卢秉久教授辨治脾肾阳虚型鼓胀用药规律研究  

Study on professor Lu Bingjiu′s medication rules in the treatment of meteorism with spleen and kideny Yang deficiency

作　　者：刘胜男 卢秉久[2] 郑佳连[2] 于澜 Liu Shengnan;Lu Bingjiu;Zheng Jialian;Yu Lan(Liaoning University of Traditional Chinese Medicine,Shenyang Liaoning 110847;Affiliated Hospital of Liaoning University of Traditional Chinese Medicine,Shenyang Liaoning 110032)

机构地区：[1]辽宁中医药大学,辽宁沈阳110847 [2]辽宁中医药大学附属医院,辽宁沈阳110032

出　　处：《山西中医药大学学报》2023年第9期964-970,975,共8页Journal of Shanxi University of Chinese Medicine

基　　金：国家中医药管理局卢秉久学术经验传承工作室(2022-304)。

摘　　要：目的:运用数据挖掘方法探究卢秉久教授辨治脾肾阳虚型肝硬化腹水(鼓胀)的用药规律。方法:采用回顾性分析方法,收集整理2020年12月1日—2022年12月1日由辽宁省名中医卢秉久教授诊治且疗效显著的脾肾阳虚型肝硬化腹水患者103例,采用Excel 2019、SPSS 25.0、SPSS Modeler 18.0等软件对处方进行药物频次统计、性味归经分析、关联规则分析、聚类分析以及疾病病因分析等。结果:涉及中药102味,药物性味多为甘温,归经多为脾经、胃经,常用补虚药、利水渗湿药、理气药,常用药物组合为茯苓-陈皮、附子-车前子、鸡内金-海螵蛸、血余炭+地榆炭-海螵蛸。核心组方为:人参、附子、桂枝、白术、茯苓、泽泻、大腹皮、陈皮、山楂、麦芽、神曲、葶苈子、楮实子、车前子、血余炭、地榆炭、海螵蛸。聚类分析得出4个聚类方,分别为通达消积方、化湿运脾方、气血双补方、培土制水方。结论:卢师治疗脾肾阳虚型肝硬化腹水患者以温阳健脾、培土制水为核心,并佐以化瘀止血、消食和胃、益气生血之品,总体用药特点可概括为阴阳并调,培土制水,既病防变,补中有行。Objective:To explore the medication rules of professor Lu Bingjiu in the treatment of ascites due to liver cirrhosis(meteorism)with spleen and kidney Yang deficiency syndrome by data mining method.Methods:A retrospective analysis method was used to collect 103 patients with ascites due to liver cirrhosis with spleen and kidney Yang deficiency syndrome diagnosed and treated by Prof.Lu Bingjiu,a famous traditional Chinese medicine doctor in Liaoning Province,with significant curative effect from December 1,2020 to December 1,2022.Excel 2019,SPSS 25.0,SPSS Modeler 18.0 and other software were used to conduct drug frequency statistics,nature,flavor and channel tropism analysis,association rule analysis,cluster analysis and disease etiology analysis.Results:102 Chinese herbs were involved.The drug nature and flavor were mostly sweet and warm,and the channel tropism was mostly spleen channel and stomach channel.Deficiency-tonifying drugs,damp-clearing and diuresis-promoting drugs,and Qi-regulating drugs were commonly used.The common drug combinations were Fuling-Chenpi,Fuzi-Cheqianzi,Jineijin-Haipiaoxiao,Xueyutan+Diyutan-Haipiaoxiao.The core ingredients were:Renshen,Fuzi,Guizhi,Baizhu,Fuling,Zexie,Dafupi,Chenpi,Shanzha,Maiya,Shenqu,Tinglizi,Chushizi,Cheqianzi,Xueyutan,Diyutan and Haipiaoxiao.Four cluster prescriptions were obtained by cluster analysis,namely,Tongda Xiaoji Prescription,Dampness-removing and Spleen-promoting Prescription,Qi-blood-tonifying Prescription,and Spleen-strengthening and Lung-controlling Prescription.Conclusion:In the treatment of patients with ascites due to liver cirrhosis with spleen and kidney Yang deficiency syndrome,Master Lu focuses on warming Yang and invigorating spleen,strengthening spleen and controlling lung,and supplements with the drugs to remove blood stasis and stop bleeding,remove food masses and harmonize stomach,and invigorate Qi and generate blood.The overall characteristics of drug use can be summarized as the combined regulation of Yin and Yang,spleen-strengthening and lun

关 键 词：肝硬化腹水 鼓胀 辨证论治 脾肾阳虚 培土制水 

分 类 号：R256.42[医药卫生—中医内科学]