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中医药治疗慢性肾脏病合并肿瘤的用药规律

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目的 基于数据挖掘方法探讨中医药治疗慢性肾脏病(CKD)合并肿瘤临床遣方用药规律。方法 收集2017 年 10月至2022 年9 月天津中医药大学第一附属医院国医堂专家门诊治疗慢性肾脏病合并肿瘤的处方,应用 Microsoft Excel 2022、SPSS 26。0 及SPSS Modeler 18。0 进行中药使用频数、性味、分类、归经、关联规则及核心药对分析。结果 最终纳入 180个处方进行统计分析,涉及中药214 味,药物频次3 017 次。药性以寒温平为主,药味以甘苦辛为主,归经多为肝脾肺胃经,其中药物频次较高的是补虚药、清热药、活血化瘀药、利水渗湿药。基于关联规则分析提示核心药物为四君子汤、五苓散、当归补血汤、生脉散加入补气升阳、活血化瘀药物加减而成,聚类分析得到4 个核心药物组合。结论 中医药治疗慢性肾脏病合并肿瘤以扶正祛邪为总的治则,以疏利少阳三焦为治疗大法,融合补肾健脾、调理中焦、疏肝理气、利湿泄浊、活血化瘀、清热解毒等治法,标本兼顾,临证疗效显著,值得借鉴与学习。
A study on the medication patterns of traditional Chinese medicine in the treat-ment of CKD combined with tumors
Objective to explore the clinical prescription and medication rules of Chinese medicine for the treat-ment of chronic kidney disease(CKD)combined with oncological diseases based on real-world data mining methods.Methods Prescriptions for the treatment of chronic kidney disease(CKD)combined with oncological diseases in the specialist outpatient clinic of the National Medical Hall of the First Affiliated Hospital of Tianjin University of Traditional Chinese Medicine(TUTM)were collected from October 2017 to September 2022,and Microsoft Excel 2022,SPSS 26.0 and SPSS Modeler 18.0 were applied to carry out the analysis of frequency of use of traditional Chinese medicines(TCMs),four natures and five flavors,classification,categorization,compati-bility rules,and core medication pairs.Results Finally,180 prescriptions were included for statistical analysis,in-volving 214 kinds of traditional Chinese medicines,with a drug frequency of 3017 times.The medicinal properties of the drugs were mainly"cold","warm"and"flat",the flavours of the drugs were mainly sweet,bitter and pun-gent,and the attributed meridians were mostly the liver,spleen,lung and stomach meridians,of which the drugs with higher frequency uses were those that tonified the deficiency,cleared heat,activated blood circulation and e-liminated blood stasis,and induced drainage and seepage of dampness.Based on the association rule analysis,it was suggested that the core drugs were"Sijunzi Tang","Wu Ling San","Angelica Blood Replenishing Tang",and"Shengmai San",with additions of drug that could"replenish qi"and"elevate yang",and activate blood circulation and eliminate blood stasis.Clustering analysis yielded four core drug combinations.Conclusion Chi-nese medicine treatment of chronic kidney disease combined with tumour is based on the general treatment princi-ple of strengthening the body defense and driving away the evil,and the general treatment method of dredging and benefiting"Shaoyang Sanjiao",integrating the treatment methods of tonifying the kidney and strengthening the spleen,regulating the"Middle Jiao","dredging the liver"and"regulating the qi","inducing dampness"and"draining the turbid",activating blood circulation and removing blood stasis,and clearing the heat and removing the toxins,with a combination of treating symptoms and causes,with remarkable efficacy,and is worthy of refer-ence,study and application.

chronic kidney diseasecancersupporting the positive and dispelling the evilpromoting blood cir-culation and removing blood stasisclearing heat and removing toxins

祝昌昊、杨精华、唐阁、郭望、王耀光

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天津中医药大学第一附属医院 肾病科,天津 300381

国家中医针灸临床医学研究中心 肾病科,天津 300381

天津中医药大学附属北辰中医院 心内科,天津 300400

慢性肾脏病 肿瘤 扶正祛邪 活血化瘀 清热解毒

国家重点研发计划资助项目国家自然科学基金资助项目天津市中医经典传承高级人才研修项目

2018YFC170410281503393津卫中便函2021642号

2024

遵义医科大学学报
遵义医科大学

遵义医科大学学报

CSTPCD
ISSN:2096-8159
年,卷(期):2024.47(7)
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