基于文献分析的古今中医药治疗大肠癌用药规律研究
发布时间：2018-08-29 17:16
【摘要】：目的:通过搜集整理古籍与现代对大肠癌病证治疗的文献,对古今医家应用中医药对大肠癌治疗的用药进行对比,梳理大肠癌中医药治疗的发展脉络、系统总结其用药规律、对比古今各自用药特点,为当今临床治疗提供用药依据,寻找合理用药、有效用药,探索防治大肠癌的有效途径,更好的为临床服务。材料与方法:古代文献来源:为更加全面的总结古人对于本病的论治,在现代医家对于本病认识的共识基础上,运用正版授权的《中华医典》软件以以“肠溜”、“肠覃”、“肠o肌薄ⅰ盎邸薄ⅰ胺骸薄ⅰ皏e瘕”、“肠风”、“脏毒”、“痢疾”、“便血”、“锁肛痔”、“脏痈痔”为关键词进行目录搜索,将搜索出的文献进行筛选,然后与辽宁中医药大学图书馆馆藏古籍进行对比校正,采用电子检索与手工检索相结合的方式,根据选方标准,确定所需录入的方药。现代文献来源:分别用“大肠癌”或“肠肿瘤”或“结直肠肿瘤”与“中医药”或“中医药疗法”为主题词,在相关期刊论文(CNKI)、万方数据、中国生物医学文献数据库(CBM)数据库中搜索1996年1月—2016年12月公开发表的中医药治疗大肠癌的相关文献及论著,筛选后,根据选方标准确定所需录入的方药。将所得方药录入Excel表格中,建立数据库,进行统计分析。结果:1.根据选方标准,共选出符合标准古代处方209首,共涉及186味中药,药物总频次为1358味次;共选出符合标准现代处方107首,共涉及193味中药,药物总频次为1055味次。2.当归用药频次为79味次,处方出现率为38.80%,在古方用药频次中位列第一;白术用药频次为62味次,处方出现率为57.94%,在今方用药频次中位列第一。3.古方中:补虚药、清热药、止血药、理气药、解表药、收涩药、活血化瘀药、温里药,这8类药总用药频次为1129味次,相对频次为83.14%;今方中:补虚药、清热药、利湿渗水药、活血化瘀药、理气药、消食药、化痰止咳平喘药、化湿药,这8类总用药频次为943味次,相对频次为89.38%。4.今方中应用利水渗湿药的相对频次为11.28%,古方中为1.27%,今方中应用最突出的为茯苓,在处方中的出现率为43.93%。5.今方中应用消食药的相对频次为4.63%,古方中为0.44%,今方中最突出的用药为麦芽。6.古方中补虚药的应用相对频次为25.92%,其中补气药在补虚药中所占频率为41.48%,补血药为43.47%;今方中补虚药的应用相对频次为33.83%,其中补气药在补虚药中所占频率为64.71%,补血药为13.17%。7.古方中清热药的应用相对频次为16.27%,其中清热燥湿药在清热药中所占频率为46.61%,清热解毒药为10.86%,清热凉血药为32.13%;今方中清热药的应用相对频次18.58%,其中清热燥湿药在清热药中所占频率为14.80%,清热解毒药为72.96%,清热凉血药为6.63%。结论:1.古代医家主要应用的药物有:补虚药、清热药、止血药、理气药、收涩药、温里药、活血化瘀药;现代医家主要应用的药物有:补虚药、清热药、利水渗湿药、理气药、活血化瘀药、消食药。2.古今医家对于本病的治法均以补虚清热为主。但古代医家在补虚清热的基础上,兼以理气止血、活血化瘀、温里等治法,更注重从“血”论治;而现代医家则更多的兼之以利水渗湿药与消食药,与补虚药相合来固护脾胃,更注重从“气”论治。3.补虚药与清热药均为古今医家应用最多的药物。4.古代医家应用补虚药以补气药、补血药为主;现代医家则重点应用补气药。5.古代医家应用清热药以燥湿清热药、清热凉血药为主;现代医家则主要应用清热解毒药。
[Abstract]:Objective: By collecting and sorting out ancient books and modern literatures on the treatment of colorectal cancer, this paper compares the use of traditional Chinese medicine in the treatment of colorectal cancer between ancient and modern physicians, combs the development of traditional Chinese medicine in the treatment of colorectal cancer, systematically summarizes the law of its use of drugs, compares the characteristics of their use of drugs in ancient and modern times, so as to provide the basis for clinical treatment and find a combination. Materials and Methods: Ancient literature sources: In order to summarize the treatment of the disease more comprehensively, on the basis of the consensus of modern physicians on the disease, using the authorized "Chinese Medical Code" software to "intestinal slippage" and "bowel fever". "Intestinal o-muscle thin____________________8594 Modern literature sources: the keywords of "colorectal cancer" or "colorectal cancer" and "traditional Chinese medicine" or "traditional Chinese medicine therapy" were used respectively, in the Chinese Journal Full Text Database (CNKI), Wanfang data, and Chinese Biomedical Literature Database (CBM). In the database, we searched the relevant literature and literatures published from January 1996 to December 2016 on the treatment of colorectal cancer. After screening, the prescriptions and medicines needed to be entered were determined according to the selection criteria. Nine of them involved 186 traditional Chinese medicines with a total frequency of 1358; 107 modern prescriptions were selected, involving 193 traditional Chinese medicines with a total frequency of 1 055. 