首页|不同教材/指南冠心病中医分型和治疗中成药对比分析

不同教材/指南冠心病中医分型和治疗中成药对比分析

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目的:系统梳理、分析不同指南/教材/行业标准中冠心病中医证型分类及治疗中成药使用情况,为中成药合理用药提供新思路。方法:收集14份指南/教材/行业标准中包含"胸痹心痛""冠心病""心绞痛"相关文字的病名,并对其证型分类进行汇总,整合同义概念证型后筛选高频次证型名称,根据《中国药典》、药品说明书对治疗中成药的成分与功效主治进行分析。结果:14份指南/教材/行业标准中共包含37个证型名称,同义概念证型整合后得到16种,出现频次最高分别为寒凝心脉、气滞血瘀、气虚血瘀、气阴两虚,痰浊壅塞、心血痹阻、心阳虚、心肾阴虚8个证型。各证型治疗中成药频次前3名的25种,包括冠心苏合丸(胶囊、软胶囊)、苏合香丸、通心络片(胶囊)、芪参益气滴丸、心通口服液、复方丹参片(丸、胶囊、颗粒、滴丸、喷雾剂)、速效救心丸、血府逐瘀丸(片、胶囊、颗粒、口服液)、心元胶囊等。同一中成药在不同指南/教材/行业标准中治疗的证型有差别,如麝香保心丸等。中成药说明书适应证与指南/教材/行业标准推荐的证型也有差异,如舒心口服液等。结论:冠心病治疗相关指南/教材/行业标准的中医证型分类及治疗中成药存在差异,为临床中成药辨证论治合理使用带来影响,亟需更统一、更高质量的参考材料,可尝试开展基于证素或"汤液经法图"体系的辨证分类,提供更为统一的辨证论治思路,促进合理用药。
Comparative study of different textbooks/guidelines on the classification of Chinese medicine and treating coronary heart disease with proprietary Chinese medicines
OBJECTIVE To systematically sort out the classification of TCM syndrome types and recommended proprietary Chinese medicines in different guidelines or textbooks for coronary heart disease(CHD),analyze the classification of TCM syn-drome and the use of proprietary Chinese medicines for CHD and provide new ideas for rational use of proprietary Chinese medi-cines.METHODS Fourteen guides/textbooks containing"chest palsy,heart pain","CHD"and"angina"related words were screened,differentiation and classification summarized and the names of high-frequency syndrome types screened after synony-mous classification.According to the Chinese Pharmacopoeia and package inserts,the composition and efficacy characteristics of proprietary Chinese medicines were reviewed.RESULTS A total of 37 certificate types were included and 16 types obtained after synonymous classification.The highest frequency was 8 types of syndrome:cold coagulation heart pulse,Qi stasis and blood sta-sis,Qi deficiency and blood stasis,Qi and Yin deficiency,phlegm turbidity,cardiac blood obstruction,heart Yang deficiency and heart&kidney Yin deficiency.At the same time,25 kinds of proprietary Chinese medicines were recommended as Top 3 fre-quency of each symptom type,including coronary heart Suhe Pills(capsules&soft capsules),Suhe Xiang Pills,Tongxin Luo Tablets(capsules),Qi ginseng Yiqi Drop Pills,Xintong Oral Liquid,Compound Danshen Tablets(pills,capsules,granules,drop pills&sprays),Fast-acting Rescue Pills,Blood Fu Zhuyu Pills(tablets,capsules,granules&oral liquid)and Xinyuan Capsules,etc.Different literatures/textbooks have different classifications of the same proprietary Chinese medicine,such as Musk Baoxin Pills.There are also variations between the functional indications of proprietary Chinese medicines and the types rec-ommended in guides/textbooks,such as Tonic Qi Oral Liquid.CONCLUSION There are differences in the classification of TCM certificates and recommended proprietary Chinese medicines in the guidelines/textbooks for CHD.It has some impact on audit&review of prescriptions and rational use of proprietary Chinese medicines,and there is an urgent need for more unified and high-quality reference materials.

coronary heart diseasechest palsyTCM certificate typeproprietary Chinese medicinesguide

高婷婷、杨宏昕、金锐

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内蒙古自治区人民医院药学处,内蒙古呼和浩特 010070

中国中医科学院西苑医院药学部,北京 100080

冠心病 胸痹 中医证型 中成药 指南

首都卫生发展科研专项

2020-2-2081

2024

中国医院药学杂志
中国药学会

中国医院药学杂志

CSTPCD北大核心
影响因子:1.198
ISSN:1001-5213
年,卷(期):2024.44(17)