余承惠运用益肾清利活血法治疗慢性肾脏病用药规律研究
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摘要
目的分析余承惠主任运用益肾清利活血法治疗慢性肾脏病(CKD)用药规律,为临床提供参考。方法收集2010年9月-2016年4月余承惠于江苏省中医院门诊治疗的CKD患者医案。构建基于Spark的四节点分布式数据挖掘平台,采用频数统计、关联规则、复杂网络等数据挖掘方法,分析处方常用药物、药物性味、归经、功效及药物之间的关联规则。结果纳入处方2534首,涉及药物246味,高频药物有白花蛇舌草、白术、茯苓、苍术、川芎、丹参、牡丹皮、黄芪、积雪草、半枝莲、北沙参、墨旱莲、地锦草等;药物性味以甘温、苦寒为主;归经以肝经、脾经及胃经为主。核心处方为黄芪、白术、苍术、茯苓、北沙参、半枝莲、白花蛇舌草、积雪草、川芎、丹参、牡丹皮。结论余承惠采用益肾清利活血法治疗CKD,其中益肾以益气养阴为主,清利以清热利湿为主,活血以活血行气、活血清热为主。
Objective To analyze Director YU Chenghui's medication rules of using Yishen Qingli Huoxue Therapy for treatment of chronic kidney disease(CKD); To provide references for clinic. Methods Clinical cases of CKD treated by YU Chenghui in outpatient of Jiangsu Province Hospital of Chinese Medicine from Sep. 2010 to Apr.2016 were collected. A four-node distributed data mining platform was built based on Spark. Data mining methods such as frequency statistics, association rules, and complex networks were used to analyze commonly used medicine,medicine taste, meridians, efficacy and the association rules. Results Totally 2534 prescriptions were enrolled, including 246 kinds of Chinese materia medica. High-frequency medicines included Hedyotis diffusa, Atractylodis Macrocephalae Rhizome, Poria, Atractylodis Rhizoma, Chuanxiong Rhizoma, Salviae Miltiorrhizae Radix et Rhizoma, Moutan Cortex, Astragali Radix, Centellae Herba, Scutellariae Barbatae Herba, Glehniae Radix, Ecliptae Herba, and Euphorbiae Humifusae Herba. The medicine properties were mainly warm and cold and the main medicine tastes were sweet and bitter. Medicine efficacy in meridians were mainly in liver, spleen and stomach meridian. The core prescriptions included Astragali Radix, Atractylodis Macrocephalae Rhizome, Atractylodis Rhizoma, Poria, Glehniae Radix, Scutellariae Barbatae Herba, Hedyotis diffusa, Centellae Herba, Chuanxiong Rhizoma, Salviae Miltiorrhizae Radix et Rhizoma, and Moutan Cortex. Conclusion YU Chenghui adopts Yishen Qingli Huoxue Therapy for CKD, in which tonifying spleen is mainly for benefiting qi and nourishing yin, clearing is mainly for clearing heat and dampness, and promoting blood circulation is mainly for promoting blood circulation to regulate qi and promoting blood circulation to clearing heat.
Objective To analyze Director YU Chenghui's medication rules of using Yishen Qingli Huoxue Therapy for treatment of chronic kidney disease(CKD); To provide references for clinic. Methods Clinical cases of CKD treated by YU Chenghui in outpatient of Jiangsu Province Hospital of Chinese Medicine from Sep. 2010 to Apr.2016 were collected. A four-node distributed data mining platform was built based on Spark. Data mining methods such as frequency statistics, association rules, and complex networks were used to analyze commonly used medicine,medicine taste, meridians, efficacy and the association rules. Results Totally 2534 prescriptions were enrolled, including 246 kinds of Chinese materia medica. High-frequency medicines included Hedyotis diffusa, Atractylodis Macrocephalae Rhizome, Poria, Atractylodis Rhizoma, Chuanxiong Rhizoma, Salviae Miltiorrhizae Radix et Rhizoma, Moutan Cortex, Astragali Radix, Centellae Herba, Scutellariae Barbatae Herba, Glehniae Radix, Ecliptae Herba, and Euphorbiae Humifusae Herba. The medicine properties were mainly warm and cold and the main medicine tastes were sweet and bitter. Medicine efficacy in meridians were mainly in liver, spleen and stomach meridian. The core prescriptions included Astragali Radix, Atractylodis Macrocephalae Rhizome, Atractylodis Rhizoma, Poria, Glehniae Radix, Scutellariae Barbatae Herba, Hedyotis diffusa, Centellae Herba, Chuanxiong Rhizoma, Salviae Miltiorrhizae Radix et Rhizoma, and Moutan Cortex. Conclusion YU Chenghui adopts Yishen Qingli Huoxue Therapy for CKD, in which tonifying spleen is mainly for benefiting qi and nourishing yin, clearing is mainly for clearing heat and dampness, and promoting blood circulation is mainly for promoting blood circulation to regulate qi and promoting blood circulation to clearing heat.
