基于数据挖掘探讨全国名中医王行宽诊疗胸痹心痛遣方用药规律及学术经验

目的：运用中医传承计算平台V3.0软件,研究王行宽教授治疗胸痹心痛遣方用药规律,传承王行宽教授诊疗胸痹心痛的学术经验。方法：收集整理2017—2020年王行宽教授于湖南中医药大学门诊诊疗冠心病心绞痛患者的原始病历资料,录入中医传承计算平台V3.0,运用软件进行方药规律研究。结果：共收集王行宽教授治疗胸痹心痛处方1 044则,所用药物多为甘、苦药物,归经以肺经为主,其次为心、脾、肝、胃、肾经;所用方剂中使用最多的经方是生脉散,最高的经验方是心痛灵Ⅲ号方;高频数药物主要有麦冬、半夏、丹参、瓜蒌皮、黄连、五味子、柴胡等药物;药物的常用剂量多为3、5、10、15 g;组方规律分析得到常用药组合129个,置信度>0.99的组合有58个,并得到常见证型核心药物;药物聚类得到6个核心药物组合。结论：王行宽教授论治胸痹心痛以益气养营、豁痰化瘀、疏肝利胆为治疗思路,并根据胸痹心痛不同证型予以辨证施治,体现其“多脏调燮、综合治理”的学术思想,其核心处方可供临床从业者参考,但仍需要进一步的临床及实验研究验证其疗效。     

中药炮制学科和饮片产业传承与创新过程中几个值得探讨的问题

本文在近年来炮制学科和饮片产业的传承、创新、发展的基本状况的调研的基础上,通过对中药炮制学科和饮片产业传承与创新过程中几个值得探讨的问题的分析,从中药饮片的定义以及其传承、创新的内容、方式方面提出了几点见解。旨在抛砖引玉,求得共识,更进一步促进学科和行业的发展。     

中药药效组分的理论与实践(一)

中药药效组分理论是中药发展中产生的新理论,对于科学地解析中药、深刻地认识中药、合理地使用中药、持续地传承中药和推动中医药产业发展具有划时代的意义。在传承创新、建立与临床疗效对应质量标准的学术思想指导下,张贵君教授于2000~2005年创立了中药生物鉴定法和中药药效组分理论,并进行了10余年的再实践。综述了中药药效组分理论形成和实践成果,为传承发展中药提供理论和技术支撑。     

缓解视疲劳功能中药复方保健产品配方规律及特点分析

目的通过检索特殊食品信息查询平台公布的具有缓解视疲劳功能的保健食品信息资料,以及药智数据网的中成药处方数据库中眼科中成药中有保健功能的产品信息资料,为具有缓解视疲劳功能的保健产品的组方与产品开发提供依据与参考。方法运用Microsoft Excel2016软件及中医传承辅助平台对检得的产品信息进行统计,分析其配方特点。结果共收集到141个具有缓解视疲劳功能的保健食品,其中64个(45.4%)保健食品配方中含有中药类原料。使用频次≥5的中药原料有6味,累计使用145次(72%),由高到低分别是菊花、枸杞子、决明子、桑椹、熟地黄、茯苓。通过无监督的熵层次聚类得到3个新处方。非中药原料在缓解视疲劳功能的保健食品中应用较为普遍,含有外来天然植物资源的60个产品,含叶黄素及维生素类的17个。统计眼科中成药中有保健功能的产品可知,使用频次≥4的中药原料有7味,累计使用32次(29%),由高到低分别是枸杞子、决明子、菟丝子、熟地黄、菊花、五味子、车前子。通过无监督的熵层次聚类得到1个新处方。结论保健食品在中药原料的选择上与中医药理论治疗视疲劳的原则基本契合,即滋补肝肾、平肝明目。但二者在中药原料选择范围、原料配伍、剂型种类等方面有所不同。此外,还在辨证保健理论指导下,尝试探讨应用文献数据处理统计方法筛选新配方、开发新产品,为中药复方保健产品的研发开辟了新思路、新方法。     

基于"肾络癥瘕"理论探讨王耀献教授治疗慢性肾衰竭的用药规律

目的：总结基于“肾络癥瘕”理论探讨王耀献教授治疗慢性肾衰竭的用药规律及其学术经验。方法：选取2013年12月至2017年12月王耀献教授于北京中医药大学东直门医院门诊诊治慢性肾衰竭患者共270例,选取其首诊处方共270首。通过关联规则及复杂熵聚类等方法分析其用药规律及组方特点。结果：本研究共纳入处方270首,涉及药物184种;通过关联规则挖掘方法,将支持度设置为“81”,置信度为“0.8”,共得到常用药物组合114个。选择相关系数为8,惩罚系数为2,通过无监督的熵层次聚类算法,通过演化及进一步聚类,获得10个新处方。寒性药、温性药、平性药应用最多,热性药最少。应用味甘者次数最多,味苦、味辛、味咸、味酸者次之,味涩者最少。归肝经者最多,归脾经、肾经次之,其次分别为归胃、肺、心、胆、大肠、小肠、膀胱、心包、三焦等经者。结论：通过数据挖掘方法客观总结了王耀献教授以“肾络癥瘕理论”为核心,治疗多样化、个体化的用药特点。     

