吴煜治疗乳腺癌肝气郁结证及脾肾两虚证方药对比分析  

Comparative Analysis of WU Yu's Prescriptions and Drugs in Treatment of Breast Cancer with Liver Qi Depression Syndrome and Spleen Kidney Deficiency Syndrome

作　　者：宋清雅 张铮 谷珍珍 吴煜[1] SONG Qingya;ZHANG Zheng;GU Zhenzhen;WU Yu(Xiyuan Hospital of Chinese Academy of Chinese Medical Sciences,Beijing 100091,China;Beijing University of Chinese Medicine,Beijing 100029,China)

机构地区：[1]中国中医科学院西苑医院,北京100091 [2]北京中医药大学,北京100029

出　　处：《辽宁中医杂志》2023年第4期137-141,共5页Liaoning Journal of Traditional Chinese Medicine

基　　金：国家重点研发计划项目(2017YFC1700606);中国中医科学院创新工程重大攻关项目(CI2021A01803);中国中医科学院西苑医院肿瘤科重点科室项目(010040107)。

摘　　要：目的对比分析吴煜教授治疗乳腺癌肝气郁结证和脾肾两虚证的用药特征,以全面总结其治疗乳腺癌的用药思想及处方特征。方法收集吴煜教授2019年11月—2020年10月出诊时开具的治疗乳腺癌肝气郁结及脾肾两虚两种证型的处方,对处方中中药的四气、五味、归经、功效进行频次分析。利用中医传承计算平台V3.0,设置不同支持度、置信度,对处方中的药物关系进行分析。结果共纳入肝气郁结证中药处方303首,脾肾亏虚证105首。肝气郁结证所用中药的四气以寒、平、温为主,五味以苦、甘、辛为主,主要归肺、肝、脾、肾经,中药功效以补虚、清热、理气、解表、化痰为主。脾肾两虚证用药四气温、平、寒为主,五味以甘、苦、辛为主,主要归脾、肺、肾、肝、胃经,功效以补虚、理气、清热、化痰、活血化瘀为主。设置支持度为230,置信度为1,肝气郁结型处方以柴胡、赤芍、枳壳、太子参、茯苓、鸡血藤、女贞子、白花蛇舌草、半枝莲、浙贝母、甘草关联性最高;设置支持度为50,置信度为1,脾肾两虚证以太子参、黄芪、半夏、麦芽、陈皮、木香、茯苓、白术、鸡血藤、黄精、墨旱莲、女贞子、白花蛇舌草、甘草关联性最高。结论吴煜教授在乳腺癌早期或患者机体耐受良好之时,常治以疏肝健脾,化痰解毒抗癌。患者身体素质不佳或出现骨髓抑制、消化道不良反应等情况时,以扶助正气、减轻不良反应为主要目的,注重脾胃的纳运,以补益脾肾、益气生血为主,兼顾化痰解毒散结。Objective To analyze the treatment characteristics of breast cancer between liver Qi depression syndrome and deficiency of spleen and kidney syndrome by Professor WU Yu and summarize the medication and prescription characteristics of breast cancer.Methods The prescriptions issued by Professor WU Yu from November 2019 to October 2020 for the treatment of liver Qi depression syndrome and deficiency of spleen and kidney syndrome were collected,and the four Qi natures,five flavors,meridian and efficacy of traditional Chinese medicine in the prescriptions were analyzed.The TCM inheritance computing platform V3.0 was used to set different support and confidence to analyze the drug relationship in prescriptions.Results A total of 303 TCM prescriptions for liver Qi depression syndrome and 105 spleen and kidney deficiency were included.The four Qi natures of Chinese medicine used in deficiency of spleen and kidney syndrome were mainly cold,flat and warm,and the five flavors were mainly bitter,sweet and pungent,mainly belonging to lung,liver,spleen and kidney meridians.The effects of Chinese medicine are mainly tonifying deficiency,clearing heat,regulating Qi,relieving surface and resolving phlegm.Four deficiency of spleen and kidney sydnrome,the four Qi natures were mainly warm,flat and cold and the five flavours were mainly sweet,bitter and pungent,mainly belonging to spleen,lung,kidney,liver and stomach meridians.The effect is supplement the deficiency,regulate Qi,clearing heat,resolve phlegm,activate blood circulation and resolve the blood stasis.The support degree was set to 230 and the confidence degree was 1.Among the prescriptions of liver Qi depression syndrome,Chaihu(Bupleuri Radix),Chishao(Paeoniae Radix Rubra),Zhiqiao(Aurantii Fructus),Taizishen(Pseudostellariae Radix),Fuling(Poria),Jixueteng(Spatholobi Caulis),Nyuzhenzi(LigustriLucidi Fructus),Baihuasheshecao(HedyotiDiffusaeHerba),Banzhilian(ScutellariaeBarbataeHerba),Zhebeimu(FritillariaeThunbergii Bulbus)and Gancao(Glycyrrhizae Radix Et Rhizoma)had the highe

关 键 词：乳腺癌 肝气郁结 脾肾两虚 方药分析 

分 类 号：R737.9[医药卫生—肿瘤]