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基于中医传承辅助平台分析肺结节方药规律

Analysis of Prescription Rules for Lung Nodules Based on Traditional Chinese Medicine Inheritance Assistant Platform

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【作者】 李晨雨刘志宇范斐婷肖晶旻李月炜吴蕾林琳陈远彬

【Author】 LI Chenyu;LIU Zhiyu;FAN Feiting;XIAO Jingmin;LI Yuewei;WU Lei;LIN Lin;CHEN Yuanbin;The Second Clinical Medical School of Guangzhou University of Chinese Medicine;Department of Respiratory and Critical Care Medicine,Guangdong Provincial Hospital of Chinese Medicine;

【通讯作者】 陈远彬;

【机构】 广州中医药大学第二临床医学院广东省中医院呼吸与危重医学科

【摘要】 目的:挖掘肺结节的中医证候与用药特点,为肺结节的中医治疗提供诊疗思路。方法:收集中国知网(CNKI)、万方数据库(Wanfang)、维普数据库(VIP)、中国生物医学文献数据库(SinoMed)、PubMed等数据库自建库到2022年12月肺结节相关的中医证候和中医处方,筛选并用Excel软件和中医传承辅助平台(V2.5)建立证候和方剂数据库进行统计分析,挖掘中医证型规律、药物频次,提取内在核心组合和新方组合。结果:纳入文献145篇,筛选出中医证型93种,中医验方211首,中药268味,其中频次≥80的证型有14种。肺结节常见证候以痰瘀互结证为主,病性证素以气虚、痰、气滞、血瘀、阴虚为主;病位证素以肺、脾、肝为主。使用的药物类别以补虚药、清热药、化痰止咳平喘药、利水渗湿药和活血化瘀药为主。常用的高频次中药有16味,前3味是甘草、茯苓、浙贝母。挖掘出药物内在核心组合16个,如党参-金荞麦-玄参、紫菀-款冬花-麻黄等;得到新方组合8组,如党参-金荞麦-玄参-牡蛎-浙贝母、紫菀-款冬花-麻黄-枇杷叶-土茯苓。结论:肺结节以脏腑辨证为主,证型多为虚实夹杂,治疗上多运用补益扶正、化痰散结、软坚散结、清热解毒散结、活血化瘀的药物,这对肺结节的诊治有一定的参考作用,但仍需进一步的临床及基础研究验证。

【Abstract】 Objective: To explore the traditional Chinese medicine(TCM) syndromes and medication characteristics of prescriptions for lung nodules,and to provide diagnosis and treatment ideas for Chinese medicine to treat lung nodules. Methods: The TCM syndromes and prescriptions related to lung nodules recorded from the day of database establishment to December 2022 were collected from China National Knowledge Infrastructure(CNKI),Wanfang,VIP,SinoMed and PubMed databases. Excel and Traditional Chinese Medicine Inheritance Assistant Platform(V2.5) were used to establish the syndrome and prescription database for statistical analysis,and the rules of TCM syndrome types and medicinal frequency were excavated, and then the core combinations and new prescription combinations were extracted.Results:A total of 145 literature were included;after selection,there were 93 kinds of TCM syndrome types,211 effective prescriptions and 268 Chinese medicinals were selected. Among them,14 syndrome types were with frequency of and over 80. The syndromes of lung nodules were mainly hlegm blended with stasis,and the syndrome elements of disease nature were mainly qi deficiency,phlegm,qi stagnation,blood stasis and yin deficiency;the syndrome elements of disease location were the lung,spleen and liver.The Chinese medicinals used were those for supplementing deficiency,clearing heat,dissolving phlegm and relieving cough and panting, promoting urination and percolating dampness, and invigorating blood and dissolving stasis. There were 16 kinds of commonly used high-frequency Chinese medicinals,and the top 3 were Glycyrrhizae Radix et Rhizoma,Poria and Fritillariae Thunbergii Bulbus. After exploration,there were 16 core combinations, such as Codonopsis Radix-Fagopyri Dibotryis Rhizoma-Scrophulariae Radixand and Asteris Radix et Rhizoma-Farfarae Flos-Ephedrae Herba. There were 8 groups of new prescription combinations, such as Codonopsis Radix-Fagopyri Dibotryis Rhizoma-Scrophulariae RadixOstreae Concha-Fritillariae Thunbergii Bulbus and Asteris Radix et Rhizoma-Farfarae Flos-Ephedrae Herba-Eriobotryae Folium-Smilacis Glabrae Rhizoma. Conclusion: For the treatment of lung nodules,zang-fu organs are mainly differentiated. The syndrome types of lung nodules are mostly deficiency-excess complex. In the treatment, mainly-used Chinese medicinals are those for supplementing, boosting and reinforcing healthy qi, dissolving phlegm and dissipating masses, softening hardness and dissipating masses, clearing heat, resolving toxins and dissipating masses, and invigorating blood and dissolving stasis. These have certain reference for diagnosis and treatment of lung nodules, but further clinical and basic researches are still needed to verify the conclusion.

【基金】 广州中医药大学“双一流”与高水平大学学科协同创新团队项目(2021xk27);广东省中医院中医药科学技术研究专项课题(YN2022QN22);广州市科技计划项目(2023A03J0226)
  • 【分类号】R259
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