摘要
目的总结梁晓春教授治疗糖尿病肾脏病(DKD)的组方特点及用药规律,传承梁晓春教授治疗DKD的学术思想。方法采用回顾性真实世界(RWS)研究方法,以北京协和医院信息系统(HIS)电子病历为载体,收集梁晓春教授2020年至2022年门诊治疗DKD患者的临床信息,构建数据库,应用中医传承计算平台(V3.5)软件,采用关联分析、聚类分析等方法分析病案处方的用药频次、性味归经、常用药物组合等,分析梁晓春教授治疗DKD的治则治法和用药规律。结果共整理梁晓春教授治疗DKD验方205则,中药193味,使用次数最多的药物为菟丝子、桑白皮、女贞子、倒扣草、土茯苓、土大黄、鬼箭羽、黄芪等,性味多甘、寒,归经多属于肝、脾、肾经。用药关联分析得出最核心的药物组合为:菟丝子-女贞子、菟丝子-倒扣草、女贞子-倒扣草、倒扣草-土茯苓、菟丝子-土茯苓等。聚类分析得出4个核心处方为菟丝子-女贞子-桑白皮-倒扣草-土茯苓、土大黄,菟丝子-鸭跖草-桑白皮-倒扣草-女贞子-土茯苓,菟丝子-女贞子-桑白皮-鸭跖草-倒扣草-土大黄,桑白皮-女贞子-菟丝子-黄芪-土茯苓-鸭跖草。结论梁晓春教授治疗DKD以补益脾肾、活血泄浊为原则,用药经验体现了补肾与固涩并用、泄浊与解毒并施、活血与利水并行的学术思想。
Objective To summarize the prescription characteristics and medication rules for the treatment of diabetic kidney disease(DKD)from professor LIANG Xiaochun and to inherit professor LIANG Xiaochun′s academic anamnesis.Methods Using the retrospective real world research(RWS)method and the electronic medical record of Peking Union Medical Union Hospital Information System(HIS),the clinical records of DKD outpatient treatment by professor LIANG Xiaochun′s from 2020 to 2022 was collected to built a database with the support of Traditional Chinese Medicine inheritance computing platform(V3.5)software.Correlation analysis,cluster analysis and other methods were used to analyze the frequency of medication performance and the medication′s four natures,five flavors,meridian tropism,and the combination of commonly used drugs in the treatment of DKD were reviewed.Results A total of 205 cases covering 193 traditional Chinese medicines were collected.The most frequent use of drugs were Cuscutae Semen,Mori Cortex,Ligustri Lucidi Fructus,Achyranthes aspera Linn,Commelinae Herba,Smilacis Glabrae Rhizoma,Radix Et Rhizoma Rumei,Ramulus Euonymi Alati and Astmgali Radix.The four natures shared by them are cold and the five flavors are mostly sweetness.The meridian tropism belongs to the liver,spleen,and kidney.The analysis of drug association showed that the core drug combination was:Cuscutae Semen-Ligustri Lucidi Fructus,Cuscutae Semen-Achyranthes aspera Linn,Ligustri Lucidi Fructus-Achyranthes aspera Linn,Achyranthes aspera Linn-Smilacis Glabrae Rhizoma,Cuscutae Semen-Smilacis Glabrae Rhizoma etc.The four core prescriptions were obtained by cluster analysis:Cuscutae Semen-Ligustri Lucidi Fructus-Mori Cortex-Achyranthes aspera Linn-Smilacis Glabrae Rhizoma-Radix Et Rhizoma Rumei,Cuscutae Semen-Commelinae Herba-Mori Cortex-Achyranthes aspera Linn-Ligustri Lucidi Fructus-Smilacis Glabrae Rhizoma,Cuscutae Semen-Ligustri Lucidi Fructus-Mori Cortex-Commelinae Herba-Achyranthes aspera Linn-Radix Et Rhizoma Rumei,Mori Cortex-Ligustri Lucidi Fructus-Cuscutae Semen-Astmgali Radix-Smilacis Glabrae Rhizoma-Commelinae Herba.Conclusions Professor LIANG Xiaochun treated DKD with the principle of tonifying the spleen and kidney,promoting blood circulation,and removing turbidity.The experience of medication embodies the academic anamnesis the combination of tonifying kidney and solidifying astringency,the combination of removing turbidity and detoxifying supplemented by activating blood and water circulation in human body.
作者
李耀洋
王书宇
杨丹
吴群励
LI Yaoyang;WANG Shuyu;YANG Dan;WU Qunli(Department of Traditional Chinese Medicine,Peking Union Medical College Hospital,CAMS&PUMC,Beijing 100730,China)
出处
《基础医学与临床》
CAS
2024年第9期1335-1340,共6页
Basic and Clinical Medicine
基金
国家中医药管理局青年岐黄学者培养项目(国中医药人教函【2022】256号)
北京协和医院中央高水平医院临床科研专项青年培优计划(2022-PUMCH-A-211)
北京协和医院中央高水平医院临床科研专项专科提升计划(2022-PUMCH-B-121)。
