刘喜明教授治疗586例2型糖尿病临床用药分析

发布时间：2018-09-11 11:56

【摘要】：目的：基于刘喜明教授治疗2型糖尿病(Type 2 diabetes mellitus, T2DM) 586例病例资料,总结刘喜明教授治疗T2DM及其并发症的用药规律。方法:1.收集2014年1月1日至2014年12月31日之间中国中医科学院广安门医院刘喜明教授门诊符合纳入标准的T2DM病例;2.运用Epidata3.1软件,建立电子数据库,应用SPSS 16.0软件对相关资料进行描述性统计分析,通过关联规则挖掘药物之间的相关性。结果：1.一般情况：男295例,女291例,男女比例为1.01:1；平均年龄54.44±8.12岁,年龄分布主要集中41～70岁之间；平均病程为8.83±2.09年,31.06%合并高血压,21.84%合并血脂异；16.72%并发周围神经病变,10.07%并发糖尿病肾病,8.53%并发糖尿病视网膜病变。2.处方药味剂量特点：每张处方平均药味8.64±1.21味,平均剂量126.34±24.19g。3.T2DM用药频率分析：以清热化痰、活血通络等药物为主,使用频率前9味药物依次是丹参、麦冬、姜半夏、黄连、炒枳实、地龙、川牛膝、蒲公英、土鳖虫。4.糖尿病周围神经病变用药频率分析：以活血药与通络药为主,使用频率前9味依次为地龙、土鳖虫、姜半夏、丹参、川牛膝、桑枝、橘络、麦冬、片姜黄。5.糖尿病肾病用药频率分析：以益气药、养阴药、活血药为主,使用频率前9味药依次为丹参、生黄芪、麦冬、玉竹、穿山龙、川牛膝、土鳖虫、地龙、北沙参。6.糖尿病视网膜病变用药频率分析：以养阴药、清热药、活血药为主,使用频率前9味依次为丹参、麦冬、菊花、黄连、地龙、女贞子、白芍、蒲公英、山药。7.常用药物分类：常用药有清热药、化痰药、通络药、养阴药、活血药、补气药六大类。8.常用药物配伍相关性分析：常见配伍有清热药与化痰药、益气药与养阴药、活血药与通络药、活血药与养阴药。黄芪与麦冬、玉竹、北沙参配伍,置信度分别52.7%、36.5%、30.0%；黄连常与姜半夏、炒枳实、全瓜蒌、僵蚕、竹茹配伍,置信度分别为52.40%、49.40%、34.30%、22.70%、21.90%;丹参常与土鳖虫、地龙配伍,置信度分别为21.4%、21.1%。结论:1.T2DM男女发病率相当,男女之比为1.01:1；平均年龄54.44±8.12岁,41～70岁最多；平均病程为8.83±2.09年。2.处方特点：每张处方平均药味8.64±1.21味,平均剂量126.34±24.19g。处方药味少,剂量轻。3.586例T2DM用药以清热化痰、活血通络等药物为主。4.糖尿病周围神经病变用药以活血通络药为主。5.糖尿病肾病用药以益气养阴及活血药为主6.糖尿病视网膜病变用药以养阴清热药及活血药为主。
[Abstract]:OBJECTIVE: Based on the data of 586 cases of type 2 diabetes mellitus (T2DM) treated by Professor Liu Ximing, the medication regularity of Professor Liu Ximing in treating T2DM and its complications was summarized. DM cases; 2. Using Epidata 3.1 software to establish an electronic database, using SPSS 16.0 software for descriptive statistical analysis of the relevant data, mining the correlation between drugs through association rules. Results: 1. General situation: 295 men, 291 women, the ratio of men and women is 1.01:1; the average age 54.44 (+ 8.12) years old, age distribution mainly concentrated 41-70 years. The average course of disease was 8.83+2.09 years, 31.06% with hypertension, 21.84% with dyslipidemia, 16.72% with peripheral neuropathy, 10.07% with diabetic nephropathy and 8.53% with diabetic retinopathy. Analysis: the main drugs used for clearing away heat and reducing phlegm, activating blood circulation and dredging collaterals were 9 Salvia miltiorrhiza, Radix Ophiopogon, Rhizoma Pinelliae, Rhizoma Coptidis, fry Fructus aurantii Immaturus, earthworm, Achyranthes bidentata, Taraxacum mongolicum, woodlouse worm.4., drug frequency of diabetic peripheral neuropathy: blood activating drugs and dredging collaterals. The first 9 flavors were earthworm, woodlouse worm, Jiang Banxia. Radix salviae miltiorrhizae, Radix Achyranthis bidentata, Ramulus Mori, orange peel, Ophiopogon japonicus, turmeric.5., and diabetic nephropathy: analysis of the frequency of medication for diabetes nephropathy: the main drugs are Qi supplementing, Yin nourishing and blood activating drugs. The frequency of the first 9 drugs is Salvia miltiorrhiza, Radix Astragali, Radix Ophiopogon, polygonatum odoratum, Dioscorea nipponica, Achyranthes bidentata, woodlouse worm, earthworm, Radix gophi.6., and diabetic retinopathy. Thermal drugs, blood-activating drugs mainly, the first nine use frequency in turn is Salvia miltiorrhiza, Ophiopogon japonicus, Chrysanthemum, Coptis chinensis, earthworm, Ligustrum lucidum, Paeonia lactiflorum, dandelion, yam. Supplementing qi and Yin nourishing drugs, activating blood circulation drugs and dredging collaterals, activating blood circulation drugs and nourishing Yin drugs, Astragalus membranaceus and Ophiopogon japonicus, polygonatum odoratum and Radix gophanae radix, the confidence level is 52.7%, 36.5%, 30% respectively; Huang Lianchang and Jiang Banxia, stir fried Fructus aurantii Immaturus, Fructus Trichosanthis, Bombyx silkworm and bamboo Ru are 52.40%, 49.40%, 34.30%, 22.70% and 21.90% respectively; the salvia miltiorrhiza is often compatible with woodlouse worm, earthworm, and confidence level. The incidence of T2DM was 21.4% and 21.1% respectively. The ratio of male to female was 1.01:1. The average age was 54.44 (+ 8.12) years, and the maximum was 41-70 years. The average course of disease was 8.83 (+ 2.09 years). The main drugs used in diabetic peripheral neuropathy are Huoxue Tongluo. 5. The main drugs used in diabetic nephropathy are Yiqi Yangyin and Huoxue. 6. The main drugs used in diabetic retinopathy are Yangyin Qingre and Huoxue.
【学位授予单位】：北京中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R249;R259

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