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基于灰色筛选法结合多变量分析方法对治疗癌性发热的中药方剂进行分析及新方剂发现

[Analysis on traditional Chinese medicine prescriptions treating cancerous fever based on grey screening method combined with multivariate analysis method and discovery of new prescriptions].

作者信息

Lin Zhi-Xian, Chen Jiang-Feng, Guo Yong

机构信息

the First Clinical Medical College of Zhejiang Chinese Medical University Hangzhou 310053,China.

Department of Oncology,the First Affiliated Hospital of Zhejiang Chinese Medical University Hangzhou 310006,China.

出版信息

Zhongguo Zhong Yao Za Zhi. 2019 Jul;44(13):2849-2857. doi: 10.19540/j.cnki.cjcmm.20190514.501.

Abstract

Cancerous fever is one of the common symptoms of advanced malignant tumors,which seriously affects the quality of life and survival of patients. At present,the clinical research on the treatment of cancerous fever by traditional Chinese medicine is limited,and there is a lack of research on the medication rules from multiple dimensions of disease-symptom-syndrome. The treatment of cancerous fever has not made substantial progress. In this study,we collected the literature on treatment of cancerous fever in Chinese medicine,and concluded that common syndrome types include Yin deficiency type,Qi deficiency type,Yang deficiency type,blood stasis type,damp-heat accumulation type,toxic heat flourishing type and liver meridian stagnated heat type. Two hundreds and fifty-seven prescriptions for Chinese medicine and 249 flavors for single medicine were extracted. The analysis of the drug composition of the drug found that the cancerous fever treatment was mainly based on heat-clearing drugs and deficiency-nourishing drugs. Apriori association analysis of the drug found that the second and third related drugs were mainly Rehmanniae Radix,Moutan Cortex,Artemisiae Annuae Herba,Trionycis Carapax and Anemarrhenae Rhizoma. The top five gray correlation degrees were Psoraleae Fructus,Bupleuri Radix,Hordei Fructus Germinatus,Scutellariae Radix and Massa Medicata Fermentata. And seven new prescriptions were evolved. The results showed that the treatment of cancerous fever can be started from the disease-symptom-syndrome,nourishing Yin and clearing heat is an important method for " disease differentiation and treatment". The combination of Bupleuri Radix and Scutellariae Radix is the embodiment of " symptom differentiation and treatment". The new prescriptions conform to the idea of " syndrome differentiation and treatment" of traditional Chinese medicine can provide reference for clinical medication. The grey screening method combined with multivariate analysis method was used to analyze the prescription rules of Chinese medicine in the treatment of cancer fever,which followed the black box structure of traditional Chinese medicine,made the potential rule of prescriptions explicit,broadened its thinking of Chinese medicine treatment,and made up for the deficiency of traditional analysis methods.

摘要

癌性发热是晚期恶性肿瘤的常见症状之一,严重影响患者的生活质量和生存期。目前,中医治疗癌性发热的临床研究有限,缺乏从病-症-证多维度的用药规律研究。癌性发热的治疗尚未取得实质性进展。本研究收集了中医治疗癌性发热的文献,总结出常见证型有阴虚型、气虚型、阳虚型、血瘀型、湿热蕴结型、热毒炽盛型、肝经郁热型。提取了257首中药方剂和249味单味药。对药物的药物组成分析发现,癌性发热治疗以清热药和补虚药为主。对药物进行先验关联分析发现,第二、三位相关药物主要为熟地黄、牡丹皮、青蒿、鳖甲、知母。灰色关联度前五位的是补骨脂、柴胡、麦芽、黄芩、六神曲。并演化出7首新方剂。结果表明,癌性发热的治疗可从病-症-证入手,滋阴清热是“辨病论治”的重要方法。柴胡与黄芩配伍是“辨证论治”的体现。新方剂符合中医“辨证论治”思想,可为临床用药提供参考。采用灰色筛选法结合多元分析方法分析中医治疗癌热的方剂规律,遵循了中医的黑箱结构,使方剂的潜在规律显性化,拓宽了中医治疗思路,弥补了传统分析方法的不足

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