysis,and TCMISS(V2.5)to analyze the TCM syndrome types,prescriptions,and Chinese medicine usage principles.Results:20 cases of FSGS cases were screened out to meet the inclusion criteria,all of which were combined with syndrome manifestation and root cause.The manifestation syndromes are mainly Spleen and Kidney Yang deficiency,Spleen and Kidney Qi deficiency,and the top 5 root causes of the syndromes are blood stasis,dampness,pathogenic wind,dampness heat,and turbidity.The number of manifestations is related to the duration of the disease(P<0.05),while the number of the root causes is related to the length of hospitalization(P<0.05).During the hospitalization of 20 children with FSGS,299 prescriptions,129 medicines,3433 frequency of medications,37 main prescriptions were practiced,of which contains 13 desiccating formulas,11 supplementing formulas,and 6 superficies-resolving formula and 1-2 other formulas.The 129 traditional Chinese medicines are mainly composed of tonic drugs,superficies-resolving drugs,diuretic drugs,phlegm-resolving and cough-relieving and asthma-relieving drugs,Qi regulating drugs,interior-warming and heat-clearing drugs.The nature and flavor are mainly sweet,pungent,and bitter,and the medicinal properties are warm,calm,and cold.The main aim meridians are the Lung meridian and Spleen meridian.Analyzing the association of the drugs,a total of 17 groups of drug pairs with a frequency of more than 60 times were obtained,and 11 of the drug group confidence levels were higher than 0.8.Conclusion:TCM Children′s FSGS syndromes have complex characteristics.The disease location is mainly in the Spleen and Kidneys and it has the charact

关 键 词：原发性局灶节段性肾小球硬化症 肾病综合征 儿童 中医证型 方剂 用药规律 

分 类 号：R277.592.6[医药卫生—中医学]