当代名老中医治疗肝硬化的证治规律  

The diagnosis and treatment regularity of contemporary TCM masters treatment of cirrhosis

作　　者：尹建程 谢军 YIN Jiancheng

机构地区：[1]湖南中医药大学,湖南长沙410208 [2]衡阳市中医医院,湖南衡阳421001

出　　处：《中医临床研究》2024年第5期58-63,共6页Clinical Journal Of Chinese Medicine

摘　　要：目的:通过数据挖掘方法探索当代名老中医治疗肝硬化的辨治思想及用药特点,为肝硬化的临床治疗提供思路与方法。方法:选取《当代名老中医典型医案集·内科分册》中治疗肝硬化病案,经数据筛选、数据规范等处理,建立标准化医案数据库,并使用中医传承辅助平台V2.5进行数据分析,探索当代名老中医治疗肝硬化的常见证型、常用药物及其属性、常用药物组合以及新方挖掘。结果:共纳入医案44则,涉及方剂87首,中药201味,药性以寒、温、平为主,药味以甘、苦、辛为主,归经依次为肝经、脾经、胃经、肺经、肾经、心经;主证型为肝郁脾虚、瘀血阻络、肝肾阴虚、湿热蕴结、水湿停滞、气滞血瘀;使用频次较高的药物为丹参、茯苓、黄芪、白术、白芍、党参、柴胡、郁金、泽泻、赤芍;高频药物组合14组,其中鳖甲-丹参、赤芍-丹参、郁金-丹参、黄芪-茯苓、党参-黄芪等为常用药对;新处方有7首,包括“白芍、郁金、泽泻、柴胡、牛膝”“党参、黄芪、牡丹皮、白术”“茵陈、栀子、白花蛇舌草、金钱草”等。结论:当代名老中医认为肝硬化属本虚标实,以肝脾肾虚损为本,兼以气滞、瘀血、水湿、热毒等有形实邪,治疗强调标本同治,注重寒热并用、性味合参,以调补肝脾肾为基础,同时重用活血化瘀、理气和血、利水渗湿、清热解毒之品以达扶正驱邪之功。Objective:To explore the differentiation thoughts and medication characteristics of contemporary TCM masters in the Otreatment of cirrhosis through data mining,so as to provide ideas and methods for the clinical treatment of cirrhosis.Methods:The medical records of treating cirrhosis in TCM were collected from Typical Medical Records of Contemporary Famous Veteran TCM Practitioners·Internal Medicine Fascicule.After data screening and data standardization,a standardized medical records database was established to carry out a data analysis by traditional Chinese medicine inheritance support system platform V2.5,so as to explore the common types,commonly used drugs and their attributes,commonly used drug combinations in prescriptions of contemporary famous veteran TCM practitioner for the treatment of cirrhosis,and new prescriptions.Results:A total of 44 medical records were included,including 87 prescriptions,with 201 kinds of Chinese medicinal materials.The drug properties were mainly cold,warm and mild,and the drug tastes were mainly sweet,bitter and spicy.The active ingredients of the drug mainly act on liver,spleen,stomach,lung,kidney and heart meridians.The main syndromes were liver stagnation and spleen deficiency syndrome,blood stasis blocking collaterals syndrome,liver-kidney Yin(阴)deficiency syndrome,damp-heat accumulation syndrome,water-dampness stagnation syndrome,and Qi(气)stagnation and blood stasis syndrome.The most frequently used drugs were Danshen(Radix et Rhizoma Salviae Miltiorrhizae),Fuling(Poria),Huangqi(Radix Astragali),Baizhu(Atractylode),Baishao(Radix Paeoniae Alba),Dangshen(Radix Codonopsis),Chaihu(Radix Bupleuri),Yujin(Radix Curcumae),Zexie(Rhizoma Alismatis)and Chishao(Radix Paeoniae Rubra).There were 14 groups of high frequency drug combinations,among which Biejia(Carapax Trionycis)-Danshen,Chishao-Danshen,Yujin-Danshen,Huangqi-Fuling,and Dangshen-Huangqi were common mated drugs.There were 7 new prescriptions such as Baishao-Yujin-Zexie-Chaihu-Niuxi(Radix Achyranthis Bidentatae),Dang

关 键 词：《当代名老中医典型医案集·内科分册》 数据挖掘 肝硬化 证治规律 

分 类 号：R575.2[医药卫生—消化系统]