摘要
目的基于古今医案云平台研究中医药治疗青光眼的用药规律。方法纳入1970年1月—2022年10月收录于古今医案云平台、中国知网、万方医学数据库、维普中文科技期刊数据库中使用中医药治疗青光眼的病例分析、医案及文献。将处方组成和治法录入Excel软件建立数据库,对中药名称规范化处理后,采用古今医案云平台(V2.3.5)软件,利用数据挖掘模块对四气、五味、归经及高频中药使用频次、聚类分析及关联规则等进行分析。结果(1)一般情况:①急性青光眼。共纳入103首方剂,涉及206味中药,共1,128频次。四气以寒性最多(61味,29.61%),五味以甘味药最多(76味,36.89%),归经以肝经用药最多(59味,28.64%)。②慢性青光眼。共纳入103首方剂,涉及中药203味,累计频次为1,157次。四气以寒性最多(47味,23.15%),五味以甘味药最多(74味,36.45%),归经以肝经用药最多(87味,42.85%)。(2)高频用药频次:①急性青光眼。用药频次≥20次的药物有16味,排在前5位的分别是茯苓(41次,39.81%)、车前子(39次,37.86%)、甘草(36次,34.95%)、防风(32次,31.07%)、菊花(31次,30.10%)。②慢性青光眼。用药频次≥20次的药物有15味,排在前5位的分别是茯苓(51次,49.51%)、当归(44次,42.72%)、白术及车前子各(35次,33.98%)、甘草(30次,29.13%)。(3)高频中药聚类分析:急、慢性青光眼各得到3类组方。①急性青光眼组方的功效分别为疏肝养血、清热利湿化痰、清热平肝。②慢性青光眼3类组方的功效分别为疏肝健脾、益气凉血、清热利湿。(4)高频中药关联规则:①急性青光眼得到3类药对,分别为清热利湿类、祛风利水消肿类、清热平肝类。②慢性青光眼得到3类药对,分别为健脾利湿类、清热利湿类、疏肝养血类。结论急性青光眼多属于实证,用药以祛邪为主;慢性青光眼多虚实夹杂,治疗以扶正祛邪为法,临床需要根据患者兼症灵活调整加减方能取得较好疗效。
OBJECTIVE To explore the medication rules of Traditional Chinese Medicine(TCM)in the treatment of glaucoma based on the ancient and modern medical case cloud platform.METHODS Case analysis,medical records,and literature on the use of TCM in the treatment of glaucoma in the ancient and modern medical case cloud platform,CNKI,VIP and Wanfang were included from January 1970 to October 2022.The prescription composition and treatment methods were entered into Excel software to establish a database.The names of Chinese medicines were standardized,and the four Qi,five flavors,meridian tropisms,as well as the frequency,cluster analysis,and association rule analysis of those high-frequency Chinese medicines were analyzed using data mining modules with the ancient and modern medical case cloud platform(V2.3.5).RESULTS(1)General information:①Acute glaucoma.A total of 103 prescriptions were included,involving 206 kinds of Chinese medicines,with a total of 1,128 frequencies.The medicine properties were mainly cold(61 medicines,29.61%),the flavors were mainly sweet(76 medicines,36.89%),and liver meridian is the most common in terms of the meridian tropisms(59 medicines,28.64%).②Chronic glaucoma.A total of 103 prescriptions were included,involving 203 kinds of Chinese medicines,with a total of 1,157 frequencies.The medicine properties were mainly cold(47 medicines,23.15%),the flavors were mainly sweet(74 medicines,36.45%),and liver meridian is the most common in terms of the meridian tropisms(87 medicines,42.85%).(2)Frequency statistics of high-frequency medicines:①Acute glaucoma.There were 16 Chinese medicines with a frequency of medication more than 20 times,and the top five were:Poria Cocos(41 times,39.81%),Semen Plantaginis(39 times,37.86%),Radix Glycyrrhizae(36 times,34.95%),Radix Saposhnikoviae(32 times,31.07%),and Flos Chrysanthemi(31 times,30.10%).②Chronic glaucoma.There were 15 Chinese medicines with a frequency of medication more than 20 times,and the top five were:Poria Cocos(51 times,49.51%),Radix Angelicae Sinensis(44 times,42.72%),Rhizoma Atractylodis Macrocephalae and Semen Plantaginis(35 times,33.98%),and Radix Glycyrrhizae(30 times,29.13%).(3)Cluster analysis of high-frequency Chinese medicines:Three types of prescriptions were obtained for acute and chronic glaucoma.①The efficacy of acute glaucoma prescriptions was to soothe liver and nourish blood,clear heat,promote dampness and dissipate phlegm,and clear heat and calm liver.②The three types of prescriptions for chronic glaucoma had the effects of soothing liver and strengthening spleen,tonifying Qi and cooling blood,and clearing heat and promoting dampness.(4)Correlation analysis of high-frequency Chinese medicines:①Three types of medicine pairs were obtained for acute glaucoma,namely clearing heat and promoting dampness,dispelling wind,promoting diuresis and reducing swelling,and clearing heat and calming liver.②There were three types of medicine pairs for chronic glaucoma,namely strengthening spleen and promoting dampness,clearing heat and promoting dampness,and soothing liver and nourishing blood.CONCLUSIONS Acute glaucoma is mostly empirical,and the medication is mainly used to dispel pathogenic factors.Chronic glaucoma is often characterized by a combination of deficiency and excess,and the treatment is based on the principle of strengthening the body resistance and eliminating pathogenic factors.In clinical practice,it is necessary to flexibly adjust the prescription according to the concurrent symptoms of patients in order to achieve good therapeutic effects.
作者
彭麟景
袁安琪
杜红彦
PENG Linjing;YUAN Anqi;DU Hongyan(Guangzhou University of Chinese Medicine,Guangzhou 510405,China)
出处
《中国中医眼科杂志》
2023年第10期910-915,共6页
China Journal of Chinese Ophthalmology
基金
国家自然科学基金项目(81704123)。
关键词
古今医案云平台
青光眼
关联分析
组方规律
Ancient and Modern Cases Cloud Platform
glaucoma
Correlation analysis
medication regularity
