基于临床疗效评价的变应性鼻炎中医诊疗指南用药分析  

Medication Analysis of Traditional Chinese Medicine Diagnosis and Treatment Guidelines for Allergic Rhinitis Based on Clinical Efficacy Evaluation

作　　者：刘翠芳 郑丹平 谢天丽 李安 陈雪 刘孟宇[1] LIU Cuifang;ZHENG Danping;XIE Tianli;LI An;CHEN Xue;LIU Mengyu(Institute of Basic Research in Clinical Medicine,China Academy of Chinese Medical Sciences,Beijing 100700,China;Institute of Information on Traditional Chinese Medicine,China Academy of Chinese Medical Sciences,Beijing 100700,China)

机构地区：[1]中国中医科学院中医临床基础医学研究所,北京100700 [2]中国中医科学院中医药信息研究所,北京100700

出　　处：《中国实验方剂学杂志》2023年第14期181-190,共10页Chinese Journal of Experimental Traditional Medical Formulae

基　　金：国家自然科学基金面上基金项目(61771491);中国中医科学院科技创新工程项目(CI2021A00701-2);中国中医科学院基本科研业务费自主选题项目(Z0557)。

摘　　要：目的:基于变应性鼻炎中医用药临床疗效评价示范研究,探索疗效评价方法在形成中医临床实践指南制定用药证据中的作用,以期丰富指南制定证据来源。方法:收集变应性鼻炎中医临床真实世界用药数据进行疗效评价,使用SPSS16.0计算临床证候、主方、用药的指南符合度,按照指南符合度对疗效及用药进行关联分析,比较临床实际应用与现行指南的用药差异。结果:收集病例198例,将临床用药分别与变应性鼻炎相关指南比较,发现临床证候符合度均在70%以上,除指南证候外,临床还有六经辨证及其他兼夹证候;临床中主方用药的指南符合度与疗效呈正相关趋势。临床常用药与指南推荐用药存在一定差异,如临床肺气虚寒证常用白芷、辛夷、五味子等,肾阳不足证常用白术、牡蛎等,脾气虚弱证常用茯苓、桂枝、辛夷等药物,儿童肺气虚寒证常用诃子、蝉蜕、干姜、人参等,肺脾气虚证常用山药、薄荷、砂仁、干姜等。成人及儿童常用药亦存在一定差异,如肺气虚寒证下成人常用白芷、辛夷、蒺藜,儿童常用人参、白芍、茯苓,肺经伏热证下成人常用柴胡、细辛、半夏、苍耳子,儿童常用鱼腥草、薄荷、陈皮、神曲。结论:通过疗效评价的方法,筛选出确有疗效的用药方案,有助于从临床有效性的角度为中医临床实践指南制定补充即时、客观、符合临床实际的用药证据。Objective:To explore the role of efficacy evaluation methods in providing evidence for traditional Chinese medicine(TCM)clinical practice guidelines based on a demonstration study of clinical efficacy evaluation of TCM for allergic rhinitis(AR),aiming to enrich the sources of evidence for guideline development.Method:Real-world data of TCM medication for AR were collected and efficacy evaluation was carried out.SPsS 16.0 software was used to calculate the conformity of clinical syndromes,main prescriptions,and medications to the guidelines.Correlation analysis of efficacy and medications was performed according to guideline conformity to compare the differences in medications between real-world clinical applications and current guidelines.Result:A total of 198 cases were collected and the clinical medications were compared with the relevant guidelines for AR.It was found that the clinical syndrome conformity was above 70%,and in addition to the guideline syndrome,there were also syndromes in six meridians and other mixed syndromes in clinical practice.The guideline conformity of the main prescriptions used in clinical practice showed a positive correlation trend with efficacy.There were some differences between the commonly used drugs in clinical practice and those recommended by the guidelines.For example,for lung Qi deficiency and cold syndrome,drugs such as Angelicae Dahuricae Radix,Magnoliae Flos,and Schisandrae Chinensis Fructus were often used.For kidney Yang deficiency syndrome,drugs such as Atractylodis Macrocephalae Rhizoma and Ostreae Concha were often used.For spleen Qi deficiency and weakness syndrome,drugs such as Poria,Cinnamomi Ramulus,and Magnoliae Flos were used.For lung Qi deficiency and cold syndrome in children,drugs such as Chebulae Fructus,Cicadae Periostracum,Zingiberis Rhizoma,and Ginseng Radix et Rhizoma were used.For lung and spleen Qi deficiency syndrome,drugs such as Dioscoreae Rhizoma,Menthae Haplocalycis Herba,Amomi Fructus,and Zingiberis Rhizoma were used.There were also some differ

关 键 词：疗效评价 临床诊疗证据 变应性鼻炎 用药分析 

分 类 号：R2-0[医药卫生—中医学] R22R285.5R765.21