| 引用本文:杨锐平，林小靖，陶春晖，姜瑞雪.基于文献的慢性萎缩性胃炎中医证候特征及用药规律研究[J].世界中医药,2023,(06):. |
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| 基于文献的慢性萎缩性胃炎中医证候特征及用药规律研究 |
| TCM Syndrome Characteristics of and Medication Rules for Chronic Atrophic Gastritis Based on Literature |
| 投稿时间：2021-07-11 |
| DOI：10.3969/j.issn.1673-7202.2023.06.024 |
| 中文关键词: 慢性萎缩性胃炎 证候 证素 用药规律 关联规则 聚类分析 数据挖掘 |
| English Keywords:Chronic atrophic gastritis Syndromes Syndrome elements Medication rules Association rules Cluster analysis Data mining |
| 基金项目:湖北省教育厅科学技术研究项目（D20172006）；湖北省卫生厅科研基金项目（2013Z-Y14） |
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| 中文摘要: |
| 目的：探讨慢性萎缩性胃炎（CAG）的证候、证素分布特点及用药规律，为CAG的规范化辨证和用药提供依据。方法：检索国家知识基础设施数据库（CNKI）、中国学术期刊数据库（CSPD）、中文科技期刊数据库（CCD）1990年1月至2020年12月中医药治疗CAG的相关文献，提取文献中的证候、证素、病例数及处方药物组成，分析比较前25年与近5年文献CAG证候与证素的频次、病例数与构成比。对药物进行频数分析，最后对高频药物进行关联规则与聚类分析。结果：最终纳入文献245篇，含中医证型42种，CAG常见证型有脾胃气虚证、胃阴亏虚证、脾胃阳虚证、脾虚气滞证、肝胃不和证、脾胃湿热证、瘀阻胃络证；CAG病位多在胃、脾和肝，常见病性证素有气虚、阳虚、热、阴虚、气滞、瘀、湿。相比于前25年文献，近5年文献更多见脾胃气虚证、胃阴亏虚证和肝胃不和证，病性证素更多见气虚、热、阴虚、气滞和瘀。共涉及处方260首，涵盖药物191种，使用频率较高的为白术（56.54％）、党参（46.54％）和白芍（46.15％）。30味高频药物聚为8类时效果最佳。结论：CAG以脾胃气虚证为主，病位主要在胃、脾和肝，病性多见气虚、阳虚、热、阴虚、气滞、瘀和湿；治疗CAG以益气健脾为主，辅以理气行滞、清热解毒、活血化瘀。 |
| English Summary: |
| To investigate the traditional Chinese medicine(TCM) syndromes and syndrome elements of chronic atrophic gastritis(CAG)，reveal the medication rules，and thus provide evidence for the standardized differentiation and treatment of CAG.Methods:The relevant articles about the treatment of CAG with TCM were retrieved from China National Knowledge Infrastructure(CNKI)，China Science Periodical Database(CSPD)，and Chinese Citation Database(CCD)，with the time interval from January 1990 to December 2020.The syndromes，syndrome elements，number of cases，and prescription composition were extracted from the literature.The frequency，number of cases，and constituent ratio of CAG syndromes and syndrome elements in the literature in the first 25 years and recent 5 years were analyzed and compared.The frequency of medicines in the prescriptions was analyzed，and finally the association rules analysis and cluster analysis were carried out for the medicines with high frequency.Results:A total of 245 qualified articles were included，involving 42 TCM syndromes.The common syndromes were deficiency of spleen and stomach qi，deficiency of stomach yin，deficiency of spleen and stomach yang，spleen deficiency and qi stagnation，liver-stomach disharmony，dampness-heat of spleen and stomach，and stasis in stomach collateral.CAG mainly affected the stomach，spleen，and liver.The common syndrome elements of CAG were qi deficiency，yang deficiency，heat，yin deficiency，qi stagnation，stasis，and dampness.Compared with the literature of the previous 25 years，the literature in the recent 5 years mainly reported deficiency of spleen and stomach qi，deficiency of stomach yin，and liver-stomach disharmony，and the syndrome elements reported more were qi deficiency，heat，yin deficiency，qi stagnation，and stasis.A total of 260 prescriptions were included，involving 191 Chinese medicines.Atractylodis Macrocephalae Rhizoma(56.54%)，Codonopsis Radix(46.54%)，and Paeoniae Radix Alba(46.15%) were used more frequently.The 30 high-frequency medicines were well clustered into 8 groups.Conclusion:The CAG patients mainly present the TCM syndrome of deficiency of spleen and stomach qi，with the stomach，spleen，and liver affected.The common syndrome elements are qi deficiency，yang deficiency，heat，yin deficiency，qi stagnation，stasis，and dampness.Replenishing qi and invigorating spleen can be taken as the main therapy for CAG，supplemented by regulating qi for relieving stagnancy，clearing heat and removing toxin，activating blood and resolving stasis. |
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