基于关联规则与复杂网络分析的名老中医治疗脂肪肝用药规律研究
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摘要
目的探讨现代名老中医治疗脂肪肝的用药规律。方法对中国知网、万方医学网等中文数据库从建库至2017年11月关于名老中医治疗脂肪肝的文献进行检索,建立名老中医治疗脂肪肝的用药规律数据库,采用复杂网络分析技术及关联规则分析等方法对名医治疗脂肪肝的用药规律进行探析。结果共纳入合格文献60篇,涉及处方80首,药物种类18种,中药165味,自拟方剂占85%。现代名老中医治疗脂肪肝的常用用药以补虚药、利水渗湿药、活血化瘀药、理气药、清热药、消食药、化痰药和化湿药为主,核心药物包括山楂、泽泻、柴胡、白术、茯苓、丹参、郁金、决明子、黄芪、白芍、赤芍、法夏、陈皮、甘草等,其中活血化瘀药与利水渗湿药最常配伍出现,山楂与荷叶是治疗脂肪肝最常见的药对。结论现代名中医治疗脂肪肝虽然以自拟方剂居多,但其主要治法离不开"扶正、祛湿、活血、理气、清热、消食、化痰"诸法,用药存在一定规律性,复杂网络分析技术及关联规则分析等数据挖掘方法有助于探索其用药规律。
Objectives To explore the medication rule of veteran traditional Chinese medicine(TCM)physicians in the treatment of nonalcoholic fatty liver disease(NAFLD).Methods The literature about veteran TCM physicians' treatment of NAFLD before November of 2017 was searched in the Chinese database to establish the database of veteran TCM physicians' medication rules.Then the complex network and association rule were used to explore veteran TCM physicians' medication rules in treating NAFLD.Results A total of 60 eligible literatures were included,which involved 80 prescriptions,18 kinds of drugs and 165 Chinese herbs.Among them 85% of those prescriptions were self-made.Veteran TCM physicians' main medicines for the treatment of NAFLD were as follows:defficiency-nourishing drugs,damp-clearing drug,blood-activating and stasis-eliminating medicine,Qiregulating drug,heat-clearing drug,digestant drug,expectorant and dampness-dissipating drug.The core drugs included Hawthorn, Alisma orientalis, Bupleurum, Atractylodes macrocephala, Poria cocos, Salvia miltiorrhiza,Tulip,Cassia seed,Astragalus membranaceus,Radix Paeoniae Alba,Radix Paeoniae Rubra,Fascia,dried tangerine peel,and Licorice.The drug for invigorating blood circulation and eliminating stasis is most commonly compatible with the damp-clearing drug.Hawthorn and lotus leaf are the most common drug pair in treating NAFLD.Conclusion Although the majority of veteran TCM physicians' prescriptions for NAFLD were self-made,the main rule can not be separated from the law of "strengthening the body resistance,clearing damp,activating blood,regulating qi,clearing heat,promoting digestion and eliminating phlegm",and the use of the drugs has certain regularity.The data excavation methods such as the complex network and association rule are helpful to analyze the medication rule.
Objectives To explore the medication rule of veteran traditional Chinese medicine(TCM)physicians in the treatment of nonalcoholic fatty liver disease(NAFLD).Methods The literature about veteran TCM physicians' treatment of NAFLD before November of 2017 was searched in the Chinese database to establish the database of veteran TCM physicians' medication rules.Then the complex network and association rule were used to explore veteran TCM physicians' medication rules in treating NAFLD.Results A total of 60 eligible literatures were included,which involved 80 prescriptions,18 kinds of drugs and 165 Chinese herbs.Among them 85% of those prescriptions were self-made.Veteran TCM physicians' main medicines for the treatment of NAFLD were as follows:defficiency-nourishing drugs,damp-clearing drug,blood-activating and stasis-eliminating medicine,Qiregulating drug,heat-clearing drug,digestant drug,expectorant and dampness-dissipating drug.The core drugs included Hawthorn, Alisma orientalis, Bupleurum, Atractylodes macrocephala, Poria cocos, Salvia miltiorrhiza,Tulip,Cassia seed,Astragalus membranaceus,Radix Paeoniae Alba,Radix Paeoniae Rubra,Fascia,dried tangerine peel,and Licorice.The drug for invigorating blood circulation and eliminating stasis is most commonly compatible with the damp-clearing drug.Hawthorn and lotus leaf are the most common drug pair in treating NAFLD.Conclusion Although the majority of veteran TCM physicians' prescriptions for NAFLD were self-made,the main rule can not be separated from the law of "strengthening the body resistance,clearing damp,activating blood,regulating qi,clearing heat,promoting digestion and eliminating phlegm",and the use of the drugs has certain regularity.The data excavation methods such as the complex network and association rule are helpful to analyze the medication rule.
