基于中医传承辅助平台研究魏葆琳教授以“复肺”立论辨治AECOPD用药规律及经验分析  

Based on the Research of the TCM Inheritance Assistance Platform,Professor Wei Baolin Debated the Treatment of AECOPD Medication Law Research and Empirical Analysis with the“Complex Lung”

作　　者：王蕴 魏葆琳[2] 刘健[2] 封继宏[2] WANG Yun;WEI BAOlin;LIU Jian;FENG Jihong(Tianjin University of Chinese Medicine,Tianjin 300193,China;The Second Affiliated Hospital of Tianjin University of Chinese Medicine,Tianjin 300250,China)

机构地区：[1]天津中医药大学,天津300193 [2]天津中医药大学第二附属医院呼吸与危重症医学科,天津300250

出　　处：《中国民族民间医药》2024年第11期112-118,共7页Chinese Journal of Ethnomedicine and Ethnopharmacy

基　　金：国家自然科学基金资助项目(编号U20A20398)。

摘　　要：目的:为了探讨魏葆琳教授辨证论治慢性阻塞性肺病急性加重期的方剂组方用药规律及治疗该病的学术思想,以期为临床辨证论治AECOPD提供更多的思路。方法:收集魏葆琳教授治疗呼吸科AECOPD患者的首诊处方231首,运用中医传承辅助平台软件(V2.5)分析其中的核心用药及组方规律。结果:231首处方中涉及中药185味,总使用频率3996次(甘草220次),四气当中以寒性药物居多,温性药物次之;五味当中以苦味药为多,甘辛味为次。归经以肺经为主,胃脾肝经为次;药物以止咳化痰平喘药为主,其次为清热药,解表药;基于熵层次的聚类新处方分析,将魏葆琳教授临床经验与之结合,一共得到8组核心组合。结论:魏葆琳教授治疗AECOPD以肺气亏虚、外邪侵袭为主要病因,治疗以复肺气宣降、畅气机为根本目的,以祛邪不伤本为原则,以化痰平喘、祛邪开肺为主,清热解毒、护胃补虚、化瘀平肝等为辅,先行治标以开肺,内外病邪同除,截断病势,兼以治本,寒温并重,因而临床效果显著。Objective In order to explore Professor Wei Baolin s academic thoughts on the prescription grouping and medication rules for the treatment of acute exacerbation of chronic obstructive pulmonary disease(COPD)and the treatment of this disease,with a view to providing more ideas for the clinical diagnosis and treatment of AECOPD.Methods We collected 231 first prescriptions of Professor Wei Baolin for the treatment of respiratory patients with AECOPD,and analyzed the core medications and the law of prescription grouping in them by using the software of Traditional Chinese Medicine Inheritance Auxiliary Platform(V2.5).Results The 231 prescriptions involved 185 flavors of traditional Chinese medicines,with a total usage frequency of 3996 times(220 times for Glycyrrhiza glabra).Among the four qi,most of them were cold medicines,followed by warm medicines;among the five flavors,most of them were bitter medicines,followed by sweet and pungent medicines.Among the five flavors,bitter medicines were the most popular and sweet and pungent medicines were the second most popular.The lung meridian was the main meridian,and the stomach,spleen and liver meridians were the second most popular;the medicines were mainly used to relieve cough,resolve phlegm,and calm asthma,followed by heat-cleansing medicines and antidiarrheal medicines.Conclusion Professor Wei Baolin s treatment of AECOPD is based on the main etiology of lung qi deficiency and invasion of external evils,and the treatment is aimed at restoring the lung qi to promote and lowering the lung qi and unobstructed qi flow,and the principle of eliminating evils without injuring the root is based on the principle of eliminating phlegm and asthma,eliminating evils to open up the lungs,and supplemented by clearing heat and detoxifying the toxin,protecting the stomach and tonifying the deficiency and resolving blood stasis and calming the liver.

关 键 词：慢性阻塞性肺病急性加重期 名医经验 方药规律 数据挖掘 

分 类 号：R256.14[医药卫生—中医内科学]