基于温病理论分析卢秉久教授治疗重度脂肪肝组方规律  

Analysis of Professor LU Bingjiu’s Prescription Rule in Treating Severe Fatty Liver Based on Theory of Epidemic Febrile Disease

作　　者：于澜 郑佳连[1] 卢秉久[1] YU Lan;ZHENG Jialian;LU Bingjiu(Affliated Hospital of Liaoning University of Traditional Chinese Medicine,Shenyang(110032),China)

机构地区：[1]辽宁中医药大学附属医院,沈阳110032

出　　处：《浙江中医药大学学报》2022年第11期1251-1260,共10页Journal of Zhejiang Chinese Medical University

基　　金：辽宁省教育厅项目(L201903)。

摘　　要：[目的]基于温病理论探究卢秉久教授治疗重度脂肪肝的用药规律。[方法]采用病例回顾性分析的方法,收集整理2017年1月至2021年12月由辽宁省名中医卢秉久教授诊治且效果明显的重度脂肪肝病例,采用Excel、SPSS 23.0、SPSS Modeler 18.0等软件对处方进行药物频次频率统计、性味归经分析、相关性分析、聚类分析及关联规则分析等,并从温病湿热理论探究卢教授治疗重度脂肪肝的用药规律。[结果]卢教授治疗重度脂肪肝多采用甘、苦、辛味药物,用药药性平和,药物多归肝、脾、肺经,常用补虚药、活血化瘀药、利水渗湿药,常用药对为桃仁-红花、川楝子-延胡索、海螵蛸-鸡内金、山楂-泽泻、柴胡-枳壳。核心组方为:桃仁、红花、川芎、当归、赤芍、柴胡、陈皮、大腹皮。聚类分析得出治疗重度脂肪肝四法:宣清导浊、行气化瘀,滋阴益肾、利湿活血,温阳健脾、化气行水,消食活血、清热降脂。[结论]卢教授治疗重度脂肪肝,遵循温病理论湿热后期治疗原则,以活血化瘀作为总则,同时兼具行气、化湿、利水、补虚,能有效防止病情进展,改善预后。[Objective] To explore the prescription rule of Professor LU Bingjiu in the treatment of severe fatty liver based on theory of epidemic febrile disease. [Methods] The patients with severe fatty liver treated by Professor LU, a famous traditional Chinese medicine doctor in Liaoning Province, from January 2017 to December 2021 were collected and analyzed retrospectively, using Excel, SPSS 23.0,SPSS Modeler 18.0 and other softwares, the frequency statistics, properties and taste analysis, correlation analysis, cluster analysis,association rule analysis, etc., to explore Professor LU’s prescription rule of severe fatty liver from the theory of damp-heat of epidemic febrile disease. [Results] Professor LU mostly uses sweet, bitter and acrid drugs in the treatment of severe fatty liver, and the drugs are mild in nature, most of them belong to liver, spleen and lung meridians, and he often uses tonifying drugs, blood-activating and stasisresolving drugs, diuresis and hygroscopic drugs. The commonly used drug pairs are Persicae Semen-Carthami Flos, Toosendan FructusCorydalis Rhizoma, Sepiae Endoconcha-Corneum Gigeriae Galli Endothelium, Crataegi Fructus-Alismatis Rhizoma, Bupleuri Radix-Aurantii Fructus, and the core prescriptions were Persicae Semen, Carthami Flos, Chuanxiong Rhizoma, Angelicae Sinensis Radix,Paeoniae Rubra Radix, Bupleuri Radix, Citri Reticulatae Pericarpium, Arecae Pericarpium. Cluster analysis shows that there are four methods to treat severe fatty liver: dispersing the clear Qi and conducting the turbid Qi, promoting Qi and removing blood stasis;nourishing Yin and tonifying the kidney, removing dampness and promoting blood circulation;warming Yang and strengthening the spleen, activating Qi and circulating water;eliminating food and promoting blood circulation, clearing away heat and lowering lipid.[Conclusion] Professor LU’s treatment of severe fatty liver follows the principle of theory of damp-heat of epidemic febrile disease, and adopts the method of promoting blood circulation and removing

关 键 词：温病理论 代谢相关性脂肪性肝病 用药规律 数据挖掘 湿热 卢秉久 

分 类 号：R575[医药卫生—消化系统]