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稳定型心绞痛的中医证候分布及用药规律研究

Distribution of Traditional Chinese Medicine Pattens and Composition Rule of Chinese Herbal Medicine for Stable Angina Pectoris

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目的:通过数据挖掘总结稳定型心绞痛的证候分布特点及组方用药规律.方法:搜索国家知识基础设施数据库(CNKI)、中国学术期刊数据库(CSPD)、中文科技期刊数据库(CCD)、PubMed、Web of Science数据库从建库至2022年2月收录的有关中医药治疗稳定型心绞痛的相关文献,建立方药数据库,并对高频药物进行关联规则及系统聚类分析.结果:共纳人文献105篇,处方111首,涉及患者9 786例,涵盖中医证型21种,频次最高证型为气虚血瘀,共提取出7个病性证素和2个病位证素.涉及中药123味,共计使用频次1 162次,使用频次前5位的中药分别是丹参70次、川芎69次、甘草54次、黄芪53次、当归50次.前30味高频药物关联规则分析显示,支持度最高的前3位药对为川芎-当归、川芎-赤芍、川芎-红花,聚类分析得到4个药物核心组合.结论:稳定型心绞痛常见气虚血瘀、痰瘀互结、气滞血瘀证;病性证素以实性居多,常见血瘀、痰浊,虚性证素主要为气虚;用药主要以活血化瘀、理气通滞、化痰降浊、益气通脉为法,是现代中医治疗稳定型心绞痛的主导思想.
Objective:This paper aims to summarize the distribution characteristics of traditional Chinese medicine(TCM)patterns and the composition rule of Chinese herbal medicine(CHM)of stable angina pectoris based on data mining.Methods:CNKI,CSPD,CCD,PubMed,and Web of Science databases were searched from the inception date till February 2022,for literature related to the treatment of stable angina pectoris with TCM,and the prescription database was established.The association rules and sys-tematic clustering analysis of high-frequency herbs were also carried out.Results:A total of 105 articles and 111 prescriptions were included,involving 9 786 patients and covering 21 types of TCM syndromes.The syndrome type with the highest frequency was qi deficiency and blood stasis.A total of seven disease syndrome elements and two disease location syndrome elements were extracted.A total of 123 kinds of CHM were involved,with a total frequency of 1 162 times.The top five herbs were Salvia miltiorrhiza(70 times),Chuanxiong Rhizoma(69 times),Glycyrrhizae Radix et Rhizoma(54 times),Astragali Radix(53 times),and Angelicae Sinensis Radix(50 times).The analysis of association rules of the top 30 high-frequency herbs showed that the top three herb pairs with the highest support were Chuanxiong Rhizoma-Angelicae Sinensis Radix,Chuanxiong Rhizoma-Paeoniae Radix Rubra,and Chuanxiong Rhizoma-Carthami Flos,and four herb core combinations were obtained by clustering analysis.Conclusion:Common syndromes of stable angina pectoris include qi deficiency and blood stasis,phlegm stagnation and blood stasis,and qi stagnation heart and blood stasis.The nature of the disease syndrome element is mostly excess,manifested as blood stasis and turbid phlegm;The syndrome element of deficiency is mainly qi deficiency.The composition rule of CHM is to invigorate blood stasis,regulate qi and stagnation,dissolve phlegm and lower turbidity,and benefit qi and open the veins,which is the leading idea of modern Chinese medicine in the treatment of stable angina pectoris.

Stable angina pectorisTraditional Chinese medicine patternsComposition rule of Chinese herbal medicineFour qi and five flavorsAssociation ruleSystematic clusteringConfidenceData mining

李兰兰、吴茜、吕乾瑜、李俊佳、杨盈天、叶雪姣、王师菡

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中国中医科学院广安门医院心血管科,北京,100053

北京中医药大学,北京,100029

稳定型心绞痛 中医证候 用药规律 四气五味 关联规则 系统聚类 置信度 数据挖掘

国家自然科学基金首都临床诊疗技术研究及示范应用项目

81473465Z191100006619025

2023

世界中医药
世界中医药学会联合会

世界中医药

CSTPCDCHSSCD北大核心
影响因子:1.266
ISSN:1673-7202
年,卷(期):2023.18(20)
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