2. Angelica sinensis was used 79 times with a prescription occurrence rate of 38.80%, ranking first in ancient prescriptions; Atractylodes macrocephala was used 62 times with a prescription occurrence rate of 57.94%. Ancient prescriptions: tonifying deficiency, clearing away heat, hemostasis, regulating qi, relieving exterior symptoms, astringent, activating blood circulation and removing blood stasis, warming the internal medicine, the total frequency of these eight drugs is 1129, the relative frequency is 83.14%; now: tonifying deficiency, clearing away heat, regulating dampness and permeating water, activating blood circulation and removing blood stasis, regulating qi, eliminating food, relieving phlegm, relieving cough and relieving asthma, regulating phlegm, relieving cough and relieving asthma. The relative frequencies of the eight kinds of herbs were 89.38%. 4. The relative frequencies of the herbs were 11.28% in the present prescription and 1.27% in the ancient prescription. The most prominent one in the present prescription was Poria cocos. The occurrence rate in the prescription was 43.93%. 5. The relative frequencies of the herbs used in the present prescription were 4.63%, 0.44% in the ancient prescription and the most prominent in the present prescription. 6. The relative frequency of the application of tonic drugs in ancient prescriptions was 25.92%. The frequency of the application of tonic drugs in tonic drugs was 41.48% and that of blood tonic drugs was 43.47%. The relative frequency of the application of tonic drugs in modern prescriptions was 33.83%. The frequency of the application of tonic drugs in tonic drugs was 64.71% and that of blood tonic drugs was 13.17%. The frequency of antipyretic and Dampness-drying drugs in antipyretic drugs was 46.61%, antipyretic and detoxicating drugs were 10.86%, and antipyretic and blood-cooling drugs were 32.13%. The relative frequency of antipyretic drugs in the present prescription was 18.58%. The frequency of antipyretic and Dampness-drying drugs in antipyretic drugs was 14.80%, antipyretic and detoxicating drugs 72.96%, and antipyretic and blood-cooling drugs was 6.63%. The medicines to be used are: tonifying deficiency medicine, clearing away heat, hemostatic medicine, regulating qi medicine, astringent medicine, warm medicine, activating blood circulation and removing stasis; the main medicines used by modern physicians are: tonifying deficiency medicine, clearing away heat medicine, diuresis and dampness medicine, regulating qi medicine, activating blood circulation and removing stasis medicine, and digestive medicine. 2. Ancient and modern physicians treat this disease mainly by tonifying deficiency and clearing away heat. On the basis of this, the treatment methods of regulating qi and stopping bleeding, activating blood circulation and removing blood stasis, warming li, etc., pay more attention to the treatment from "blood"; modern physicians pay more attention to the combination of water-promoting and dampness-permeating medicines and digestive medicines, and the combination of tonifying deficiency medicines to strengthen the spleen and stomach, and pay more attention to the treatment from "qi". 3. tonifying deficiency medicines and clearing away heat medicines are the most used medicines in ancient and modern times. Deficiency-tonifying drugs are mainly Qi-tonifying drugs and blood-tonifying drugs, while modern physicians mainly use Qi-tonifying drugs. 5. Ancient physicians used heat-clearing drugs mainly for dampness and heat-clearing, while modern physicians mainly used heat-clearing and detoxifying drugs.
