摘要
目的:分析中药治疗冠状动脉粥样硬化性心脏病(简称冠心病)合并焦虑和(或)抑郁的用药规律,为中医临床用药提供数据参考。方法:纳入2022年12月-2023年9月中国中医科学院西苑医院山西医院心血管科收治的28例冠心病合并焦虑和(或)抑郁患者的首剂处方,以及通过中国中医科学院西苑医院建立的心血管病中西医结合临床科研一体化云平台收集的2015年-2019年收治的94例冠心病合并焦虑和(或)抑郁患者的首剂中药处方,共122首。建立中药处方数据库。基于古今医案云平台对数据进行用药频次、四气五味、归经分布、中药关联规则及高频率中药聚类分析。结果:本研究共纳入冠心病合并焦虑和(或)抑郁患者的中药处方122个,涉及中药193味。其中使用频次居前10位的药物分别为甘草、半夏、柴胡、丹参、茯苓、瓜蒌、黄芪、党参、桂枝、川芎;治疗冠心病合并焦虑和(或)抑郁的中药药性以温、平、微寒、寒为主,药味以甘、苦、辛常见,多归于肺经、脾经、肝经、心经;得到关联规则数据4组,分别为黄芪-丹参,茯苓-半夏,党参-甘草,枳壳-柴胡-黄芩;对高频使用中药进行聚类分析,最终得到4个中药聚类组:半夏,茯苓;甘草,党参,白术;瓜蒌,三七,丹参,黄芪;黄芩,柴胡,枳壳,桂枝,川芎,赤芍。结论:在冠心病合并焦虑和(或)抑郁的治疗中,以益气、活血、理气、化痰中药配伍为主。
Objective:To analyze the medication rules of TCM in the treatment of coronary heart disease complicated with anxiety and/or depression,so as to provide data reference for the clinical treatment.Methods:In this study,122 patients with coronary heart disease complicated with anxiety and/or depression were collected,and the TCM prescription database was established.Based on the cloud platform of ancient and modern medical records,the data was analyzed for medication frequency,distribution of four Qi(气),five flavors and meridians,association rules of Chinese medicine,and clustering analysis of high-frequency Chinese medicine.Results:A total of 122 TCM prescriptions involving 193 TCMs were included in this study,among which the top 10 most frequently used drugs were Gancao(Radix Glycyrrhizae),Banxia(Rhizoma Pinelliae),Chaihu(Radix Bupleuri),Danshen(Radix et Rhizoma Salviae Miltiorrhizae),Fuling(Poria),Gualou(Fructus Trichosanthis),Huangqi(Radix Astragali),Dangshen(Radix Codonopsis),Guizhi(Ramulus Cinnamomi),and Chuanxiong(Rhizoma Chuanxiong).The medicinal properties of included Chinese medicine for the treatment of coronary heart disease complicated with anxiety and/or depression was mainly warm,flat,slightly cold,and cold.The medicine flavor was mainly sweet,bitter,and pungent.The meridian tropism was mostly lung meridian,spleen meridian,liver meridian,and heart meridian.Four groups of association rule data were obtained,which were Huangqi-Danshen,Fuling-Banxia,Dangshen-Gancao,Zhiqiao(Fructus Aurantii)-Chaihu-Huangqin(Radix Scutellariae),and the cluster analysis of high-frequency used Chinese medicine finally obtained four clusters:Banxia,Fuling,Gancao,Dangshen,Baizhu(Rhizoma Atractylodis Macrocephalae);Gualou,Sanqi(Radix Notoginseng),Danshen,Huangqi;Chaihu,Zhike,Guizhi,Chuanxiong,Chishao(Radix Paeoniae Rubra).Conclusion:In the treatment of coronary heart disease complicated with anxiety and/or depression,the main treatment method of traditional Chinese medicine is to tonify Qi,activate blood circulation,regulate Qi and resolving phlegm.
出处
《中医临床研究》
2024年第20期87-94,共8页
Clinical Journal Of Chinese Medicine
基金
国家中医心血管病临床医学研究中心专项科研基金(CMC2022001)
山西省中医药管理局科研项目(2022ZYYC031)
中国中医科学院西苑医院苗圃课题(2019XYMP-27)。
