基于“脾气散精”理论挖掘卢秉久教授治疗NAFLD合并T2DM的用药规律  

Exploration of Lu Bingjiu′s experience in the treatment of NAFLD with T2DM on the theory of"disperse temper and nourish essence"

作　　者：王宠雯 卢秉久[2] WANG Chong-wen;LU Bing-jiu(First Clinical College of Liaoning University of Traditional Chinese Medicine,Liaoning Shenyang,110847,China;不详)

机构地区：[1]辽宁中医药大学第一临床学院,辽宁沈阳110847 [2]辽宁中医药大学附属医院肝病科

出　　处：《中西医结合肝病杂志》2023年第12期1108-1112,1115,共6页Chinese Journal of Integrated Traditional and Western Medicine on Liver Diseases

摘　　要：目的:基于“脾气散精”理论总结卢秉久教授治疗非酒精性脂肪性肝病(NAFLD)合并2型糖尿病(T2DM)的学术思想及用药规律。方法:回顾性分析2019年3月1日至2023年2月28日就诊于辽宁中医药大学附属医院专家门诊并由卢秉久教授诊治的178例NAFLD合并T2DM患者的临床资料。对患者处方进行药物频次频率、性味归经统计分析,并进行相关性分析、关联规则分析及聚类分析。结果:卢秉久教授治疗NAFLD合并T2DM多采用甘、苦、辛味药物,重用温性药,药物多归脾、肝经,常用补虚药、清热药、利水渗湿药,常用药对为神曲-麦芽、五味子-麦冬、延胡索-川楝子、佩兰-豆蔻、山茱萸-牡丹皮、桃仁-红花、枸杞子-菊花。核心组方为陈皮、泽泻、茯苓、苍术、白术、车前子、柴胡。聚类分析得到5组药物,分析得出治法为健脾化痰、行气宽中,凉血活血、逐瘀止痛,健脾益胃、养阴生津,健脾消食、化浊降脂,健脾渗湿、温中助阳。结论:卢秉久教授以“脾气散精”理论为基本治疗思路治疗NAFLD合并T2DM,以健脾为主,兼以行气、活血、滋阴、温中。Objective:To summarize Professor Lu Bingjiu′s academic thoughts and medication rules in the treatment of nonalcoholic fatty liver disease(NAFLD)with diabetes mellitus type 2(T2DM)on the theory of"disperse temper and nourish essence".Methods:A retrospective analysis method was used to collect and sort out NAFLD patients with T2DM who were treated by Professor Lu Bingjiu at the expert clinic of the Affiliated Hospital of Liaoning University of Traditional Chinese Medicine from March 1,2019 to February 28,2023.Perform a statistical analysis on the medication frequency and properties of the prescribed drugs for patients,including their classification according to traditional Chinese medicine theory.Conduct relevant and correlation analyses,association rule mining,and cluster analysis.Results:Professor Lu Bingjiu used sweet,bitter and spicy drugs in the treatment of NAFLD complicated with T2DM,and favors warm properties.The drugs were mostly directed to the spleen and liver meridians.The commonly used drugs were tonic drugs,antipyretic drugs,and diuretic drugs.The commonly used drug pairs were Shenqu-Malt,Schisandra chinensis-Ophiopogon japonicus,Corydalis yanhusuo-Chinaberry,Peran-Cardamom,Cornus officinalis-Peony peel,Peach kernel-Safflower,Wolfberry-Chrysanthemum.The core ingredients were:orange peel,alisma orientalis,poria cocos,atractylodes rhizome,atractylodes macrocephala,plantain seed,and bupleurum.Clustering analysis yields five categories of medicine with the following treatment methods:tonifying spleen and resolving phlegm,promoting qi circulation and regulating the middle,cooling blood and activating blood circulation,expelling stasis and alleviating pain,tonifying spleen and nourishing stomach,replenishing yin and generating fluid,tonifying spleen and reducing food stagnation,transforming turbidity and lowering lipid,tonifying spleen and dispelling dampness,warming middle and enhancing yang.Conclusion:Professor Lu Bingjiu treats NAFLD with T2DM based on the theory of"spleen-qi dispersing essence",focusi

关 键 词：非酒精性脂肪性肝病 2型糖尿病 脾气散精 数据挖掘 卢秉久 

分 类 号：R575[医药卫生—消化系统] R587[医药卫生—内科学]