Zhang Dong, Feng Zhen-Zhen, Wang Lu, Guo Wen, Liu Wen-Rui, Zhang Hai-Long, Li Jian-Sheng
Co-construction Collaborative Innovation Center for Chinese Medicine and Respiratory Diseases by Henan & Education Ministry of China/Henan Key Laboratory of Chinese Medicine for Respiratory Disease, Henan University of Chinese Medicine Zhengzhou 450000, China.
the First Affiliated Hospital of Henan University of Chinese Medicine Zhengzhou 450003, China.
Zhongguo Zhong Yao Za Zhi. 2022 Jan;47(1):235-243. doi: 10.19540/j.cnki.cjcmm.20210722.501.
The present study explored the regularity of prescriptions for the treatment of intermediate and advanced lung cancer to provide references for clinical medication. CNKI, Wanfang, VIP, and CBM were searched for the research papers on the treatment of lung cancer by Chinese medicine published from database inception to May 31, 2021. The relevant information of qualified papers was extracted to establish a database. The Chinese medicines with frequency >3% underwent analysis of the latent structure and association rules by Lantern 5.0 and SPSS Molder 14.1, respectively, and the prescription regularity in the treatment of intermediate and advanced lung cancer was analyzed based on the frequency description. A total of 713 papers were included, involving 327 Chinese medicines with a cumulative frequency of 12 794 and 106 prescriptions with a cumulative frequency of 824. The commonly used Chinese medicines were dominated by deficiency-tonifying, heat-clearing, phlegm-resolving, and cough/dyspnea-relieving drugs, such as Astragali Radix, Atractylodis Macrocephalae Rhizoma, Glycyrrhizae Radix et Rhizoma, Ophiopogonis Radix, Poria, and Hedyotis Diffusa, which are cold, warm, and plain in nature and sweet, bitter, and pungent in flavor, and mainly act on lung, spleen, and stomach meridians. Commonly used prescriptions included Shashen Maidong Decoction, Liujunzi Decoction, and Baihe Gujin Decoction. The latent structure analysis revealed 32 latent variables and 65 hidden classes. Six comprehensive clustering models and 11 core prescriptions were obtained by professional knowledge inference. The common syndromes of intermediate and advanced lung cancer were inferred to be Qi and Yin deficiency in the lung, Qi deficiency in the lung and spleen, Yin deficiency in the liver and kidney, combined phlegm and stasis, phlegm-heat obstructing lung, and Qi stagnation and blood stasis. Forty-four strong associations were screened out by association rules analysis, including four pairwise strong associations(Polygonati Odorati Rhizoma→Ophiopogonis Radix, Polygonati Odorati Rhizoma→Glehniae Radix, Amomi Fructus→Atractylodis Macrocephalae Rhizoma, and Polygonati Rhizoma→Astragali Radix) and 40 triplet strong associations(such as Trichosanthis Radix+Glehniae Radix→Ophiopogonis Radix, Polygonati Odorati Rhizoma+Glehniae Radix→Ophiopogonis Radix, Trichosanthis Radix+Ophiopogonis Radix→Glehniae Radix, and Scutellariae Barbatae Herba+Codonopsis Radix→Hedyotis Diffusa). In the treatment of intermediate and advanced lung cancer, Qi-replenishing and Yin-nourishing drugs are mainly employed, assisted with cancer-resisting, toxin-removing, spleen-invigorating, phlegm/stasis-resolving, and blood-activating drugs based on syndrome differentiation. The roots were treated following the principles of tonifying lungs and replenishing the spleen, and symptoms following the principles of removing the toxin, dispelling stasis, and resolving phlegm.
本研究探讨中晚期肺癌的用药规律,为临床用药提供参考。检索中国知网、万方、维普、中国生物医学文献数据库中自建库至2021年5月31日发表的中医药治疗肺癌的研究论文,提取合格论文的相关信息建立数据库。对使用频率>3%的中药分别运用兰灯5.0和SPSS Molder 14.1进行潜在结构分析和关联规则分析,并基于频次描述分析中晚期肺癌的用药规律。共纳入713篇文献,涉及327味中药,累计频次12 794次;106首方剂,累计频次824次。常用中药以补虚、清热、化痰、止咳平喘类药物为主,如黄芪、白术、甘草、麦冬、茯苓、白花蛇舌草等,药性寒、温、平,味甘、苦、辛,主要归肺、脾、胃经。常用方剂有沙参麦冬汤、六君子汤、百合固金汤等。潜在结构分析得到32个潜在变量和65个隐藏类。通过专业知识推理得到6个综合聚类模型和11首核心方剂。推断中晚期肺癌的常见证型为肺气阴两虚、肺脾气虚、肝肾阴虚、痰瘀互结、痰热壅肺、气滞血瘀。关联规则分析筛选出44个强关联,包括4个两两强关联(玉竹→麦冬、玉竹→北沙参、砂仁→白术、黄精→黄芪)和40个三联强关联(如天花粉+北沙参→麦冬、玉竹+北沙参→麦冬、天花粉+麦冬→北沙参、半枝莲+党参→白花蛇舌草)。中晚期肺癌治疗以补气养阴药为主,根据辨证辅以抗癌、解毒、健脾、化痰祛瘀、活血等药物。治病求本,遵循补肺健脾原则;对症治疗,遵循解毒、化瘀、化痰原则。