摘要
目的:探讨中药内服治疗腰椎间盘突出症术后残留症状的用药规律。方法:利用计算机检索中国知网、万方数据库、维普网、PubMed、Web of Science中有关中药内服治疗腰椎间盘突出症术后残留症状的文献,检索时限均为建库至2023年1月31日。提取入选文献中的内服方剂,统计方剂的主治证型、药物组成,以及药物的功效、性、味、归经。采用Microsoft Excel 2021软件统计药物的主治证型、出现频次,以及药物的功效、性、味、归经分布情况。采用SPSS Modeler 18.0软件对筛选出的高频药物进行关联规则分析,采用SPSS Statistics 21.0软件对筛选出的高频药物进行聚类分析。结果:纳入研究的文献共117篇,包含123首内服方剂。方剂的主治证型主要有4个,其中气滞血瘀证(42次)、肾虚血瘀证(35次)、肝肾亏虚证(23次)的出现频次较高。123首内服方剂涉及183味中药,累计出现1363次,其中出现频次≥20的药物共20味,排在前3位的依次为当归(82次)、甘草(70次)、牛膝(66次)。药物功效统计结果显示,补虚药(453次)、活血化瘀药(378次)、祛风湿药(147次)的出现频次较高。药性统计结果显示,温性药(664次)、平性药(397次)的出现频次较高。药味统计结果显示,甘味药(746次)、苦味药(624次)、辛味药(592次)的出现频次较高。药物归经统计结果显示,归肝经(900次)、脾经(599次)、肾经(438次)的药物出现频次较高。将出现频次≥20的中药作为高频药物,通过关联规则分析得到11条关联规则,其中前3位依次为川芎→当归、黄芪→当归、红花→当归;涉及7个核心药物,主要为补虚药(黄芪、当归、甘草)和活血化瘀药(红花、川芎、赤芍、桃仁);通过聚类分析,得到4类药物组合。结论:中药内服治疗腰椎间盘突出症术后残留症状的用药规律为,以补虚药为主,辅以活血化瘀药;多用药性温、平,药味甘、苦、辛,归肝经、脾经、肾经的药物;多以黄芪、当归、甘草、红花、川芎、赤芍、桃仁为主药进行加减。
Objective:To excavale the clinical medication rules of oral Chinese herbal medicine(CHM)prescriptions in treatment of re sidual symptoms after surgery for lumbar disc herniation(LDH).Methods:All artidles aboul oral CHM prescriptions for trealment of residu-al symptoms emerged after surgery for LDH included from database establishing to January 31,2023 were retrieved from the China National Knowledge Intemet,W anfang Database,Vip Database,PubMed and Web of Science through computer.The obtained articles were screened according to the predefined inclusion and exclusion criteria,and the oral CHM prescriptions were extracted from the included artidles,fol-lowed by statistics on the indications,ingredients contained in the CHM prescriptions as well as the efficacy,medicinal property,medicinal flavor and merdian tropism of each Chinese herbs(CHs)in prescriptions.The normalized and standardized CHs in the extracted prescrip-tions were input into the Microsoft Office Excel 2021 software for building a database,based on which their indications,occurrence frequen-cy,ffcacy,medicinal property,medicinal flavor and meridian tropism were staistically analyzed.The high-frequency CHs were then subjec ted to association rule analysis by using SPSS Modeler 18.0 software and cluster analysis by using SPSS Statistics 21.0 software.Results:One hundred and seventeen articles were included in the final analysis,involving 123 oral CHM prescriptions,and they mainly acted on 4 indications,anong which Qi-stagnation and blood-stasis syndrome(42 times),kidney-deficiency and blood-stagnation syndrome(35 times)and liver-kidney deficiency syndrome(23 times)occurred more frequently.One hundred and eighty-three CHs(appeared 1363 times)were involved in the 123 oral CHM prescriptions,among which 20 ones displayed a occurrence frequency of≥20,and the top 3 ones with high occurrence frequency ineluded Angelicae Sinensis Radix(TCD)(82 times),Glyeyrthizae Radix et Rhizoma(TCD)(70 times)and Achyranthes Bidentalae Radix(TCD)(66 times).The results of statistics on eficacy showed that the CHs with high occur-rence frequency included reinforcing deficiency herbs(453 times),promoting blood circulation and removing blood stasis herbs(378 times)and dispelling pathogenic wind and dampeness herbs(147 times).The results of statistics on medicinal property showed that the most fre-quently used CHs were those with a warm property(664 times),fllowed by the ones with a neulral property(397 times).The resuls of sta tistics on medicinal flavor showed that the CHs with sweel,bitter and pungent flavors were more prefered,with their occurrence frequency ol being 746,624 and 592 times respectively.The results of statistics on meridian tropism showed that the CHs mainly acted on the liver me ridians(900 times),spleen meidians(599 times)and kidney meidians(438 times).The CHs with occurrence frequency of≥20 were con-sidered as the high frequency herbs.Eleven association rules were obtained through association rule analysis,among which the top 3 ones in-cluded Chuanxiong Rhizoma-+Angelicae Sinensis Radix(TCD),Astmgali Radix(TCD)-+Angelicae Sinensis Radix(TCD)and Carthami Flos(TCD)→Angelicae Sinensis Radix(TCD).The association rule analysis on the high frequency berbs involved 7 core herbs,which were mainly the reinforcing deficiency herbs(Astmgali Radix(TCD),Angelicae Sinensis Radix(TCD),Glyeyrhizae Radix e Rhizoma(TCD))as well as the pronoting blood eirculation and removing blood stasis bherbs(Carthami Flos(TCD),Chuanxiong Rhizoma,Paconiae Radix Rubra,Persicae Semen).Furthermore,4 new berb combinations were obtained by cluster analysis on the high frequency berbs.Conclusion:The oral CHM prescriptions aimed at treating residual symptoms after surgery for LDH are centred on the reinforcing deficiency herbs,sup-plemented by the promoting blood circulation and removing blood stasis herbs,and the CHs in oral CHM prescriptions are often the ones presented with warmn and neutral properties,sweet,biter and pungent flavors and mainly act on liver,spleen and kidney meridians.Astmgali Radix(TCD),Angelicae Sinensis Radix(TCD),Glyeyrhizae Radix et Rhizoma(TCD),Carthami Flos(TCD),Chuanxiong Rhizoma,Pacon-iae Radix Rubra and Persicae Semen are usually used as the core of the oral CHM prescriptions.
作者
王一迪
范利娟
石洋
白超楠
崔宏勋
WANG Yidi;FAN Lijuan;SHI Yang;BAI Chaonan;CUI Hongxun(Postgraduate College of Henan University of Chinese Medicine,Zhengzhou 450046,Henan,China;Luoyang Orthopedic-Traumatological Hospital,Zhengzhou 450016,Henan,China)
出处
《中医正骨》
2023年第8期37-42,共6页
The Journal of Traditional Chinese Orthopedics and Traumatology
基金
全国中医药创新骨干人才项目(国中医药人教函[2019]128号)
河南省中医药拔尖人才项目(豫中医科教[2018]25号)。
关键词
椎间盘移位
腰椎
手术后并发症
中药
方剂分析
计算机辅助
数据挖掘
intervertebral disc displacement
lumbar vetebrae
postoperaive complications
Tradional Chinese Drugs
formula analysis
computer assisted
data mining
作者简介
通讯作者:崔宏勋,E-mail:chx6542@126.com。
