摘要
目的挖掘中药复方汤剂联合西药治疗多囊卵巢综合征(PCOS)的用药规律及辨证配伍特点。方法检索中国知网(CNKI)、万方(WanFang)、维普(VIP)等数据库中2019年1月至2025年7月相关文献。提取中药复方组成、西药使用方案、中医证型等数据,使用Excel 2021建立处方数据库,采用Python 3.13.5进行频次分析、聚类分析及关联规则分析。结果共纳入60篇临床研究文献,中药复方汤剂中,茯苓(42次,5.51%)、当归(35次,4.59%)、半夏(33次,4.33%)、菟丝子(33次,4.33%)、陈皮(28次,3.67%)、香附(27次,3.54%)为高频药物。西药使用主要包括克罗米芬(13次,21.67%)、二甲双胍(13次,21.67%)、炔雌醇环丙孕酮(11次,18.33%)、来曲唑(9次,15.00%)、炔雌醇环丙孕酮+二甲双胍(5次,8.33%)、地屈孕酮(3次,5%)。处方证型分析,PCOS前五种证型依次为肾虚痰湿(占比18.3%)、肾虚血瘀(占比16.7%)、痰湿(占比11.7%)、肾虚肝郁(占比8.3%)、肾虚痰瘀(占比6.7%),茯苓、半夏、二甲双胍主要应用于“痰湿痰瘀”类证型。中药-中药关联分析结果显示,提升度较高的药组为“白芍、山茱萸”与“菟丝子、紫石英”组合,其提升度均为5.625,置信度为0.750。高频中药聚类分析得出4个聚类群。结论本研究总结了中药复方汤剂结合西药辨证治疗PCOS的临床用药规律,体现了“补肾调经为本,化痰疏肝为标”的治法,以及中药复方辨证施治与西药协同治疗的临床思路。
Objective To explore the medication rules and characteristics of syndrome differentiation and compatibility in the treatment of polycystic ovary syndrome(PCOS)with Chinese herbal compound decoctions combined with Western medicine.Methods Relevant literature published between January 2019 and July 2025 was retrieved from databases including CNKI,WanFang,and VIP.Data on the composition of Chinese herbal formulas,Western medicine regimens,and TCM syndrome types were extracted.A prescription database was established using Excel 2021,and data mining techniques including frequency analysis,cluster analysis,and association rule analysis were performed using Python 3.13.5.Results A total of 60 clinical research articles were included.Among the Chinese herbal compound decoctions,the high-frequency herbs were Poria(42 times,5.51%),Angelica sinensis(35 times,4.59%),Pinellia ternata(33 times,4.33%),Cuscuta chinensis(33 times,4.33%),Citri Reticulatae Pericarpium(28 times,3.67%),and Cyperi Rhizoma(27 times,3.54%).The primary Western medicines used were Clomiphene(13 times,21.67%),Metformin(13 times,21.67%),Cyproterone Acetate and Ethinylestradiol Tablets(11 times,18.33%),Letrozole(9 times,15.00%),Cyproterone Acetate and Ethinylestradiol Tablets+Metformin(5 times,8.33%),and Dydrogesterone(3 times,5%).Analysis of prescription syndrome types revealed that the top five TCM syndromes of PCOS were kidney deficiency with phlegm-dampness(18.3%),kidney deficiency with blood stasis(16.7%),phlegm-dampness(11.7%),kidney deficiency with liver depression(8.3%),and kidney deficiency with phlegm-stasis(6.7%).Poria,Pinellia ternata,and Metformin were primarily used for"phlegm-dampness and phlegm-stasis"syndrome types.Association rule analysis of Chinese herbs showed that the herb combinations with the highest lift were"White Peony Root and Cornus Fruit"and"Cuscuta chinensis and Fluorite,"both with a lift of 5.625 and a confidence of 0.750.Cluster analysis of high-frequency Chinese herbs identified four clusters.Conclusion This study summarizes the clinical medication rules of Chinese herbal compound decoctions combined with Western medicine for the treatment of PCOS based on syndrome differentiation,demonstrating a treatment approach focused on"tonifying the kidney and regulating menstruation as the root,resolving phlegm and soothing the liver as the branch."It reflects the clinical rationale of applying Chinese herbal compound decoctions through syndrome differentiation in combination with Western medicine for synergistic therapy.
作者
刘媛
许靖
LIU Yuan;XU Jing(Department of Pharmacy,Tianjin Central Hospital of Gynaecology Obsterics,Tianjin 300110,China)
出处
《中国处方药》
2025年第23期94-98,共5页
Journal of China Prescription Drug
关键词
多囊卵巢综合征
中药复方
西药联合
用药规律
数据挖掘
辨证分型
Polycystic ovary syndrome
Chinese herbal compounds
Western medicine combination
Medication patterns
Data mining
Syndrome differentiation
