基于文献挖掘名老中医治疗非瓣膜性房颤的证—药关联规律

目的利用中医传承辅助平台挖掘名老中医著作中治疗非瓣膜性房颤的证—药关联规律。方法收集山东中医药大学及山东省图书馆内名老中医临床著作中治疗非瓣膜性房颤医案,运用中医传承辅助平台(TCMISS)V2.5对房颤合并疾病及其证素、证型、用药进行频数统计或关联分析,并进行药证网络可视化展示。结果共纳入医案173则,药物共209味。合并其他西医疾病排名前三位分别为冠心病、心力衰竭、高血压病;证候要素排在前三位的依次为气虚、阴虚、血瘀;证型排在前三位的分别是心血瘀阻证、气阴两虚证、气血两虚证;9种证型中,心血瘀阻证常合并气虚证素,根据关联边目数筛选的关键药物排名前三分别为丹参、黄芪、桂枝。结论临床治疗非瓣膜性房颤及开发房颤新药优先考虑以气虚、阴虚、血瘀等为主要适应证,证型以心血瘀阻证最常见,优先考虑丹参、黄芪、桂枝、麦冬等核心药物;名老中医在辨病基础上强调辨证论治,本研究通过证药关联分析总结其辨证用药规律,为临床治疗非瓣膜性房颤提供一定的参考。

Syndrome-herb association rules of famous veteran doctors of TCM in the treatment of non-valvular atrial fibrillation were mined based on literature study

Objective To mine the rules of syndrome-herb association of famous veteran doctors of TCM in the treatment of non-valvular atrial fibrillation(NVAF)by using TCM inheritance auxiliary platform(TCMISS).Methods Medical cases of NVAF in clinical works of famous veteran doctors of TCM in Shandong University of Traditional Chinese Medicine and Shandong Library,were collected.TCMISS V2.5 was used to carry out frequency statistics or correlation analysis of atrial fibrillation associated diseases and its syndrome elements,syndrome types and medications,and to perform herb-syndrome network visual display.Results A total of 173 medical cases and 209 drugs were included.Coronary heart disease,heart failure and hypertension were the top three diseases combined with other western medicine.The first three syndrome elements were qi d eficiency,yin deficiency and blood stasis.The top three syndrome types are syndrome of blood stasis in heart,syndrome of deficiency of both qi and yin,syndrome of deficiency of both qi and blood.Among the 9 syndrome types,the syndrome of blood stasis in heart was often combined with syndrome element of qi deficiency.And the top three key drugs selected according to the relevant border number were Radix Salviae Miltiorrhizae,Ridix Astragali seu Hedysari and Ramulus Cinnnamomi.Conclusion In the clinical treatment of NVAF and the development of new drugs for atrial fibrillation,qi deficiency,yin deficiency,blood stasis and other indications should be given priority.The syndrome of blood stasis in heart is the most common syndrome type,and the core drugs such as Radix Salviae Miltiorrhizae,Ridix Astragali seu Hedysari,Ramulus Cinnnamomi and Radix Ophiopogonis should be given priority.Based on disease differentiation,famous veteran doctors of TCM emphasize treatment based on syndrome differentiation.In this study,the medication laws of syndrome differentiation were summarized by syndrome-herb association analysis,and it provides a reference for the clinical treatment of NVAF.