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[基于数据挖掘的国医大师于国友治疗胃肠功能衰竭用药规律研究]

[Prescription regularity of famous veteran traditional Chinese medicine Doctor Yu Guoyou for treating gastrointestinal failure based ondata mining].

作者信息

Wang Qing, Chen Yi-Lian, Wu Guo-Lin, Xiong Fu-Lin, Yu Guo-You

机构信息

The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, China.

Zhejiang University of Traditional Chinese Medicine, Hangzhou 310053, China.

出版信息

Zhongguo Zhong Yao Za Zhi. 2017 Oct;42(19):3809-3814. doi: 10.19540/j.cnki.cjcmm.20170901.003.

Abstract

Gastrointestinal failure is a kind of severe systemic inflammatory response, and often complicated with multiple organ dysfunction syndrome. Integrated traditional Chinese and Western medicine have a better curative effect in treating it. This study collected the famous veteran TCM physician Yu Guoyou's 175 prescriptions for treating 89 cases of gastrointestinal failure, calculated the frequency of traditional Chinese medicines and their categories, and analyzed the medication regularity with system clustering method, so as to summarize Yu's frequently used drugs and prescriptions. The results showed the top three most frequently used drugs aremagnolia bark, bitter orange, and rhubarb, which are components of Xiaochengqi decoction; Among the traditional Chinese medicines, medicines of tonifying deficiency, regulating qi, clearing heat, eliminating phlegm and dissipating dampness are most commonly used. Among the tonic medicines, those for tonifying Qi accounted for 2/3, which was the largest proportion; At the same time, some new prescriptions and new drug combinations were excavated and could be used as the reference for clinical medication. According to the findings, when differentiating syndromes of gastrointestinal failure, Yu regards the spleen and stomach Qi deficiency as the root cause and the heat toxin, blood stasis, Qi stagnation and dampness as the symptoms. In the treatment of gastrointestinal function failure, Yu gives priority to strengthening spleen, regulating Qi and purgation, prescribes medicines for dissolving blood stasis and detoxication, dissipating dampness, clearing heat and eliminating phlegm according to syndrome types. In other words, the treatment is based on syndrome differentiation, and the prescription is modified according to symptoms. In particular, Yu attaches importance to stomach-Qi recuperation and gastrointestinal function recovery in the process of treatment.

摘要

胃肠功能衰竭是一种严重的全身炎症反应,常并发多器官功能障碍综合征。中西医结合治疗该病具有较好的疗效。本研究收集了名老中医于国友治疗89例胃肠功能衰竭的175首方剂,计算中药及其类别出现的频次,采用系统聚类法分析用药规律,以总结于氏常用药物及方剂。结果显示,使用频次最高的前三味药为厚朴、枳实、大黄,均为小承气汤的组成药物;在中药类别中,补虚药、理气药、清热药、化痰祛湿药最为常用。在补虚药中,补气药占2/3,比例最大;同时,挖掘出一些新方剂和新药物组合,可为临床用药提供参考。根据研究结果,于氏在辨治胃肠功能衰竭时,以脾胃气虚为本,热毒、血瘀、气滞、湿邪为标。在治疗胃肠功能衰竭时,于氏以健脾理气通下为主,根据证型佐以活血化瘀、解毒、祛湿、清热化痰之品。即辨证论治,随症加减。尤其在于氏治疗过程中重视胃气的恢复和胃肠功能的恢复。

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