基于临床医案分析藏医“屑瓦”病的临床用药规律  

Based on Clinical Medical Records,the Clinical Medication Law of Tibetan Medicine“Shuwa”Disease was Analyzed

作　　者：冈根 尼玛次仁 奔苏·晋美 Khangkar;Nyima Tsering;Bensur Jigme(Tibetan Medicine University,Lhasa 850000,China;Tibetan Hospital of Tibet Autonomous Region,Lhasa,850000,China)

机构地区：[1]西藏藏医药大学,西藏拉萨850000 [2]西藏自治区藏医院,西藏拉萨850000

出　　处：《亚太传统医药》2023年第6期95-99,共5页Asia-Pacific Traditional Medicine

摘　　要：目的:通过藏医临床医案分析、总结“屑瓦”病的诊疗特点及组方用药规律。方法:收集2021年10月-2022年10月,由西藏自治区藏医院皮肤科收治的第一诊断为藏医“屑瓦”病的病历并建立相关数据库;运用SPSS 26.0统计软件和Excel 2019对上述病历数据进行患者年龄、性别、症状、方剂、药物频次及关联规则等多角度分析。结果:108例病历共涉及39首方剂,其中频次>10的方剂有十味乳香丸、二十五味大汤散等10首高频方剂;频次>100的单味药有诃子、川木香、余甘子等10味高频单药。时辰用药以二十五味大汤散、十味乳香丸、二十味沉香丸等为轴心进行加减方剂配伍。药物关联规则分析以诃子-余甘子、诃子-毛诃子、诃子-渣驯等组合最突出。聚类分析得到4组针对不同证型的常用组方。结论:藏医治疗“屑瓦”病用药规律揭示,核心药物功效皆以清热解毒、祛寒除湿、镇痛活血、消除黄水、调和三因为主,客观总结分析了临床藏医治疗“屑瓦”病的用药规律。Objective:To summarize the characteristics of diagnosis and treatment of"Shuwa"disease and the rules of prescription and medication through the analysis of clinical medical records of Tibetan medicine.Methods:From October 2021 to October 2022,the medical records of the first diagnosed"Shuwa'disease were collected from the dermatology department of Tibetan Hospital of Tibet Autonomous Region,and a related database was established.IBM-SPSS Statistics 26 and Microsoft Excel 2019 were used to analyze the above medical record data from multiple perspectives,such as patient age,gender,symptoms,prescriptions,drug frequency and association rules.Results:A total of 39 prescriptions were involved in 108 medical records,of which 10 prescriptions with frequency>10 were 10 high-frequency prescriptions such as 10 taste Frankincense pills and 25 taste Datang powder;among them,the single-flavor medicines with a frequency of>100 were 10 high-frequency single medicines such as Haozi,Chuanmuxiang and Yuganzi.The medicine is matched with 25 taste Datang powder,lo taste Frankincense pills,20 taste Chenxiang pills,etc.,as the axis for addition and subtraction prescriptions.The analysis of drug association rules is most prominent in the combination of Haozi-Yu Ganzi,Haozi-Mao Haozi,Haozi-Zhazi.Cluster analysis obtained 4 groups of common groups for different syndrome types.Conclusion:The rules of drug use in Tibetan medicine for treating"Shuwa"disease reveal that the core drug effects are mainly clearing heat and detoxifying,dispelling cold and dehumidifying,analgesic and activating blood circulation,eliminating yellow water and reconciling three causes.Objective summary and analysis of clinical Tibetan medicine treatment of"Shuwa"disease medicine law.

关 键 词：藏医药 屑瓦 临床用药规律 

分 类 号：R275[医药卫生—中医皮科]