郭朋诊治慢性乙型肝炎肝硬化腹水的用药经验  

GUO Peng′s Medication Experience in Treating Chronic Hepatitis B Cirrhosis with Ascites

作　　者：杨小纤 杨丰瑞 严海艺 郭朋[3] YANG Xiaoxian;YANG Fengrui;YAN Haiyi;GUO Peng(Nanjing University of Chinese Medicine,Nanjing 210029,Jiangsu,China;Changchun University of Chinese Medicine,Changchun 130117,Jilin,China;Xiyuan Hospital,China Academy of Chinese Medical Sciences,Beijing 100091,China)

机构地区：[1]南京中医药大学,江苏南京210029 [2]长春中医药大学,吉林长春130117 [3]中国中医科学院西苑医院,北京100091

出　　处：《辽宁中医杂志》2025年第3期24-27,I0002,共5页Liaoning Journal of Traditional Chinese Medicine

基　　金：国家自然科学基金项目(81673967)。

摘　　要：目的通过数据挖掘技术探索郭朋教授治疗慢性乙型肝炎肝硬化腹水患者的临床用药规律,总结其辨治思想,为临床治疗提供思路与方法。方法收集2019年12月—2021年12月郭朋教授于中国中医科学院西苑医院肝病科门诊诊治慢性乙型肝炎肝硬化腹水的处方,汇总患者的临床用药数据并对其进行规范化,将处理好的数据录入中医传承辅助平台(V2.5),通过平台的数据挖掘、关联规则、聚类分析等方法,将郭朋教授用药规律进行客观化呈现,并总结其相关学术思想及理论。结果共纳入处方107首,中药117味,获得由14味中药组成的核心处方——利水方:丹参、醋鸡内金、茯苓、麸炒白术、木香、白茅根、猪苓、蝉蜕、黄芪、砂仁、车前子、玉米须、冬瓜皮、泽兰;药性依次为寒性、温性、平性、凉性、热性;药味依次为甘味、苦味、辛味、酸味、咸味、涩味;归经主要以脾、肝、胃、肺、肾为主。结论郭朋教授治疗慢性乙型肝炎肝硬化腹水注重恢复肝脾功能,以“内生湿热”和“血不利”为两大病因,遵循“培中州利三焦、宣于外利其内”两大原则,用药往往寒温并用,苦辛并行,使机体热消湿退血行,湿热瘀毒郁结得散,腹水得平。Objective To explore the clinical medication pattern of Professor GUO Peng in treating patients with chronic hepatitis B cirrhosis ascites through data mining technology,summarize his ideas of discriminative treatment and provide ideas and methods for clinical treatment.Methods The prescriptions for the treatment of chronic hepatitis B cirrhosis with ascites by professor GUO Peng at the outpatient department of liver diseases in Xiyuan Hospital of China Academy of Chinese Medical Sciencesfrom December 2019 to December 2021 were collected.The clinical medication data of patients was summarized and standardized,and then the processed data was inputnto the Traditional Chinese Medicine Inheritance Assistant Platform(V2.5).Through the platform′s data mining,association rules,clustering analysis and other methods,the medication rules of Professor GUO Peng were objectively presented and his relevant academic thoughts and theories were summarized.Results A total of 107 prescriptions and 117 Chinese herbal medicines were included,and a core formula consisting of 14 herbal medicines,named Lishui Formula(利水方),was obtained.The formula included Danshen(Salviae Miltiorrhizae Radix et Rhizoma),vinegar-processed Jineijin(Galli Gigerii Endothelium Corneum),Fuling(Poria),Baizhu(Atractylodis Macrocephalae Rhizoma)stir-frying with bran,Muxiang(Aucklandiae Radix),Baimaogen(Imperatae Rhizoma),Zhuling(Polyporus),Chantui(Cicadae Periostracum),Huangqi(Astragali Radix),Sharen(Amomi Fructus),Cheqianzi(Plantaginis Semen),Yumixu(Stigma Maydis),Dongguapi(Benincasae Exocarpium)and Zelan(Lycopi Herba).The properties of the herbal medicines were successively cold,warm,neutral,cool and heat in nature,while the tastes were sweet,bitter,pungent,sour,salty and astringent.The main meridian tropism were spleen,liver,stomach,lung and kidney meridians.Conclusion Professor GUO Peng emphasizes the importance of restoring liver and spleen function in the treatment of chronic hepatitis B cirrhosis with ascites.He believes that“endogenous damp-heat

关 键 词：肝硬化 腹水 乙型肝炎 经验 数据挖掘 

分 类 号：R256.4[医药卫生—中医内科学]