【学位授予单位】：辽宁中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R273
[Abstract]:Objective: By collecting and sorting out ancient books and modern literatures on the treatment of colorectal cancer, this paper compares the use of traditional Chinese medicine in the treatment of colorectal cancer between ancient and modern physicians, combs the development of traditional Chinese medicine in the treatment of colorectal cancer, systematically summarizes the law of its use of drugs, compares the characteristics of their use of drugs in ancient and modern times, so as to provide the basis for clinical treatment and find a combination. Materials and Methods: Ancient literature sources: In order to summarize the treatment of the disease more comprehensively, on the basis of the consensus of modern physicians on the disease, using the authorized "Chinese Medical Code" software to "intestinal slippage" and "bowel fever". "Intestinal o-muscle thin____________________8594 Modern literature sources: the keywords of "colorectal cancer" or "colorectal cancer" and "traditional Chinese medicine" or "traditional Chinese medicine therapy" were used respectively, in the Chinese Journal Full Text Database (CNKI), Wanfang data, and Chinese Biomedical Literature Database (CBM). In the database, we searched the relevant literature and literatures published from January 1996 to December 2016 on the treatment of colorectal cancer. After screening, the prescriptions and medicines needed to be entered were determined according to the selection criteria. Nine of them involved 186 traditional Chinese medicines with a total frequency of 1358; 107 modern prescriptions were selected, involving 193 traditional Chinese medicines with a total frequency of 1 055. 2. Angelica sinensis was used 79 times with a prescription occurrence rate of 38.80%, ranking first in ancient prescriptions; Atractylodes macrocephala was used 62 times with a prescription occurrence rate of 57.94%. Ancient prescriptions: tonifying deficiency, clearing away heat, hemostasis, regulating qi, relieving exterior symptoms, astringent, activating blood circulation and removing blood stasis, warming the internal medicine, the total frequency of these eight drugs is 1129, the relative frequency is 83.14%; now: tonifying deficiency, clearing away heat, regulating dampness and permeating water, activating blood circulation and removing blood stasis, regulating qi, eliminating food, relieving phlegm, relieving cough and relieving asthma, regulating phlegm, relieving cough and relieving asthma. The relative frequencies of the eight kinds of herbs were 89.38%. 4. The relative frequencies of the herbs were 11.28% in the present prescription and 1.27% in the ancient prescription. The most prominent one in the present prescription was Poria cocos. The occurrence rate in the prescription was 43.93%. 5. The relative frequencies of the herbs used in the present prescription were 4.63%, 0.44% in the ancient prescription and the most prominent in the present prescription. 6. The relative frequency of the application of tonic drugs in ancient prescriptions was 25.92%. The frequency of the application of tonic drugs in tonic drugs was 41.48% and that of blood tonic drugs was 43.47%. The relative frequency of the application of tonic drugs in modern prescriptions was 33.83%. The frequency of the application of tonic drugs in tonic drugs was 64.71% and that of blood tonic drugs was 13.17%. The frequency of antipyretic and Dampness-drying drugs in antipyretic drugs was 46.61%, antipyretic and detoxicating drugs were 10.86%, and antipyretic and blood-cooling drugs were 32.13%. The relative frequency of antipyretic drugs in the present prescription was 18.58%. The frequency of antipyretic and Dampness-drying drugs in antipyretic drugs was 14.80%, antipyretic and detoxicating drugs 72.96%, and antipyretic and blood-cooling drugs was 6.63%. The medicines to be used are: tonifying deficiency medicine, clearing away heat, hemostatic medicine, regulating qi medicine, astringent medicine, warm medicine, activating blood circulation and removing stasis; the main medicines used by modern physicians are: tonifying deficiency medicine, clearing away heat medicine, diuresis and dampness medicine, regulating qi medicine, activating blood circulation and removing stasis medicine, and digestive medicine. 2. Ancient and modern physicians treat this disease mainly by tonifying deficiency and clearing away heat. On the basis of this, the treatment methods of regulating qi and stopping bleeding, activating blood circulation and removing blood stasis, warming li, etc., pay more attention to the treatment from "blood"; modern physicians pay more attention to the combination of water-promoting and dampness-permeating medicines and digestive medicines, and the combination of tonifying deficiency medicines to strengthen the spleen and stomach, and pay more attention to the treatment from "qi". 3. tonifying deficiency medicines and clearing away heat medicines are the most used medicines in ancient and modern times. Deficiency-tonifying drugs are mainly Qi-tonifying drugs and blood-tonifying drugs, while modern physicians mainly use Qi-tonifying drugs. 5. Ancient physicians used heat-clearing drugs mainly for dampness and heat-clearing, while modern physicians mainly used heat-clearing and detoxifying drugs.
【学位授予单位】：辽宁中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R273
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