幽门螺杆菌相关性胃溃疡中医证型、证素的分布特点及中药用药规律  

Distribution Characteristics of TCM Syndromes,Syndrome Elements,and Herbal Medication Patterns in Helicobacter Pylori-Associated Gastric Ulcers

作　　者：王晓娟 周顺华 高晴 仲美琪 任保平 宋厚盼[1,2] WANG Xiaojuan;ZHOU Shunhua;GAO Qing;ZHONG Meiqi;REN Baoping;SONG Houpan(Hunan Provincial Key Laboratory of Diagnostic and Therapeutic Research in Chinese Medicine,Hunan University of Chinese Medicine,Changsha Hunan 410208,China;School of Traditional Chinese Medicine,Hunan University of Chinese Medicine,Changsha Hunan 410208,China)

机构地区：[1]湖南中医药大学中医诊断学湖南省重点实验室,湖南长沙410208 [2]湖南中医药大学中医学院,湖南长沙410208

出　　处：《中医药导报》2025年第3期106-113,共8页Guiding Journal of Traditional Chinese Medicine and Pharmacy

基　　金：国家自然科学基金项目(82374429);湖南省重点研发计划项目(2024JK2122);湖南省自然科学基金项目(2023JJ30460);刘良院士工作站指导项目(22YS003)。

摘　　要：目的:探讨幽门螺杆菌(Hp)相关性胃溃疡患者的中医证型、证素分布特点和中药用药规律。方法:检索中国知网、维普数据库、万方数据库2000年1月至2024年6月有关Hp相关性胃溃疡临床研究的文献,筛选文献后统计分析Hp相关性胃溃疡中医证型、证素分布特点及用药规律。结果:共纳入38篇文献,涉及Hp相关性胃溃疡病例1806例。其中医证型涉及12种,主要为脾胃虚弱证(22.42%)、湿热蕴脾证(19.26%)及脾胃虚寒证(18.15%)等。病位证素中,出现频率由高到低依次为胃、脾、肝,共占总数的95.29%;病性证素中,出现频率由高到低依次为气滞、情志、食积、气虚、热、湿、血瘀、毒及阳虚,共占总数的88.75%。治疗Hp相关性胃溃疡前10味高频中药分别是甘草、黄连、陈皮、半夏、白芍、蒲公英、党参、黄芪、柴胡及白及。结论:Hp相关性胃溃疡辨证以脾胃虚弱证为主,与气滞、情志及食积等病因相关,治疗以甘草、黄连、陈皮、半夏及白芍为核心药物,多以陈皮-茯苓、甘草-柴胡为核心药对进行加减配伍。Objective:To explore the distribution characteristics of traditional Chinese medicine(TCM)syndromes,syndrome elements,and herbal medication patterns in patients with Helicobacter pylori(Hp)-associated gastric ulcers.Methods:Literature on clinical studies of Hp-associated gastric ulcers published between January 2000 and June 2024 was retrieved from databases including CNKI,VIP,and Wanfang.After screening,statistical analysis was conducted to examine the distribution characteristics of TCM syndromes,syndrome elements,and medication patterns.Results:A total of 38 articles involving 1806 cases of Hp-associated gastric ulcers were included.Twelve TCM syndromes were identified,with the most common being spleen-stomach deficiency syndrome(22.42%),damp-heat encumbering the spleen syndrome(19.26%),and spleen-stomach deficiency-cold syndrome(18.15%).Among the disease location syndrome elements,the stomach,spleen,and liver were the most frequently involved,accounting for 95.29%of cases.Among the disease nature syndrome elements,qi stagnation,emotional factors,food retention,qi deficiency,heat,dampness,blood stasis,toxicity,and yang deficiency were the most common,accounting for 88.75%of cases.The top 10 high-frequency herbs used to treat Hp-associated gastric ulcers were Gancao(Glycyrrhizae Radix),Huanglian(Coptidis Rhizoma),Chenpi(Citri Reticulatae Pericarpium),Banxia(Pinelliae Rhizoma),Baishao(Paeoniae Radix Alba),Pugongying(Taraxaci Herba),Dangshen(Codonopsis Radix),Huangqi(Astragali Radix),Chaihu(Bupleuri Radix),and Baiji(Bletillae Rhizoma).Conclusion:The primary TCM syndrome in Hp-associated gastric ulcers is spleen-stomach deficiency syndrome,which is associated with etiological factors such as qi stagnation,emotional factors,and food retention.The core herbs for treatment include Gancao(Glycyrrhizae Radix),Huanglian(Coptidis Rhizoma),Chenpi(Citri Reticulatae Pericarpium),Banxia(Pinelliae Rhizoma),and Baishao(Paeoniae Radix Alba).The core herb pairs often used in formulations are Chenpi(Citri Reticulatae Pericarpium)

关 键 词：幽门螺杆菌 胃溃疡 证型 证素 用药规律 

分 类 号：R256.33[医药卫生—中医内科学]