基于文献研究的肝衰竭肠源性内毒素血症中医治法及用药规律分析  

Traditional Chinese medicine treatment and medication law analysis of intestinal endotoxemia in liver failure based on literature research

作　　者：曾孟晖 杜珊 陈斌[3] ZENG Menghui;DU Shan;CHEN Bin

机构地区：[1]长沙县人民医院(湖南省人民医院星沙院区),湖南长沙410100 [2]湖南中医药大学,湖南长沙410208 [3]湖南中医药大学第一附属医院,湖南长沙410007

出　　处：《中医临床研究》2023年第15期45-50,共6页Clinical Journal Of Chinese Medicine

基　　金：湖南省中医药科研计划项目(C2022005)。

摘　　要：目的:总结分析肝衰竭肠源性内毒素血症(Intestinal Endotoxemia,IETM)的中医治法及用药规律,为临床治疗提供参考。方法:在中国知网、万方数据库、维普数据库中检索中医或中西医结合治疗肝衰竭IETM的临床研究,文献发表时间范围为2000年-2021年。提取中医治法和用药信息并建立数据库,进行中医治法、用药频次及频率、主药剂量的统计和聚类分析。结果:共纳入文献154篇,其中中药口服91篇、中药灌肠69篇。在口服中药方剂中,中医治法频次在前5位的依次是活血化瘀、清热解毒、益气健脾、通腑泻下、利湿退黄;在灌肠中药方剂中,中医治法频次在前5位的依次是活血化瘀、通腑泻下、清热解毒、益气健脾、利湿退黄。口服中药方剂共91首,涉及中药148味,频次在前10位的中药依次是大黄、丹参、赤芍、茵陈、白术、茯苓、栀子、黄芪、郁金、枳实;灌肠中药方剂共69首,涉及中药77味,频次在前10位的中药依次是大黄、赤芍、枳实、厚朴、茯苓、乌梅、薏苡仁、蒲公英、黄芩、丹参。对高频药物进行聚类分析,得到口服中药方剂10组药对聚类组合、4组3味药聚类组合、2组多味药聚类组合。灌肠中药方剂得到7组药对聚类组合、3组3味药聚类组合、2组多味药聚类组合。口服中药方剂主药大黄、丹参、赤芍常用剂量依次为1~10 g、11~20 g、11~20 g;灌肠中药方剂主药大黄、赤芍、枳实常用剂量依次为11~20 g、21~30 g、11~20 g。结论:治疗肝衰竭IETM的口服和灌肠中药方剂均以活血化瘀、清热解毒、通腑泻下、益气健脾为主要治法,口服中药侧重于益气健脾,灌肠中药侧重于通腑泻下;常重用赤芍、大黄以加强凉血化瘀之力。Objective:To summarize and analyze traditional Chinese medicine treatment and medication laws of intestinal endotoxemia(IETM)in liver failure,and to provide a reference for clinical treatment.Methods:The clinical studies of IETM in the treatment of liver failure in TCM or the integrative medicine were searched in CNKI,Wanfang and VIP databases.The literature was published from 2000 to 2021.The information of TCM treatment and medication was extracted and the database was established,and the statistics and cluster analysis of traditional Chinese medicine treatment,medication frequency and frequency,and dosage of main drugs were carried out.Results:A total of 154 articles were included,including 91 of oral TCM medicines and 69 of enemas.In the oral TCM prescriptions,the frequency of the top 5 were activating blood circulation and removing blood stasis,channeling Fu(腑)organs and purging,clearing heat and detoxifying,invigorating Qi(气)and strengthening spleen,and disinhibiting dampness and relieving jaundice.Among enema prescriptions,the frequency of the top 5 were activating blood circulation and removing blood stasis,channeling Fu organs and purging,clearing heat and detoxifying,invigorating Qi and strengthening spleen,and disinhibiting dampness and relieving jaundice.There were 91 oral TCM prescriptions,involving 148 kinds of traditional Chinese medicine.The top 10 TCM prescriptions were Dahuang(Rhubarb),Danshen(Radix salviae miltiorrhizae),Chishao(Radix paeoniae rubra),Yinchen(Herba Artemisiae capillaris),Baizhu(Rhizoma Atractylodis Macrocephalae),Fuling(Poria cocos),Zhizi(Gardenia jasminoides),Huangqi(Radix Astragali),Yujin(Radix curcumae),Zhishi(Fructus aurantii Immaturus).There were 69 enema prescriptions,involving 77 kinds of traditional Chinese medicine.The top 10 prescriptions were Dahuang,Chishao,Zhishi,Houpo(Magnolia officinalis),Fuling,Wumei(Fructus Mume),Yiyiren(Coix semen),Pugongying(Dandelion),Huangqin(Scutellaria baicalensis),Danshen.Through cluster analysis of high frequency drugs,10 groups of d

关 键 词：肝衰竭 肠源性内毒素血症 中医治法 用药规律 文献研究 

分 类 号：R631[医药卫生—外科学]