主 办:北 京 中 医 药 大 学
ISSN 1006-2157 CN 11-3574/R

北京中医药大学学报 ›› 2020, Vol. 43 ›› Issue (6): 449-456.doi: 10.3969/j.issn.1006-2157.2020.06.002

• 新冠肺炎专题 • 上一篇    下一篇

基于关联规则探讨中医药防治新型冠状病毒肺炎协定处方的用药规律*

丁霞1, 李园2, 李萍2, 苏泽琦3, 吴凤芝4, 褚福浩1, 谷晓红1#   

  1. 1 北京中医药大学中医学院 北京 100029;
    2 北京中医药大学东直门医院;
    3 北京中医药大学北京中医研究院;
    4 北京中医药大学期刊中心
  • 收稿日期:2020-02-09 发布日期:2020-07-06
  • 通讯作者: #谷晓红,女,博士,教授,主任医师,博士生导师,主要研究方向:温病学理论及基础研究,E-mail: guxh1003@126.com
  • 作者简介:丁霞,女,博士,教授,主任医师,博士生导师
  • 基金资助:
    *科技部国家重点研发计划资助项目(No.2018YFC1704100,No.2018YFC1704106)

Exploration of characteristics of TCM formulae for novel coronavirus pneumonia based on association rules*

Ding Xia1, Li Yuan2, Li Ping2, Su Zeqi3, Wu Fengzhi4, Chu Fuhao1, Gu Xiaohong1#   

  1. 1 School of Chinese Medicine, Beijing University of Chinese Medicine, Beijing 100029, China;
    2 Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing 100700, China;
    3 Beijing Research Institute of Chinese Medicine, Beijing University of Chinese Medicine, Beijing 100029, China;
    4 Journal Center, Beijing University of Chinese Medicine, Beijing 100029, China
  • Received:2020-02-09 Published:2020-07-06
  • Contact: Prof. Gu Xiaohong, M.M., Chief Physician, Doctoral Supervisor. Beijing University of Chinese Medicine. No.11 Beisanhuan Donglu Road, Chaoyang District, Beijing 100029. E-mail: guxh1003@126.com
  • Supported by:
    National Key Research and Development Project, Ministry of Science and Technology (No. 2018YFC1704100, No. 2018YFC1704106)

摘要: 目的 分析中医药防治新型冠状病毒肺炎(简称“新冠肺炎”)的协定处方用药规律,为临床新冠肺炎的防治提供思路和依据。方法 收集自疫情发生截止2020年2月6日,国家卫生健康委员会及国家中医药管理局联合印发的《新型冠状病毒感染的肺炎诊疗方案(试行)》(第三至五版)及2020年2月6日最新公布的临床有效方剂“清肺排毒汤”;北京市中医管理局印发的《北京市新型冠状病毒感染的肺炎防治方案》(第一、第二版);全国各省、市卫生健康委员会或中医药管理局,各省市级医院颁布的协定处方;全国各医学流派及数位名医向社会公开的防治新冠肺炎的处方。应用R软件(V3.6.1)分别对预防和治疗类处方进行药物频数及关联规则分析。结果 预防类处方共107首,涉及121味中药,其中使用频率大于20%的有11味,为甘草、黄芪、金银花、桔梗、连翘、苍术、防风、白术、芦根、广藿香、桑叶,关联规则显示黄芪、甘草、金银花、连翘、防风为核心组合;治疗类处方共115首,涉及203味中药,其中使用频率大于20%的有7味,为甘草、黄芩、石膏、苦杏仁、麻黄、连翘、金银花,关联规则显示麻黄、苦杏仁、石膏、甘草为核心组合。结论 对于新冠肺炎的预防以益气固表为主,辅以清热解毒燥湿之法,常见组方为玉屏风散、银翘散;在治疗上,总体以清热、解毒、燥湿为主,常见组方为麻杏石甘汤加黄芩、连翘,依病情进展分期治疗,并根据兼证加减用药。

关键词: 新型冠状病毒肺炎, 中医药, 协定处方, 关联规则, 用药规律

Abstract: Objective To analyze the prescription characteristics of consensus formulae for the prevention and treatment of novel coronavirus pneumonia (NCP) also known as coronavirus disease 2019 (COVID-19) with traditional Chinese herbal medicine. Methods We collected the following formulae released from the start of NCP outbreak to February 6, 2020: foumulae in the “Diagnosis and Treatment Protocol for Novel Coronavirus Pneumonia (Trial)” (3rd to 5th ed.) issued jointly by the National Health Commission and the National Administration of Traditional Chinese Medicine of PRC; the latest clinically-proven effective prescription Qingfei Paidu Tang (Lung-clearing and Toxin-expelling Decoction) (February 6, 2020 ed.); formulae in the “Prevention and Treatment Protocol for Novel Coronavirus Pneumonia in Beijing” (1st and 2nd ed.) issued by the Beijing Municipal Administration of Traditional Chinese Medicine; prescriptions approved and released by varied health commissions, traditional Chinese medicine administrations and hospitals at provincial and municipal levels; and prescriptions made public by various medical schools and several prestigious doctors for the prevention and treatment of NCP. The R software (V 3.6.1) was used to analyze the frequency of occurrence of herbs and association rules in formulae for preventive and therapeutic purposes respectively. Results 107 preventive formulae involving 121 herbs were identified. 11 herbs with frequency of occurrence over 20% were Gancao (Licorice Root, Radix et Rhizoma Glycyrrhizae), Huangqi (Astragalus Root, Radix Astragali), Jinyinhua (Honeysuckle Flower, Flos Lonicerae Japonicae), Jiegeng (Platycodon Root, Radix Platycodonis), Lianqiao (Weeping Forsythia Capsule, Fructus Forsythiae), Cangzhu (Atractylodes Rhizome, Rhizoma Atractylodis), Fangfeng (Siler, Radix Saposhnikoviae), Baizhu (White Atractylodes Rhizome, Rhizoma Atractylodis Macrocephalae), Lugen (Reed Rhizome, Rhizoma Phragmitis), Guanghuoxiang (Cablin Patchouli, Herba Pogostemonis), and Sangye (Mulberry Leaf, Folium Mori). The core combinations of herbs included Huangqi, Gancao, Jinyinhua, Lianqiao, and Fangfeng according to association rules. There were 115 therapeutic prescriptions involving 203 herbs, of which the following 7 herbs were the most frequently used with frequency of occurrence over 20%: Gancao, Huangqin (Scutellaria Root, Radix Scutellariae), Shigao (Gypsum, Gypsum Fibrosum), Kuxingren (Bitter Apricot Kernel, Semen Armeniacae Amarum), Mahuang (Ephedra, Herba Ephedrae), Lianqiao, and Jinyinhua. The core combinations of herbs included Mahuang, Kuxingren, Shigao, and Gancao according to association rules. Conclusion For the prevention of NCP, the main method used seems to be boosting qi to consolidate the exterior, supplemented by clearing heat, resolving toxins and drying dampness. The commonly used formulae were Yupingfeng San (Jade Wind-Barrier Powder) and Yinqiao San (Lonicera and Forsythia Powder). For therapeutic purpose, clearing heat, resolving toxins, and drying dampness were the major methods adopted. The most frequently used prescription was Maxing Shigan Tang (Ephedra, Apricot Kernel, Gypsum and Licorice Decoction) plus Huangqin and Lianqiao. Treatment should vary according to the progression and stage of the disease with modifications based on complications.

Key words: novel coronavirus pneumonia, traditional Chinese herbal medicine, concensus formula, association rules, prescription characteristics

中图分类号: 

  • R272