基于数据挖掘治疗肥胖2型糖尿病的用药规律

目的:基于数据挖掘技术分析和总结近30年中国期刊全文数据库(CNKI)中以中医药治疗肥胖2型糖尿病的用药规律。方法:收集CNKI中运用中医药方剂治疗肥胖2型糖尿病的文献,筛选并建立方剂数据库,运用中医传承辅助系统(V2.5)软件,探讨内服中药治疗肥胖2型糖尿病的用药经验。结果:筛选治疗肥胖2型糖尿病方剂45首,涉及中药107种。演化得到核心组合10个,新处方5首。结论:通过中医传承辅助平台对CNKI数据库筛选出的方剂进行分析,阐明组方规律,为临床应用和新药开发提供参考。     

Right Atrial Isomerism in Four Siblings

Heterotaxy syndromes, right or left atrial isomerism, result from disruption of left–right axis determination and their manifestations include complicated heart defects. Recent studies in model organisms have revealed complex genetic pathways and several genes involved in this process. In affected humans, however, molecular studies have identified mutations in a small number of individuals, while in most the cause remains unknown. Furthermore, although family data suggest, autosomal recessive inheritance, such genes have not yet been identified. We have studied six members of a family, four children affected with right atrial isomerism (RAI) and their healthy parents, for disturbances of left–right axis development. The children, one female and three males who all had complicated heart defects, succumbed and had an autopsy. Their nonconsanguineous parents were examined by cardiac and abdominal ultrasound or MRI. In all four children the heart defects included single ventricle with dysplastic atrioventricular (AV) valve, total anomalous pulmonary venous drainage (TAPVD), and malposition of great arteries (MGA) with pulmonary stenosis (PS). All had asplenia; two also had dextrocardia and abdominal situs inversus. The diagnosis of RAI was made postnatally in the first child and prenatally in others. Two siblings had no surgery and died as a newborn, one with obstructed supracardiac TAPVD and the other with regurgitating AV valve. Two children underwent heart surgery. One had repair of obstructive infracardiac TAPVD but died in infancy. The other underwent both hemi-Fontan operation and heart transplantation but died at the age of 2 years. This is the first report describing four children with RAI in the same family. The occurrence of RAI in male and female siblings without any indication of left–right axis abnormalities in their parents suggests autosomal recessive inheritance of human isomerism.     

The mitochondrial plasmid of the true slime mold <Emphasis Type="Italic">Physarum polycephalum</Emphasis> bypasses uniparental inheritance by promoting mitochondrial fusion

Mitochondrial DNA (mtDNA) is inherited maternally in most eukaryotes. Linear mitochondrial plasmids in higher plants and fungi are also transmitted from the maternal parent to the progeny. However, mF, which is a mitochondrial linear plasmid of Physarum polycephalum, evades uniparental mitochondrial inheritance. We examined 36 myxamoebal strains of Physarum and isolated three novel mF⁺ strains (JE8, TU111, NG111) that harbored free mF plasmids. These strains were mated with the mF^– strain KM88. Of the three mF^– × mF⁺ crosses, only KM88 × JE8 displayed complete uniparental inheritance. However, in KM88 × TU111 and KM88 × NG111, the mtDNA of KM88 and mF of TU111 and NG111 were inherited by the plasmodia and showed recombination. For example, although the mtDNA of TU111 was eliminated, the mF of TU111 persisted and became inserted into the mtDNA of KM88, such that recombinant mtDNA represented 80% of the total mtDNA. The parental mitochondria fused to yield giant mitochondria with two or more mitochondrial nucleoids. The mF appears to exchange mitochondria from the recipient (paternal) to the donor (maternal) by promoting mitochondrial fusion.The first two authors have equally contributed to this work     

雌激素受体α基因Pvu Ⅱ和Xba Ⅰ酶切多态性与冠心病相关性

目的 探讨中国人群中雌激素受体(ER)α基因Pvu Ⅱ和Xba Ⅰ酶切多态性与冠心病(CAD)的相关性.方法 将2004年4月至2006年12月在中山大学附属第五医院心内科住院的中国南方汉族CAD患者236例为病例组,117例选自健康体检者或同期在我院住院的非CAD患者为对照组,应用聚合酶链反应-限制片断长度多态性(PCR-RFLP)分析的方法,检测CAD组和对照组的ERα基因型,比较其与相关指标的关系.结果 ERα酶切多态性分析结果显示Pvu Ⅱ存在PP、Pp、pp 3种基因型;Xba Ⅰ酶切也可区分出XX、Xx、xx 3型.Pvu Ⅱ多态性中,CAD组P等位基因型频率也显著高于对照组[42.2%(199/472)比33.8%(79/234),P=0.032],pp基因型的高密度脂蛋白水平显著高于P等位基因携带者,两组之间基因型分布差异具有统计学意义(P=0.041),X等位基因在对照组和CAD组分别为16.5%(78/472)和16.2%(38/234),两组基因型和等位基因频率差异均无统计学意义.结论 中国南方汉族人群中ERαPvu Ⅱ酶切多态性与CAD有关,P等位基因可能是CAD独立遗传危险因素;ERα Xba Ⅰ酶切多态性与CAD未发现相关.