Shi Jun, Wei Pin-Kang
Cadet Corps, PLA Postgraduate Medical School, Chinese PLA General Hospital, Beijing 100853.
Zhongguo Zhong Xi Yi Jie He Za Zhi. 2012 Apr;32(4):556-9, 571.
To summarize the herbal medication by Professor WEI Pin-kang's prescriptions in treating chemotherapy induced nausea and vomiting (CINV).
On the basis of outpatient and inpatients' medical records concerning CINV from case-database (keywords: chemotherapy and vomiting), data of 143 patients and 143 effective prescriptions were collected. The herbs and those category, nature, flavor and meridian distribution were summarized by frequency method using SPSS 13.0 Software. The couple herbs were analyzed by hierarchical cluster analysis.
A total of 144 herbs were used (2 353 frequencies). Six groups of herbs [ frequency >5%, cumulative relative frequency (CRF) 58.89%] were used frequently as follow: the herbs for regulating qi (17.81%), resolving phlegm (13.51%), invigorating qi (8.07%), relieving food retention (7.44%), calming Gan to stop endogenous wind (7.05%), and warming the interior (5.01%). The most frequently used herbs ( >20 frequencies, CRF 77.31%) had 31 species as follow: the herbs for regulating qi (6 species), calming Gan to stop endogenous wind (4 species), resolving phlegm (3 species), external application (2 species), invigorating qi (2 species), warming the interior (2 species), activating blood and removing blood stasis (2 species), promoting diuresis and resolving dampness (1 species), purgation (1 species), invigorating blood (1 species), relieving exterior syndrome with pungent-warm property (1 species), relieving exterior syndrome with pungent-cool property (1 species), astringent (1 species), resolving dampness with aromatic property (1 species), calming the mind (1 species), eliminating heat and dampness (1 species), relieving food retention (1 species). Frequency of Rhizoma Pinelliae was 127 including Rhizoma Pinelliae (processed with ginger) 83 (65.35%). Frequency of prepared Radix et Rhizoma Rhei was 85 (95.51% of Prea- praed Rhizoma Rhei). These herbs were mostly of warm nature (43.99%). The total frequency of herb-nature was 3 677 and the pungent (34.76%), bitter (32.06%) and sweet herbs (18.22%) were most frequently used (CRF 85.04%). The total frequency of meridian distribution was 6 627 and these herbs were mostly attributed to Pi, Wei, Gan, and Fei meridians (CRF 71.34%). The most frequently used couple-herbs included Rhizoma Pinelliae and Rhizoma Atisaematis, Fructus Aurantii Immaturus and Submature Bitter Orange, Flos Caryophylli and Calyx Kaki, Rhizoma Coptidis and Os Sepiae, Rumulus Ginnamomi and Radix Paeoniae, Fructus Citri Sarcodactylis and Fructus Citri, aloeswood and toad skin, scorpion and centipede, earth worm and Gekko Swinhoana, bupleurum root and curcumae, fossilia ossis mastodi and oyster, large head atractylodes and poria, and so on.
Professor WEI Pin-kang regarded the therapy of dissolving phlegm and regulating Wei as the fundamental treatment of CINV. He emphasized gastrointestinal metabolic disorders induced by phlegm and stagnation related to chemotherapeutics. He laid equal emphasis on regulating qi, dissolving phlegm, and removing stagnation.
总结魏品康教授治疗化疗所致恶心呕吐（CINV）的用药经验。
基于病例数据库中有关CINV的门诊及住院病历（关键词：化疗、呕吐），收集143例患者的资料及143首有效方剂。运用SPSS 13.0软件，采用频数法对药物及其类别、性味、归经分布进行总结。通过系统聚类分析法分析药对。
共使用144味中药（频数2353次）。常用6类药物[频数>5%，累计相对频数（CRF）58.89%]，依次为理气药（17.81%）、化痰药（13.51%）、补气药（8.07%）、消食药（7.44%）、平肝息风药（7.05%）、温里药（5.01%）。常用高频药物（>20次，CRF 77.31%）共31种，依次为理气药（6种）、平肝息风药（4种）、化痰药（3种）、外用（2种）、补气药（2种）、温里药（2种）、活血化瘀药（2种）、利水渗湿药（1种）、泻下药（1种）、补血药（1种）、辛温解表药（1种）、辛凉解表药（1种）、收涩药（1种）、芳香化湿药（1种）、安神药（1种）、清热燥湿药（1种）、消食药（1种）。半夏使用频数为127次，其中姜半夏83次（65.35%）。制大黄使用频数为85次（占生大黄的95.51%）。这些药物大多性温（43.99%）。药物性味总频数为3677次，以辛味药（34.76%）、苦味药（32.06%）、甘味药（18.22%）最为常用（CRF 85.04%）。药物归经总频数为6627次，主要归脾胃、肝、肺经（CRF 71.34%）。常用药对有半夏与天南星、青皮与枳壳、丁香与柿蒂、黄连与海螵蛸、桂枝与白芍、佛手与陈皮、沉香与蟾蜍皮、全蝎与蜈蚣、地龙与蛤蚧、柴胡与郁金、龙骨与牡蛎、白术与茯苓等。
魏品康教授认为化痰和胃是治疗CINV的根本大法，强调痰凝气滞与化疗药所致的胃肠代谢紊乱密切相关，注重理气化痰、消积导滞。
