|
|
基于数据挖掘探讨李红梅治疗围绝经期综合征的用药规律
|
Abstract:
目的：通过数据挖掘的方法，总结李红梅教授治疗围绝经期综合征的用药规律。方法：收集并筛选2023年09月至2023年12月黑龙江中医药大学附属第二医院妇科门诊李红梅教授收治的围绝经期综合征患者的中药处方共61首，将用药信息录入EXCEL 2016，运用SPSS Modeler、Origin 2022软件，采用频数、关联规则、聚类分析等方法进行统计和分析。结果：1) 药物频次分析：61首处方涉及中药141味，使用频次共计1206次，用药频次 ≥ 20次的药物有19味，使用频次居前10位的药物依次是柴胡、桂枝、黄芩、百合、浮小麦、龙骨、牡蛎、黄芪、姜半夏、茯苓。2) 药物性味归经：寒性药物使用频数最多，达460次，占比38.14%；五味以甘、苦、辛为主，占比分别为38%、25%和18%；归经多归肺、肝、心经，其次为脾、肾、胃、胆、大肠经；补虚药使用频次最高，达343次，其次为清热药(174次)和解表药(148次)。3) 组方规律分析：药物组合54个，包含中药6味，组合频次从高到低依次是龙骨和牡蛎、牡蛎和桂枝、龙骨和桂枝、浮小麦和百合等为代表，总结其基础方剂为柴胡桂枝龙骨牡蛎汤。结论：围绝经期综合征的基本病机为肝郁肾虚，痰浊、瘀血是常见兼夹病理产物，治疗以疏肝和解、滋阴清热为主，兼以健脾益气、扶正祛邪、渗湿利水。
Objective: To summarize the medication patterns of Professor Li Hongmei in the treatment of perimenopausal syndrome by using data mining. Methods: A total of 61 prescriptions with perimenopausal syndrome were collected and screened from the outpatient department of gynecology of the Second Affiliated Hospital of Heilongjiang University of Chinese Medicine from September to December in 2023, and recorded the medication information in Excel 2016 and analyzed by using SPSS Modeler and Origin 2022 software. Results: 1) Frequency analysis: 61 prescriptions involved 141 kinds of traditional Chinese medicine, total frequency of use 1206 times and more than 20 times of 19 drugs. The 10 most frequently used drugs were Chaihu, Guizhi, Huangqin, Baihe, Fuxiaomai, Longgu, Muli, Huangqi, Jiangbanxia and Fuling. 2) Properties and Meridians: The most frequent use of cold drugs was 460 times (38.14%), the main five tastes were sweet, bitter and acrid (38%, 25% and 18%), and the meridians mainly belong to lung, liver and heart and then spleen, kidney, stomach and gallbladder. The tonic herbs were used the most frequently, up to 343 times, followed by heat-clearing drugs (174 times) and surface-relieving drugs (148 times). 3) Prescription law: There are 54 drug combinations, including 6 kinds of traditional Chinese medicine. The combination frequency from high to low is represented by Longgu and Muli, Muli and Guizhi, Longgu and Guizhi, Fuxiaomai and Baihe, etc. Conclusion: The basic pathogenesis of perimenopausal syndrome is cardinal disadvantage, stagnation of liver-qi and deficiency of kidney. Phlegm and blood stasis are common pathological products, so the treatment is mainly to soothe the liver and reconcile, to nourish yin and clear heat and also to strengthen the spleen of qi, to strengthen the body and
| [1] | 围绝经期综合征(更年期综合征)重点人群治未病干预指南[J]. 北京中医药大学学报, 2023, 46(8): 1048-1062. |
| [2] | 贝政平, 来佩璃, 张斌. 妇产科疾病诊断标准[M]. 北京: 科学出版社, 2007. |
| [3] | Schoenaker, D.A., Jackson, C.A., Rowlands, J.V. and Mishra, G.D. (2014) Socioeconomic Position, Lifestyle Factors and Age at Natural Menopause: A Systematic Review and Meta-Analyses of Studies across Six Continents. International Journal of Epidemiology, 43, 1542-1562. https://doi.org/10.1093/ije/dyu094 |
| [4] | 李骏驰, 章舒, 曾琼仙, 等. 昆明市围绝经期妇女健康状况及影响因素分析[J]. 中国妇幼保健, 2016, 31(18): 3806-3808. |
| [5] | 刘萌芳, 黄海燕. 三明市三元区妇女更年期健康调查研究[J]. 现代诊断与治疗, 2013, 24(15): 3400-3402. |
| [6] | An, J. and Li, L. (2023) Urban-Rural Differences in Epidemiology and Risk Factors of Menopause Syndrome in Middle-Aged Chinese Women. Menopause, 30, 306-316. https://doi.org/10.1097/gme.0000000000002135 |
