[关键词]
[摘要]
目的 应用“中医传承辅助系统(V2.50)”软件挖掘中医药方剂治疗酒精性肝病的组方规律。方法 检索中国期刊全文数据库(CNKI)、万方数据库、中文科技期刊全文数据库(VIP)中运用中医方剂治疗酒精性肝病的文献,运用中医传承辅助平台统计分析中医药治疗酒精性肝病的组方用药规律。结果 通过统计发现共涉及107首方剂,其中酒精性脂肪肝、酒精性肝炎、酒精性肝硬化治疗的方剂较多。通过“频次统计”分析发现共涉及中药149味,累计频次1 195次。使用频次≥15的中药共23味,累计使用频次为737次(62%),应用较多的是活血化瘀药、利水渗湿药、补益药、清热药、解酒毒药、理气药。用药频数排名前10的药物中丹参、茯苓、柴胡、甘草、白术、泽泻、郁金的常用剂量符合《中国药典》2015年版规定的剂量,山楂、茵陈、葛根超出规定剂量。在药对频次分析中,丹参-柴胡组合应用最多;从药物间组合的关联规则分析中发现,郁金和丹参的关联性最强,即丹参随郁金的出现而出现的概率达88%;从网络展示图可以看出,治疗以丹参、茯苓为主。通过无监督的熵层次聚类算法,提取出用于新方聚类的核心组合14个,进一步聚类可得到7个新处方。结论 中医药治疗酒精性肝病以活血化瘀、化湿、补益、解酒毒、行气为主,且始终以“顾护脾胃功能”为宗旨,符合中医药治疗酒精性肝病的理论基础。核心组合与新方为临床用药和新药研发提供了参考,但新处方不能直接应用到临床治疗,必须与中医药理论及临床实践相结合作进一步评判。
[Key word]
[Abstract]
Objective To summarize the prescription rules of traditional Chinese medicine (TCM) for treating alcoholic liver disease (ALD) based on TCM inheritance support system (V2.50). Methods The literatures about TCM prescriptions for treating ALD were collected from CNKI, Wanfang database, and VIP database. The TCM inheritance platform system was used to analyze the prescription rules of TCM in the treatment of alcoholic liver disease. Results Statistics showed that the majority of prescriptions were used to treat alcoholic fatty liver, alcoholic hepatitis, and alcoholic cirrhosis. Through "frequency statistics" analysis, 107 prescriptions were found involving 149 flavors of TCM, with a cumulative frequency of 1 195 times. Twenty-three Chinese medicines with a frequency of ≥ 15 times were used, and the cumulative frequency was 737 times (62%). The most frequently used medicines were blood-activating and stasis-removing drugs, water-diffusing and damp-permeating drugs, tonics, heat-clearing drugs, antialcoholic poisons and qi-regulating drugs. The commonly used doses of Salvia miltiorrhiza, Poria cocos, Bupleurum chinense, Glycyrrhiza uralensis, Atractylodes macrocephala, Alismatis Rhizoma, and Curcumae Radix in the top 10 medicines ranked in the frequency of medication accorded with the prescribed doses in the Pharmacopoeia of the People's Republic of China (2015 edition), while Crataegi Fructus, Artemisiae Scopariae Herba, and Puerariae Lobatae Radix exceeded the prescribed doses. In the frequency analysis of drug pairs, the combination of S.miltiorrhiza and B. chinense was the most widely used. According to the association rules of drug combination, the correlation between Curcumae Radix and S. miltiorrhiza was the strongest, that was, the probability of S. miltiorrhiza appearing with the emergence of Curcumae Radix was 88%. From the network display chart, it was indicated that S. miltiorrhiza and P. cocos were the main herbs for treatment. Through unsupervised entropy hierarchical clustering algorithm, 14 core combinations for new clustering were extracted, and seven new prescriptions can be obtained by further clustering. Conclusion The basic principles of TCM treatment of ALD include promoting blood circulation and removing blood stasis, removing dampness, tonifying, detoxifying alcohol, and promoting qi, and with "protecting spleen and stomach function" as its purpose, which accords with the theoretical basis of traditional Chinese medicine in treating alcoholic liver disease. Core combinations and new prescriptions provide references for clinical drug use and new drug research and development, but new prescriptions must be further evaluated with the combination of traditional Chinese medicine theory and clinical practice.
[中图分类号]
R28;R286.5
[基金项目]
国家自然科学基金资助项目(81703723)