岐黄学者张学智培土畅中法治疗幽门螺杆菌根除后化生性慢性萎缩性胃炎的处方用药规律  

ZHANG Xuezhi's medication pattern for treating metaplasia chronic atrophic gastritis post-HP eradication adheres to the traditional Chinese medicine principles of spleen nourishment and middle burner regulation

作　　者：曹峻文 叶晖[2] 黄秋月 杨闪闪 张希颜 李程程 米尔阿依·穆合塔尔 张学智[2] CAO Junwen;YE Hui;HUANG Qiuyue;YANG Shanshan;ZHANG Xiyan;LI Chengcheng;MIERAYI·Muhetaer;ZHANG Xuezhi(Department of Digestive Diseases,Beijing University of Traditional Chinese Medicine Dongzhimen Hospital,Beijing,100029,China;Department of Traditional Chinese Medicine and Integration of Traditional and Western Medicine,Peking University First Hospital)

机构地区：[1]北京中医药大学东直门医院消化科,北京100029 [2]北京大学第一医院中医科、中西医结合科

出　　处：《中国中西医结合消化杂志》2024年第7期568-574,共7页Chinese Journal of Integrated Traditional and Western Medicine on Digestion

基　　金：首都卫生发展科研专项(No:首发2022-2-4077);中央高水平医院临床科研专项(No:2022CR64);国家中医药管理局中医药传承与创新“百千万”人才工程岐黄学者(No:国中医药人教函[2018]284号);中央高水平医院临床科研业务费资助(北京大学第一医院科研种子基金项目)(No:2023SF25);中央高水平医院临床科研业务费资助(北京大学第一医院科研种子基金项目)(No:2024SF49)。

摘　　要：目的:运用数据挖掘探究张学智教授培土畅中法治疗幽门螺杆菌(HP)根除后化生性慢性萎缩性胃炎(MCAG)的用药规律。方法:收集2022年9月—2023年9月张学智教授治疗HP根除后MCAG处方,运用R4.3.2、SPSS Modeler 18.0和Cytospace 3.10.1对处方进行分析。结果:共收集150首处方,中药共162味,频次共3289次,频数排名前20药物功效以补虚、理气为主。药性以寒、温、平为主,药味以甘、苦、辛为主,归经以肝经、肺经、脾经、胃经为主。关联规则得到“黄芪、瓦楞子-柴胡”、“陈皮-黄芪”、“黄连-黄芪”等药对,聚类分析呈现2个类别。得到核心处方:黄芪、茯苓、白术、三七、陈皮、法半夏、香附、丹参、甘草,同时运用中药权重方法计算加权相似度>0.5共计99首,合计占66%的处方。结论:张教授认为HP根除后MCAG属本虚标实,应以培土补虚为本,寒热并用,攻补兼施,注重调理气机、燥化痰湿、活血化瘀。Objective This study aims to investigate the medication patterns employed by Professor ZHANG Xuezhi in the treatment of Metaplasia Chronic Atrophic Gastritis following the eradication of Helicobacter pylori(HP)using data mining techniques.Methods Prescriptions from Professor ZHANG Xuezhi for Metaplasia CAG after HP eradication between September 2022 and September 2023 were collected.The analysis was conducted using R 4.3.2,SPSS Modeler 18.0,and Cytospace 3.10.1.Results A total of 150 prescriptions were collected,comprising 162 different Chinese herbs with a total frequency of 3289 occurrences.The top 20 drugs by frequency primarily targeted tonifying deficiencies and regulating qi.The predominant nature of the drugs was cold,warm,and neutral,while the predominant tastes were sweet,bitter,and pungent.The associated meridians included the liver,lung,spleen,and stomach.Association rules revealed pairs of drugs such as"Astragalus,Valeriana-Bupleurum","Tangerine Peel-Astragalus",and"Coptis-Astragalus".Cluster analysis revealed two distinct categories.The core prescription included Astragalus,Poria,Atractylodes,Notoginseng,Tangerine Peel,Pinellia,Cyperus,Salvia,and Licorice.Using a traditional Chinese medicine weight method,99 prescriptions with a weighted similarity greater than 0.5 were identified,collectively constituting 66%of the prescriptions.Conclusion Professor ZHANG suggests that post-HP eradication,Metaplasia chronic atrophic gastritis is characterized by deficiency with excess symptoms.The treatment approach should focus on tonifying deficiencies,combining cold and warm properties,and emphasizing the regulation of qi,elimination of dampness,and promotion of blood circulation to resolve stasis.

关 键 词：慢性萎缩性胃炎 幽门螺杆菌 肠上皮化生 用药规律 

分 类 号：R573.3[医药卫生—消化系统]