| [7] | 聂广宁, 王小云, 杨洪艳, 等. 中国城市女性绝经年龄影响因素调查[J]. 中国妇幼保健, 2011, 26(8): 1191-1193. |
| [8] | 翟子涵. 河北省女性非医务工作者更年期认知情况及相关影响因素调查[D]: [硕士学位论文]. 石家庄: 河北医科大学, 2021. |
| [9] | 张梦莎. 河南省部分地区40~65岁女性围绝经期相关症状的调查与分析[D]: [硕士学位论文]. 郑州: 郑州大学, 2019. |
| [10] | 张绍芬, 包蕾. 绝经期健康管理策略[J]. 实用妇产科杂志, 2015, 31(5): 333-334. |
| [11] | Hill, K. (1996) The Demography of Menopause. Maturitas, 23, 113-127. https://doi.org/10.1016/0378-5122(95)00968-x |
| [12] | 张志刚, 杨军用, 赵新芳, 等. 蔡钢教授治疗围绝经期综合征的临床经验[J]. 临床医学研究与实践, 2020, 5(12): 125-126. |
| [13] | 宗岩, 刘枚, 蒋莉, 等. 夏桂成国医大师诊治围绝经期综合征经验探析[J]. 江苏中医药, 2017, 49(2): 21-22. |
| [14] | 李广美, 刘素荣. 刘素荣辨证治疗女性围绝经期综合征经验[J]. 湖南中医杂志, 2017, 33(8): 39-40. |
| [15] | 贾汝楠, 刘玉兰. 高慧教授治疗围绝经期综合征经验[J]. 河北中医, 2020, 42(10): 1455-1457. |
| [16] | 吕晶武. 徐琴教授治疗围绝经期综合征的经验[J]. 光明中医, 2017, 32(3): 325-327. |
| [17] | 贾琳, 冯志海. 冯志海教授运用丹栀逍遥散治疗围绝经期综合症经验[J]. 中国民族民间医药, 2017, 26(6): 71-72. |
| [18] | 王海强, 周千瑶, 李冰琪, 等. 柴胡化学成分及药理作用研究进展[J]. 吉林中医药, 2024, 44(1): 96-100. |
| [19] | 徐雪娇, 李天英, 李欣, 等. 柴胡化学成分及抗抑郁机制研究进展[J]. 化学工程师, 2022, 36(6): 65-67+81. |
| [20] | 刘萍, 张丽萍. 桂枝化学成分及心血管药理作用研究[J]. 辽宁中医杂志, 2012, 39(10): 1926-1927. |
| [21] | Pan, H., Xi, Z., Wei, X. and Wang, K. (2022) A Network Pharmacology Approach to Predict Potential Targets and Mechanisms of “Ramulus cinnamomi (Cassiae—Paeonia lactiflora” Herb Pair in the Treatment of Chronic Pain with Comorbid Anxiety and Depression. Annals of Medicine, 54, 413-425. https://doi.org/10.1080/07853890.2022.2031268 |
| [22] | 国家药典委员会. 中华人民共和国药典一部2020年版[M]. 北京: 中国医药科技出版社, 2020. |
| [23] | 马艳春, 范楚晨, 冯天甜, 等. 茯苓的化学成分和药理作用研究进[J]. 中医药学报, 2021, 49(12): 108-111. |
| [24] | Zhu, D., Wang, S., Lawless, J., He, J. and Zheng, Z. (2016) Dose Dependent Dual Effect of Baicalin and Herb Huang Qin Extract on Angiogenesis. PLOS ONE, 11, e0167125. https://doi.org/10.1371/journal.pone.0167125 |
| [25] | 龚发萍, 郑鸣. 黄芩的化学成分及药理作用[J]. 临床合理用药杂志, 2021, 14(34): 176-178. |
| [26] | Pan, G., Xie, Z., Huang, S., Tai, Y., Cai, Q., Jiang, W., et al. (2017) Immune-Enhancing Effects of Polysaccharides Extracted from Lilium Lancifolium Thunb. International Immunopharmacology, 52, 119-126. https://doi.org/10.1016/j.intimp.2017.08.030 |
| [27] | 孙佳宁, 连希希, 孙伶俐, 等. 百合主要成分及药理作用研究进展[J]. 中国野生植物资源, 2022, 41(7): 45-50. |
| [28] | 裴妙荣, 孟霜, 李慧峰. 浮小麦与小麦的止汗作用及5-二十一烷基间苯二酚等化合物含量比较研究[J]. 中华中医药学刊, 2013, 31(9): 2030-2032+2089. |
| [29] | Liu, Y., Mo, X., Tang, X., Li, J., Hu, M., Yan, D., et al. (2017) Extraction Optimization, Characterization, and Bioactivities of Polysaccharides from Pinelliae rhizoma Praeparatum Cum Alumine Employing Ultrasound-Assisted Extraction. Molecules, 22, Article 965. https://doi.org/10.3390/molecules22060965 |
| [30] | 高奎旭, 王瑶, 胡美变, 等. 半夏多糖的提取纯化、结构分析及药理作用研究进展[J]. 中华中医药学刊, 2024, 42(7): 147-153. |
| [31] | Su, H., Shaker, S., Kuang, Y., Zhang, M., Ye, M. and Qiao, X. (2021) Phytochemistry and Cardiovascular Protective Effects of Huang‐Qi (Astragali radix). Medicinal Research Reviews, 41, 1999-2038. https://doi.org/10.1002/med.21785 |
| [32] | 江远玲, 冯楠, 邵欣宇, 等. 黄芪的现代药理作用研究进展[J]. 西南医科大学学报, 2023, 46(5): 456-460+463. |
