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作 者:申世雨 王一帆 张琳琪[2] SHEN Shiyu;WANG Yifan;ZHANG Linqi(The First Clinical Medical College,Henan University of Chinese Medicine,Henan Province,Zhengzhou 450003,China;Department of Nephrology,the First Affiliated Hospital of Henan University of Chinese Medicine,Henan Province,Zhengzhou 450003,China)
机构地区:[1]河南中医药大学第一临床医学院,河南郑州450003 [2]河南中医药大学第一附属医院肾病科,河南郑州450003
出 处:《中国医药导报》2024年第1期22-26,共5页China Medical Herald
基 金:国家中医药管理局全国老中医药专家学术经验继承工作项目(国中医药人教函〔2022〕76号)。
摘 要:目的运用隐结构模型分析法,挖掘复杂性尿路感染(cUTI)的用药规律。方法计算机检索CNKI、万方数据知识服务平台、维普网、中国生物医学文献数据库、PubMed、Cochrane Library中有关中医药治疗cUTI的文献,检索时间为建库至2022年9月,利用Office Excel 2019软件建立并规范数据库,运用隐结构模型学习、综合聚类及频数分析等方法分析数据库,总结cUTI的用药规律。结果共纳入文献335篇,涉及中药254味,频率>0.35%的中药65味,功效以清热药、利水渗湿药、补虚药为主。药性多为寒、平,药味多甘、苦、淡,主归肺、肾经。隐结构分析共得到隐变量17个,结合专业知识后综合聚类为4类,推断cUTI的常见证候为膀胱湿热证、肾阳亏虚证、阴虚内热证、热毒蕴结证,代表方剂分别为八正散、真武汤、六味地黄丸、五味消毒饮等。结论cUTI的治疗以清湿热贯穿始终,其病机复杂,多为虚实夹杂之侯,病性偏实者着重祛湿热并适当配伍养阴药,利水通淋而不伤阴,病性偏虚者重补虚并适当配伍清湿热药避免湿热羁留。Objective To explore the drug use rules of complicated urinary tract infection(cUTI)by using latent structure model analysis method.Methods CNKI,Wanfang Data,VIP,China Biomedical Literature Database,PubMed,and Cochrane Library literatures on the treatment of cUTI with traditional Chinese medicine were searched by computer.The retrieval period was from inception to September 2022.Office Excel 2019 software was used to establish and standardize the database,and the methods of latent structure model learning,comprehensive clustering,and frequency analysis were used to analyze the database,and the drug use rules of cUTI were summarized.Results A total of 335 literatures were included,involving 254 kinds of traditional Chinese medicine and 65 kinds of traditional Chinese medicine with a frequency>0.35%.The main efficacy was clearing heat drugs,diuresis and diffusing dampness drugs,and tonifying deficiency drugs.Drug natures were mostly cold,flat,drug flavours were mostly sweet,bitter,light,which is mainly attributed to the lung,kidney channels.A total of 17 latent variables were obtained by the analysis of latent structure,which were classified into four categories by combining with professional knowledge.It was concluded that the common symptoms of cUTI were syndrome of dampness-heat of bladder,syndrome of kidney-yang deficiency,syndrome of endogenous heat due to yin deficiency,and syndrome of heat-toxin amassment pattern.The representative formulations were Bazheng Powder,Zhenwu Decoction,Liuwei Dihuang Pills,Wuwei Xiaodu Drink.and so on.Conclusion The treatment of cUTI is to clear dampness-heat throughout,and its pathogenesis is complex,most of which are intermingled deficiency and excess.The patients with partial deficiency focus on removing dampness-heat and appropriate combination of yin nourishing medicine,so as to relieve stranguria without damaging yin,and the patients with partial deficiency resupplement deficiency and appropriate combination of dampness-heat clearing medicine to avoid dampnessheat retention
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