基于真实世界的消渴肾病组方规律研究  

Real World Based Study on Prescription Rules of Diabetic Kidney Disease

作　　者：杨金月 覃佐涛 王芳[1] 文思 朱国龙[1] 韩庆龙[1] YANG Jingyue;QIN Zuotao;WANG Fang;WEN Si;ZHU Guolong;HAN Qinglong(Three Gorges University Hospital of Traditional Chinese Medicine,Yichang Traditional Chinese Medicine Hospital,Yichang 443000,Hubei,China)

机构地区：[1]三峡大学中医医院,宜昌市中医医院,湖北宜昌443000

出　　处：《辽宁中医药大学学报》2022年第11期196-203,共8页Journal of Liaoning University of Traditional Chinese Medicine

基　　金：宜昌市医疗卫生科研项目(A20-2-041)。

摘　　要：目的 筛选2018年1月—2019年12月于湖北省中医院光谷院区内分泌科住院治疗,并且符合研究纳入标准的处方共计127首,通过分析软件总结消渴肾病患者组方规律及临床症状分布规律,为临床症-药配伍奠定基础。方法 运用古今医案云平台(V2.3.7),将其处方的药物频次、四气、五味、归经、功效及患者的症状、舌脉、证型、证素进行统计分析;并运用关联分析,将药物-药物,症状-症状,症状-药物进行关联挖掘;在通过层次式聚类的方法,将药物频次前20的药物进行聚类分析。结果 消渴肾病是本虚标实的疾病,临床多见口干、乏力、泡沫尿、多饮等典型症状。用药规律是在补肾健脾,固精缩尿的基础上,以黄芪、山药、金樱子、芡实、山萸肉、胡芦巴、杜仲等药物为主,辅以知母、赤芍等滋阴清热,茯苓、泽泻等化痰渗湿,丹参、赤芍等活血化瘀,药物关联多以水陆二仙丹、六味地黄丸加减治疗居多;症状-药物关联多以:泡沫尿-金樱子、芡实,下肢水肿-浮萍,睡眠欠佳-酸枣仁等药物。结论 消渴肾病是以本虚为主,虚实夹杂的疾病,临床症状表现多样,病位涉及肝、脾、肾等脏腑,治疗上以补益气血为主,兼顾化痰活血、清热利湿、平衡阴阳、固精缩尿等。Objective A total of 127 prescriptions that met the inclusion criteria of this study were screened from January 2018 to December 2019 in the department of endocrinology of optics valley hospital of Hubei province hospital of traditional Chinese medicine.The distribution rules of prescription and clinical symptoms of patients with diabetic kidney disease were summarized by analyzing the software,so as to lay the foundation for clinical symptom-drug compatibility.Methods The ancient and modern medical record cloud platform(V2.3.7)was used to statistically analyze the frequency,four Qi,five flavor,meridian return,efficacy and symptoms,tongue and pulse,syndrome type and syndrome element of the prescribed drugs.Using association analysis,drug-drug,symptom-symptom,symptom-drug association mining;In the hierarchical clustering method,the top 20 drugs in drug frequency were clustered and analyzed.Results Diabetic nephropathy was a disease characterized by deficiency of the origin and excess of the essence.In clinical practice,typical symptoms such as dry mouth,fatigue,foam urine,and polydipsia were common.The rule of medication was based on tonifying the kidney,strengthening the spleen,consolidating essence and shrinking urine,it was mainly made of Huangqi(Astragali Radix),Shanyao(Dioscoreae Rhizoma),Jinyingzi(Rosae Laevigatae Fructus),Qianshi(Euryales Semen),Shanyurou(Cornifructus),Huluba(Trigonellae Semen),Duzhong(Eucommiae Cortex),etc,it was supplemented by Zhimu(Anemarrhenae Rhizoma)and Chishao(Paeoniae Radix Rubra)to nourish Yin and clear heat,Fuling(Poria)and Zexie(Alismatis Rhizoma)to dissipate phlegm and damp,Danshen(Salviae Miltiorrhizae)and Chishao(Paeoniae Radix Rubra)to promote blood circulation and remove blood stasis,most of the drugs were related to Shuilu Erxian Pill(水陆二仙丹)and Liuwei Dihuang Pill(六味地黄丸);Symptoms-drug associations were mostly:foam urine-Jinyingzi(Rosae Laevigatae Fructus),Qianshi(Euryales Semen),lower limb edema-Fuping(Spirodelae Herba),poor sleep-Suanzaoren(Ziziphi Spi

关 键 词：消渴肾病 数据挖掘 真实世界 

分 类 号：R255.4[医药卫生—中医内科学]