引文
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[8]曾斌芳,杨旋,王洁.中医药治疗非酒精性脂肪肝的临床进展[J].新疆医科大学学报,2018,41(2):144-146.
[9]许勇,陶颖,苟小军.非酒精性脂肪肝中医病因病机探析[J].中华中医药学刊,2016,34(11):2586-2589.
[10]刘鲲,刘娜,张玉珂.山楂免疫和保健作用研究[J].光明中医,2017,32(18):2727-2730.
[11]杨静云,李宇兴,赖永勤,等.山楂、泽泻、决明子与红曲霉混合发酵产物对高血脂大鼠调脂作用研究[J].中草药,2017,48(07):1369-1373.
[12]邢增智,陈旺,曾宇.泽泻的化学成分与药理作用研究进展[J].中医药导报,2017,23(15):75-78.
[13]黄晓欢.泽泻提取物对非酒精性脂肪肝的作用机制研究[J].按摩与康复医学,2017,8(6):76-78.
[2]Diehl A M,Day C.Cause,Pathogenesis,and Treatment of Nonalcoholic Steatohepatitis[J].N Engl J Med,2017,377(21):2063-2072.
[3]Wang F S,Fan J G,Zhang Z,et al.The global burden of liver disease:the major impact of China[J].Hepatology,2014,60(6):2099-2108.
[4]Fan J G,Kim S U,Wong V W.New trends on obesity and NAFLD in Asia[J].J Hepatol,2017,67(4):862-873.
[5]Wong V W,Chan W K,Chitturi S,et al.Asia-Pacific Working Party on Non-alcoholic Fatty Liver Disease guidelines 2017-Part1:Definition,risk factors and assessment[J].J Gastroenterol Hepatol,2018,33(1):70-85.
[6]Chalasani N,You nossi Z,Lavine J E,et al.The diagnosis and management of nonalcoholic fatty liver disease:Practice guidance from the American Association for the Study of Liver Diseases[J].Hepatology.2018,67(1):328-357
[7]European Association for the Study of the Liver(EASL),European Association for the Study of Diabetes(EASD),European Association for the Study of Obesity(EASO).EASL-EASD-EASO Clinical Practice Guidelines for the management of non-alcoholic fatty liver disease[J].J Hepatol,2016,64(6):1388-1402
[8]曾斌芳,杨旋,王洁.中医药治疗非酒精性脂肪肝的临床进展[J].新疆医科大学学报,2018,41(2):144-146.
[9]许勇,陶颖,苟小军.非酒精性脂肪肝中医病因病机探析[J].中华中医药学刊,2016,34(11):2586-2589.
[10]刘鲲,刘娜,张玉珂.山楂免疫和保健作用研究[J].光明中医,2017,32(18):2727-2730.
[11]杨静云,李宇兴,赖永勤,等.山楂、泽泻、决明子与红曲霉混合发酵产物对高血脂大鼠调脂作用研究[J].中草药,2017,48(07):1369-1373.
[12]邢增智,陈旺,曾宇.泽泻的化学成分与药理作用研究进展[J].中医药导报,2017,23(15):75-78.
[13]黄晓欢.泽泻提取物对非酒精性脂肪肝的作用机制研究[J].按摩与康复医学,2017,8(6):76-78.