基于现代文献的脾胃湿热证疾病分布及处方用药研究

摘要

目的：分析现代文献中脾胃湿热证对应疾病的分布情况及其处方、用药情况，为脾胃湿热证进一步的临床及科研提供一定的参考资料。方法以“脾胃湿热证”为主题词、题名／关键词，系统检索中国知网（CNKI）、万方数据知识服务平台、维普资讯（VIP）3大中文数据库自建库以来到2015年12月31日的所有相关文章，选取其中明确具备脾胃湿热证临床治疗的相关文章，运用Microsoft Excel 2010建立数据库，对相关数据进行统计分析。结果检索到的1681篇文献中，符合纳入标准的共109篇；脾胃湿热证最常见于消化系统疾病（86．41％），还可见于皮肤病（5．83％）等；脾胃湿热证的常用处方是平胃散、藿朴夏苓汤、三仁汤等清热、祛湿类处方，同时还可以合并运用对病（症）治疗的其他功用的处方；脾胃湿热证治疗中使用频率超过1％的中药分别为：黄连、半夏、厚朴、甘草、陈皮、黄芩、茯苓、蒲公英、藿香、苍术、薏苡仁、白豆蔻、白术、枳壳、栀子、延胡索、白芍、吴茱萸、干姜、竹茹、茵陈、石菖蒲、郁金、枳实、柴胡、白及、丹参、杏仁、砂仁、木香、佛手、滑石。结论现阶段，脾胃湿热证在临床病种分布上虽然以消化系统的疾病为主，但在其他系统疾病中的分布也不容忽视；脾胃湿热证的选方、用药应当以整体观念、病证结合及辨证论治为基本原则；中医古籍中的经典成方仍然是目前治疗脾胃湿热证的中坚力量，但是与时俱进的现代名老中医的临床经验方以及医院院内制剂的作用也已经凸显出来。%Objective To analyze the distribution of diseases with TCMpattern of spleen-stomach damp-ness-heat (SSDHP)and the prescriptions and Chinese herbal medicines involved,so as to guide TCM clinical practice and further research on SSDHP.Methods Taking “SSDHP”(Chinese:脾胃湿热证) as subject term or title /keyword,the databases of China National Knowledge Infrastructure(CNKI),Wan-fang Data Knowledge Service Platform and VIP Information were systematically retrieved,from the begin-ning of the databases to 31 December,2015.The articles related to treatment on SSDHP were collected, and the database was established by using Microsoft Excel 2010,on which data were descriptively statisti-cal analyzed.Results 109 articles were eligible from total 1 681 retrieved ones.The top two diseases with SSDHP were digestive system disorders (86.41%)and dermatoses (5.83%).The common formu-la directed at clearing heat and dampness including Pingwei Powder,Huopu Xialing Decoction,and Sanren Decoction,combined with specific medications for exact symptoms.The common Chinese herbal medications with frequency more than 1 percent were listed as the following:Golden Thread (Huangli-an),Pinellia Tuber(Banxia),Official Magnolia Bark(Houpu),Liquorice Root (Gancao),Dried De-coctionerine Peel (Chenpi),Baical Skullcap Root (Huangqin),Indian Bread (Fuling),Dandelion (Pugongying),Agastache Rugosus (Huoxiang),Atractylodes Rhizome (Cangzhu),Coix Seed (Yiy-iren),Round Cardamon Fruit (Baidoukou),Largehead Atractylodes Rhizome (Baizhu),Orange Fruit (Zhiqiao),Immature Orange Fruit (Zhizi ),Corydalis Rhizoma (Yanhusuo ),White Peony Root (Baishao),Medicinal Evodia Fruit (Wuzhuyu),Dried Ginger (Ganjiang),Bamboo Shavings (Zhu-ru),Virgate Wormwood Herb (Yinchen),Grassleaf Sweetflag Rhizome (Shichangpu),Turmeric Root Tuber (Yujin),Immature Orange Fruit (Zhishi),Chinese Thorowax Root(Chaihu),Common Bletilla Tuber (Baiji),Danshan Root (Danshen),Bitter Apricot Seed (Kuxingren),Villous Amomum Fruit (Sharen),Common Aucklandia Root (Muxiang),Finger Citron (Foshou),Talc (Huashi).Conclu-sion Now,the diseases with SSDHP were most common in digestive system,but also in other systems. And the prescription and Chinese herbal medicines should be applied by holistic conception,combination of disease and pattern and pattern differentiation and treatment.Classic herbal formulas in TCM ancient books are still playing the strictly key roles in clinical practice,but proved formulas of modern outstand-ing senior traditional Chinese practitioners and Hospital Preparations also are paid more attention by re-searchers.