摘要
目的:分析近10年中医治疗类风湿关节炎(rheumatoid arthritis,RA)文献,探讨RA的中医证候分布特点与遣方用药规律,为临床治疗提供参考。方法:检索'知网'数据库2008—2018年中医药治疗RA的文献,系统提取其中涉及中医证候分型、舌脉表现、方药使用等信息,进行规范并归类,应用统计软件SPSS 17.0对证候、舌脉、方剂、中药的频次、频率进行统计分析。结果:共检出文献9494篇,纳入研究247篇;共出现9种舌质,8种舌苔,21种脉象;经规范证候名称后,获得共计15种证候,最常见的前五位证型为风湿痹阻、肝肾不足、寒湿痹阻、湿热痹阻、瘀血痹阻;在证候分布的基础上进行证候要素提取,得到10种证素,居于前6位的为风、寒、湿、肾虚、瘀;除自拟方外,治疗RA方剂共计37首,主要来源于《伤寒论》和《金匮要略》两大中医经典;共使用了171味中药,药物总使用频次为1524次,平均每处方使用13.6味中药,以祛风湿药、活血化瘀药、补肾壮骨药、利湿药为最常用。结论:综合证候分型与方药使用两方面,得出RA的核心病理要素为(肾)虚、湿、瘀。
Objective:To analyze the literature of rheumatoid arthritis(RA)treated by traditional Chinese medicine in recent 10 years and explore the characteristics of TCM syndrome patterns of RA patients and herbal prescription regularity so as to to provide references for clinical treatment.Methods:The literature of traditional Chinese medicine in RA treatment between 2008 and 2018 was searched in the'CNKI'database.Systematically we extracted the information related to TCM syndrome differentiation,lingual-pulse expression,prescription use from those literature and then we standardized and classified the data.SPSS 17.0 software was applied for the analysis of occurrence frequency of syndromes,syndrome elements,tongue and pulse,prescription and traditional Chinese medicine.Results:A total of 9494 reports were obtained and 247 reports met the inclusion criteria.In the 247 included reports,9 kinds of tongue texture,8 kinds of tongue fur and 21 kinds of pulse were present.After the standardization and combination of the similar syndromes,15 syndromes were included into the analysis.In the 14 included syndrome patterns,the leading 5 patterns were wind-damp arthralgia,liver-kidney deficiency,cold-damp arthralgia,damp-heat arthralgia,blood stasis arthralgia.Ten syndrome elements were extracted from the syndromes.The top syndrome elements were wind,cold,dampness,kidney deficiency and blood stasis.Apart from the self-designed prescription,there were 37 prescriptions for treating RA,mainly from the two classical Chinese medicine classics Shanghanlun and Jinkui Yaolue.A total of 171 traditional Chinese drugs were used,with a total frequency of 1524 times.An average of 13.6 traditional Chinese drugs were used per prescription.Dispelling wind and dampness drugs,invigorating blood and removing blood stasis drugs,nourishing kidney and strengthening bones drugs and dehumidifying drugs are most commonly used.Conclusion:The core pathological elements of RA are deficiency,dampness and blood stasis.
作者
赵越
晏菁遥
黄闰月
陈秀敏
王茂杰
吴晓东
黄清春
ZHAO Yue;YAN Jingyao;HUANG Runyue;CHEN Xiumin;WANG Maojie;WU Xiaodong;HUANG Qingchun(Section Rheumatology Research,Guangdong Provincial Hospital of Chinese Medicine,Guangzhou 510006,Guangdong,China;Department of Rheumatology Guangdong Provincial Hospital of Chinese Medicine,Guangzhou 510006,Guangdong,China)
出处
《中华中医药学刊》
CAS
北大核心
2019年第9期2168-2177,共10页
Chinese Archives of Traditional Chinese Medicine
基金
国家自然科学基金项目(81774218)
国家中医药管理局国家中医临床研究基地项目(JDZX2015197)
广东省中医院院内专项项目(YN2015MS05)
关键词
类风湿关节炎
中医证候
方剂
中药
分布规律
文献研究
rheumatoid arthritis
traditional chinese medical syndrome
prescriptions
Chinese medicine
distribution characteristics
literature research
