摘要
目的:探讨甲亢中医辨证论治规律和理法方药诊疗体系。方法:运用SPSS 18.0统计软件频数分析和系统聚类分析法对1979年1月至2012年6月中国期刊全文数据库(CNKI)收录的中医诊治甲亢的文献中的症状、证型、方剂和药物进行分析和归类,总结出甲亢证型、主要症状,分析证候要素和脏腑病位,得出甲亢证候、治法和方药。结果:160篇文献共得证型44个,其中气阴两虚、痰气郁结、肝郁气滞、肝火炽盛、痰瘀互结、阴虚火旺证为主要证型;共得5类症状聚类证型,分别是气阴两虚、阴虚火旺型,肝郁气滞火旺、气阴两虚型,气血亏虚、痰瘀互结伴湿热型,肝肾阴虚、痰气郁结伴痰湿阻络型,阴虚火旺、痰湿互结型,聚类证型与频数分布分析证型基本一致。证候病机以实性居多,占59.10%,主要为火热、气滞、痰凝、血瘀,虚性病机占40.90%,主要为阴虚和气虚;脏腑病位主要在肝、肾、心、脾、胃。共用方剂311首,成方归为14类,以补益剂、清热剂、和解剂、祛痰剂、理气剂、安神剂为主,自拟方多按清热泻火、化痰散结、疏肝解郁、滋阴养血治法进行组方。共涉及中药282味,按功能归为19大类,清热、补虚、化痰止咳平喘、活血化瘀、平肝息风类药物最为常用,占75.60%,清热药为第一位,使用频次最多的是夏枯草;药物主要归经为肝、肺、心、肾、脾、胃;通过聚类分析,得出7个聚类方,适用于气滞血瘀、心肝肾阴虚火旺、阴虚阳亢、瘀热互结、气滞痰凝等证型的甲亢病。结论:中医对甲亢的病因病机的分析、辨证分型、遣方用药的临床研究结果可为目前该病的辨证论治提供参考。
Objective： To explore the TCM syndrome differentiation and treatment laws and diagnosis-treatment system of theory, therapies, formulae and medicine on hyperthyroidism. Methods： Frequency analysis and classified analysis were used with SPSS 18.0 for the literature in treating hyperthyroidism by TCM collected in CNKI from January 1979 to June 2012, to summarize the TCM syndromes and main symptoms, and to analysis syndrome elements and disease location at Zang and Fu, for obtaining the characteristics of TCM syndrome, therapy and formula of hyperthyroidism. Results： Total of 44 syndromes were counted in 160 articles, among them, syndrome of deficiency of both qi and yin, mutual stagnation of phlegm and qi, stagnation of liver qi, excess of liver fire, accumulation of phlegm and blood stasis, yin-deficiency and fire-excess were the main syndromes of hyperthyroidism; 5 classified syndromes were achieved through hierarchical cluster analysis to the counted symptoms, they were syndrome of deficiency of qi and yin, yin-deficiency and fire-excess, syndrome of stagnation of liver and fire-excess, qi and yin deficiency, syndrome of deficiency of qi and blood, accumulation of phlegm an blood stasis with dampness and heat, syndrome of yin-deficiency of liver and kidney, stagnation of phlegm and qi, phlegm and dampness blocking meridians, syndrome of yin- deficiency and fire-excess, accumulation of phlegm and dampness. And the clustering syndromes were basically the same as the main syndromes achieved by frequency analysis. Excess pathogenesis occupied the majority （the rate was 59.10%） in all syndrome pathogenesis, mainly were fire and heat, stagnation of qi, coagulation of phlegm, deficiency pathogenesis occupied 40.90%, mainly were yin-deficiency and qi-deficiency; disease location mainly in liver, kidney, heart, spleen and stomach. 311 formulae were attained, composition formulae could be classified into 14 types according formula textbooks, the main types concluded tonify formula, heat-cleating formula, mediation formula, phlegm-removing formula, regulating qi formula, tranquilizer formula; experimental formulae mainly were composed in terms of therapies of cleating heat and fire, removing phlegm and dispersing coagulation, regulating liver and relieving stagnation, nourishing yin and blood. 282 kinds of Chinese medicine were involved in, could be classified into 19 types, among which, Chinese medicine of heat-clearing, tonifying deficiency, removing phlegm, relieving cough and asthma, activating blood regulation and removing stasis, stabilizing live and removing wind were the most used, occupied 75.60%, and application of cleating heat medicine located the first, Xiakucao （prunella vulgaris） was used the most in it. Classified meridians of Chinese medicine of treating hyperthyroidism mainly were liver, lung, heart, kidney, spleen and stomach, which were matched up with the disease location. 7 clustering formulae were achieved through hierarchical cluster analysis methods to 67 counted Chinese medicines, which were applied the following types of hyperthyroidism： syndrome of qi stagnation and blood stasis, yin-deficiency and fire-excess of heart, liver and kidney, yin-deficiency and yang-excess, accumulation of blood stasis and heat, qi stagnation and phlegm coagulation. Conclusion： Clinical research on analyzing etiology and pathogenesis, syndrome differentiation and treatment, formula composition and Chinese medicine application of hyperthyroidism form TCM can provide reference for the diagnosis, syndrome differentiation and treatment of this disease.
出处
《中华中医药杂志》
CAS
CSCD
北大核心
2013年第11期3250-3255,共6页
China Journal of Traditional Chinese Medicine and Pharmacy
基金
河南省国际科技合作项目(No.094300510056,No.104300510019)
河南省科技创新团队项目(No.2010-29)
郑州市科技创新团队项目(No.10CXTD145)~~
关键词
甲亢
中医
证候分析
方药分析
Hyperthyroidism
TCM
Syndrome analysis
Formula and Chinese medicine analysis