引文
[1]余承惠,何伟明,江燕.余承惠肾系病临证用药心悟[M].北京:人民卫生出版社,2014:1.
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[3]余江毅,熊宁宁,余承惠,等.肾病湿热病理的临床分析和实验研究[J].中国中西医结合杂志,1992,12(8):458-460,451.
[4]谢佳东,房裴裴,胡孔法,等.现代名老中医临床诊疗方药数据抽取与清理方法研究[J].时珍国医国药,2017,28(11):2786-2788.
[5]国家药典委员会.中华人民共和国药典:一部[M].北京:中国医药科技出版社,2015.
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[7]宋观礼,刘保延,王映辉,等.基于中医临床科研信息一体化技术平台的冠心病诊治规律研究[J].中华中医药杂志,2013,28(5):1247-1252.
[8]黄玉华,李园白,杨阳,等.蔡连香从“冲任”论治妇科疾病辨证用药规律研究[J].中国中医药信息杂志,2017,24(3):91-95.
[9]施俊,叶敏,陆烨,等.魏品康从痰论治胃癌用药规律研究[J].中国中医药信息杂志,2017,24(10):85-89.
[10]施雪斐,王一花,陈丽云,等.严世芸治疗心律失常用药规律研究[J].中国中医药信息杂志,2018,25(10):101-105.
[11]江燕,何伟明,余承惠.肾炎湿热论[J].四川中医,2014,32(1):53-54.
[12]魏明刚,孙伟.白花蛇舌草在泌尿系统疾病治疗中的应用[J].中医学报,2013,28(11):1741-1742.
[13]曾凤铭.重用白花蛇舌草治疗肾炎血尿[J].中医杂志,2009,50(7):628-629.
[14]彭暾,刘向明.白花蛇舌草治疗肾性蛋白尿[J].中医杂志,2007,48(4):342.
[15]杨迎,刘嘉琛,杜肖肖,等.积雪草治疗肾系疾病的探究[J].世界最新医学信息文摘,2018,18(24):195,198.
[16]刘婷,王晓妍,曹志群.半枝莲药理作用及临床应用研究进展[J].河南中医,2013,33(3):424-426.
[17]周承.中药黄芪药理作用及临床应用研究[J].亚太传统医药,2014,10(22):100-101.
[18]郑晓珂,于洋,周静,等.白术各化学拆分组分及其配伍对大鼠肾病综合征的影响[J].中药新药与临床药理,2016,27(4):467-474.
[2]余江毅,熊宁宁,余承惠.慢性肾病瘀血与湿热病理的临床和实验研究[J].辽宁中医杂志,1995,22(2):91-92.
[3]余江毅,熊宁宁,余承惠,等.肾病湿热病理的临床分析和实验研究[J].中国中西医结合杂志,1992,12(8):458-460,451.
[4]谢佳东,房裴裴,胡孔法,等.现代名老中医临床诊疗方药数据抽取与清理方法研究[J].时珍国医国药,2017,28(11):2786-2788.
[5]国家药典委员会.中华人民共和国药典:一部[M].北京:中国医药科技出版社,2015.
[6]国家中医药管理局《中华本草》编委会.中华本草[M].上海:上海科学技术出版社,1999.
[7]宋观礼,刘保延,王映辉,等.基于中医临床科研信息一体化技术平台的冠心病诊治规律研究[J].中华中医药杂志,2013,28(5):1247-1252.
[8]黄玉华,李园白,杨阳,等.蔡连香从“冲任”论治妇科疾病辨证用药规律研究[J].中国中医药信息杂志,2017,24(3):91-95.
[9]施俊,叶敏,陆烨,等.魏品康从痰论治胃癌用药规律研究[J].中国中医药信息杂志,2017,24(10):85-89.
[10]施雪斐,王一花,陈丽云,等.严世芸治疗心律失常用药规律研究[J].中国中医药信息杂志,2018,25(10):101-105.
[11]江燕,何伟明,余承惠.肾炎湿热论[J].四川中医,2014,32(1):53-54.
[12]魏明刚,孙伟.白花蛇舌草在泌尿系统疾病治疗中的应用[J].中医学报,2013,28(11):1741-1742.
[13]曾凤铭.重用白花蛇舌草治疗肾炎血尿[J].中医杂志,2009,50(7):628-629.
[14]彭暾,刘向明.白花蛇舌草治疗肾性蛋白尿[J].中医杂志,2007,48(4):342.
[15]杨迎,刘嘉琛,杜肖肖,等.积雪草治疗肾系疾病的探究[J].世界最新医学信息文摘,2018,18(24):195,198.
[16]刘婷,王晓妍,曹志群.半枝莲药理作用及临床应用研究进展[J].河南中医,2013,33(3):424-426.
[17]周承.中药黄芪药理作用及临床应用研究[J].亚太传统医药,2014,10(22):100-101.
[18]郑晓珂,于洋,周静,等.白术各化学拆分组分及其配伍对大鼠肾病综合征的影响[J].中药新药与临床药理,2016,27(4):467-474.
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