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[转载]摘译“基于数据挖掘探讨340例新冠肺炎的中医用药规律”,黄威07

已有 1782 次阅读 2020-8-13 19:17 |系统分类:观点评述|文章来源:转载

In clustering analysis, four categories of TCM commonly used in treating COVID-19 were identified. Category 1: Radix Codonopsis, Radix Astragali, Rhizoma Pinelliae Preparatum, Poria cocos, and Pericarpium Citri Reticulatae; category 2: Fructus Forsythiae, Rhizoma Atractylodis, and Fructus Tsaoko ; category 3: Radix Glycyrrhizae and Radix Platycodonis; category 4: Radix Scutellariae, Radix Bupleuri, Semen Armeniacae Amarum, Herba Pogostemonis, and Rhizoma Atractylodis Macrocephalae. Drugs of category 1 have the functions of reinforcing lung and consolidating the exterior, replenishing Qi and strengthening spleen, drying the wetness-evil and eliminating phlegm. They are the main medicines of Six Gentlemen decoction. Yellow Emperor's Inner Canon said that "if deficient, supplement". During the treatment of COVID-19, strengthening the vital energy and expelling pathogenic factors are always highlighted, especially for the patients in convalescent stage; their therapy is mainly tonifying the spleen and lung to promote the recovery of the patients' body. The drugs of category 2 mainly focus on clearing heat and removing dampness. Dampness poison attacks the lung and could lead to damp stagnation and heat transformation. At the same time of treatment, heat clearing and dampness transformation are needed.

The TCM prescriptions of 340 COVID-19 patients were subjected to the complex network analysis. The core combination consists of Herba Pogostemonis, Rhizoma Pinelliae Preparatum, Pericarpium Citri Reticulatae, Rhizoma Atractylodis Macrocephalae​, Rhizoma Atractylodis, Poria cocos, Radix Bupleuri, Radix Scutellariae, Semen Armeniacae Amarum and Radix Glycyrrhizae. In the prescriptions, Rhizoma Pinelliae Preparatum, Pericarpium Citri Reticulatae, Rhizoma Atractylodis Macrocephalae​, and Poria cocos are the main components of Special Achievement (Yi Gong) powder. They can invigorate the spleen, expel dampness and resolve phlegm; whenRadix Bupleuri and Radix Scutellariae are supplemented, harmonizing the lesser Yang can be achieved. Herba Pogostemonis, Rhizoma Atractylodis, Semen Armeniacae Amarum and Radix Glycyrrhizae dispel dampness and diffuse the lung. Radix Bupleuri, Radix Scutellariae, Rhizoma Pinelliae Preparatum​ and Radix Glycyrrhizae are key components of Minor Bupleurum decoction (for harmonizing the lesser Yang). Xue Shengbai, a master of febrile diseases, believes that the evil hidden in the membrane-source causes half-interior half-exterior pattern in the lesser Yang; the evil of warm heat and dampness can block the functioning of Qi, and functioning of Qi between exterior and interior, as well as between upper and lower parts, is blocked, leading to the dysfunction of triple energizer and viscera. Minor Bupleurum decoction has the function of harmonizing the lesser Yang and clearing away evil.

According to the Hubei diagnosis and treatment program [26] and related clinical studies [27,28], as the main pathological feature of COVID-19, the dampness evil runs through the whole disease, and dampness toxin obstructing lung is the core pathogenesis of the disease. This study is based on the AMMR platform system, achieved the multi-aspect and multi-plane association and integration of data, and analyzed and discussed the prescription rule for treating COVID-19. Through the data analysis of 340 COVID-19 patients discharged from our hospital, we found that most of the patients were middle-aged and elderly people, and most of them had dry cough, anorexia and fatigue. The TCMs with pungent/sweet taste, warm nature and of the lung/spleen meridians were more commonly used. The treatment mainly focuses on clearing away heat and detoxification, removing dampness and resolving phlegm. Lung cleansing & detoxifying decoction is a common clinical prescription, which profoundly reflects that the TCM formula is derived from classics and ancient prescriptions fit for today's use, thus giving full play to the unique advantages of TCM. However, this paper also has shortcomings; the sample size is not large, and the new prescription obtained here lacks clinical application. It needs to be considered and practiced repeatedly in the later stage to find and develop therapeutic drugs from the treasure house of TCM, so as to provide reference for clinical treatment of this disease.对湖北诊疗方案[26]及相关临床研究表明[27,28]:湿邪作为该病的主要病理特点,贯穿疾病的始终,湿毒壅肺为本病的核心病机,本研究基于古今医案平台系统,对数据实现了多方位、多平面的关联与融合,借此分析并探讨治疗新冠肺炎的组方用药规律,通过对本院340例新冠肺炎出院患者的数据统计分析结果得到临床患病多以中老人为主,发病时多为干咳、纳差、乏力等表现,多选用辛甘、温性及归肺脾经的中药,治疗以清热解毒、祛湿化痰为主,以清肺排毒汤为临床常见方,深刻体现了组方源于经典、古方今用的特点,充分发挥中医药独特优势。然而,本文也有不足之处,样本量不大,并且通过其得出的新方缺乏临床的实际应用,需要后期经过斟酌并反复实践,从传统中医药宝库中寻找和开发治疗药物,以期对临床治疗本病有所借鉴。



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