摘要
目的采用数据挖掘的方法对中药治疗心力衰竭伴利尿剂抵抗的临床组方用药规律进行探索。方法检索中国知网、万方数据库等7个国内外数据库从建库起至2021年10月有关中药治疗心力衰竭伴利尿剂抵抗的文献。采用频次分析、关联规则分析、聚类分析等方法进行统计分析。结果最终纳入文献41篇,包含方剂39首。该病以阳虚和水停为最主要证素,共使用单味中药72味,累计使用438次,使用频次前5的依次是茯苓、黄芪、附子、白术和桂枝。使用频次≥5次的中药有30味,涉及9种功效,以补虚药、利水渗湿药、活血化瘀药和温里药为主。关联规则分析得到白术→茯苓和桂枝→茯苓等以茯苓为核心的药物配伍。聚类分析得到6个新方组合,功效以温阳利水、益气活血为主。结论心衰伴利尿剂抵抗为本虚标实、寒热错杂之证,核心病机为“虚”、“水”、“瘀”,临床以阳虚水泛为主证,治以温阳利水为主,辅以益气活血,茯苓配伍白术、桂枝为常用药对组合,真武汤为治疗该病的基础方。
Objective To explore the medication rules of clinical prescriptions of Chinese medicine in the treatment of heart failure with diuretic resistance based on data mining method.Methods Seven domestic and foreign databases,including CNKI and Wanfang,were searched for literature on Chinese medicine for heart failure with diuretic resistance from the establishment of the database to October 2021.Frequency analysis,association rule analysis and cluster analysis were used for statistical analysis.Results A total of 41 literatures were included,including 39 prescriptions.Yang deficiency and water retention were the main symptoms of the disease.A total of 72 single herbs were used,with a total of 438 times of use.There are 30 Chinese medicines with a frequency of more than 5 times,involving 9 efficacy categories,mainly tonic medicines,diuresis and dampness medicines,blood-activating and stasis-removing medicines,and interior-warming medicines.The association rule analysis yielded drug compatibility with Poria as the core,such as Atractylodis Macrocephalae Rhizoma→Poria and Cinnamomi Ramulus→Poria.Cluster analysis yielded six new formula combinations with efficacy in warming Yang,inducing diuresis,benefiting qi and invigorating Blood.Conclusion Heart failure with diuretic resistance is a syndrome of root vacuity and tip repletion,cold-heat complex,and the core pathogenesis is"deficiency","water"and"stasis".The treatment of this disease occurs by warming yang and excreting water,supplemented by replenishing qi and activating blood circulation.Poria with Atractylodis Macrocephalae Rhizoma and Cinnamomi Ramulus are commonly used combinations,and Zhen Wu Decoction is the basic formula for the treatment of this disease.
作者
郭红鑫
李彬
闫海峰
李兴渊
朱明军
Guo Hongxin;Li Bin;Yan Haifeng;Li Xingyuan;Zhu Mingjun(The First Clinical Medical College of Henan University of Chinese Medicine,Zhengzhou 450046,China;The First Affiliated Hospital of Henan University of Chinese Medicine,Zhengzhou 450003,China)
出处
《世界科学技术-中医药现代化》
CSCD
北大核心
2023年第9期3063-3070,共8页
Modernization of Traditional Chinese Medicine and Materia Medica-World Science and Technology
基金
国家科学技术部国家重点研发计划(2019YFC1710003):不同区域人群心脑血管疾病中医健康状态监测、预警与防控模式的示范研究,负责人:朱明军
国家自然科学基金委员会重点项目(82030120):基于病证结合的冠心病心力衰竭血瘀证演变规律及中医药干预机制研究,负责人:朱明军
国家自然科学基金委员会面上项目(82074226):基于能量代谢研究人参总次苷干预冠心病心肌重构的作用及机制,负责人:李彬。
关键词
中药
心力衰竭
利尿剂抵抗
数据挖掘
用药规律
真武汤
Chinese medicine
Heart failure
Diuretic resistance
Data mining
Medication rules
Zhenwu decoction
作者简介
通讯作者:朱明军,教授,博士研究生导师,主要研究方向:中医药防治心血管疾病的临床和基础研究。
