国医大师吕仁和治疗慢性肾脏病用药规律研究
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国家重点研发计划项目(2018YFC1704100)——基于“道术结合”思路与多元融合方法的名老中医经验传承创新研究;国家中医药管理局全国名老中医药专家“吕仁和名医”传承工作室(JB063)


Professor Lyu Renhe's Experience in Treating Chronic Kidney Disease
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    目的:通过对吕仁和教授治疗慢性肾脏病(CKD)用药规律进行总结,系统归纳吕教授治疗CKD的学术思想与临床经验。方法:选取吕教授2012年1月至2021年6月治疗CKD的处方,应用FangNet平台,基于PageRank算法,分析处方药物的性味归经、核心药物及药物群组。结果:研究纳入患者294例,涉及294诊次,处方涉及中药159种,总频次2 304次。药性以平性、寒性和温性为主,药味以甘味和苦味为主,归经主要为肝、心、脾、肾4经。药物权重等级分析显示,吕教授治疗CKD的核心药物为丹参、猪苓、川芎等。药物-药物共现性分析显示,吕教授治疗CKD的常用药对为香橼-佛手、桃仁-红花、赤芍-牡丹皮;聚类分析显示出9个药物群组,体现了吕教授肝肾同治,活血与利水并重的治疗思想。结论:基于PageRank算法进行药物-药物、症状-药物相关性分析,总结吕教授临床治疗CKD的学术经验,重视病证结合,分期辨证论治,针对不同证候和症状应用药对、药串,核心治法为活血化瘀散结法,治疗上强调扶正与祛邪兼顾。

    Abstract:

    To summarize the medication rules of Professor Lyu Renhe in treating chronic kidney disease(CKD) and elucidate the academic thought and clinical experience.Methods:The prescriptions used by Professor Lyu for treating CKD from January 2012 to June 2021 were selected.FangNet and PageRank algorithm were employed to analyze the natures,tastes,meridian tropism of Chinese medicines,core medicines,and medicine combinations of the prescriptions.Results:A total of 294 patients corresponding to 294 consultations were included in this study.The prescriptions involved 159 Chinese medicines with the total frequency of 2 304.The Chinese medicines used in the prescriptions were mainly plain,cold,or warm,tasted sweet or bitter,and showed tropism to liver,heart,spleen,and kidney meridians.The weight ranking showed that the core medicines were Salviae Miltiorrhizae Radix et Rhizoma,Polyporus,and Chuanxiong Rhizoma.The co-occurrence network showed that the common medicine pairs were Citri Fructus-Citri Sarcodactylis Fructus,Persicae Semen-Carthami Flos,and Paeoniaeradix Rubra-Moutan Cortex.The cluster analysis revealed nine medicine clusters,which reflected Professor Lyu's ideas of treating liver and kidney together and activating blood and promoting urination at the same time.Conclusion:PageRank algorithm was employed to analyze the medicine-medicine and symptom-medicine correlations.Professor Lyu emphasizes the combination of disease and syndrome and advocates staged treatment based on syndrome differentiation by applying medicine pairs and combinations with consideration to different symptoms and signs.Following the principle of activating blood,resolving stasis,and dissipating nodules,the treatment should consider both reinforcing healthy qi and dispelling pathogenic qi.

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张楷童,肖永华,赵进喜,倪博然,朱荔炜,张耀夫,阮智超,许竣贺,洑晓哲,傅强.国医大师吕仁和治疗慢性肾脏病用药规律研究[J].世界中医药,2023,(10).

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  • 收稿日期:2022-01-28
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  • 在线发布日期: 2023-06-06
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