[1]王贵民,张豆,杨鹏斐,等.基于量效关系分析陈友芝“二参一仙汤”治癌方证规律[J].西部中医药,2024,37(07):55-62.[doi:10.12174/j.issn.2096-9600.2024.07.14]
　WANG Guimin,ZHANG Dou,YANG Pengfei,et al.Professor Chen Youzhi′s Laws of Treating Cancer with Ershen Yixian Tang Based on Dose-effect Relationship[J].Western Journal of Traditional Chinese Medicine,2024,37(07):55-62.[doi:10.12174/j.issn.2096-9600.2024.07.14]
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基于量效关系分析陈友芝“二参一仙汤”治癌方证规律
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《西部中医药》[ISSN:2096-9600/CN:62-1204/R]

卷:
37
期数:
2024年07期
页码:
55-62
栏目:
二次研究
出版日期:
2024-07-15

文章信息/Info

Title:
Professor Chen Youzhi′s Laws of Treating Cancer with Ershen Yixian Tang Based on Dose-effect Relationship
作者:
王贵民1, 张豆2, 杨鹏斐2, 李廷保2
1.会宁县中医医院，甘肃 会宁 730799
2.甘肃中医药大学，甘肃 兰州 730000
Author(s):
WANG Guimin1, ZHANG Dou2, YANG Pengfei2, LI Tingbao2
1.Huining County Hospital of Traditional Chinese Medicine, Huining 730799, China
2.Gansu University of Traditional Chinese Medicine, Lanzhou 730000, China
关键词:
二参一仙汤; 量效关系; 名医经验; 陈友芝
Keywords:
dose-effect relationship; famous doctor's experience
分类号:
R273
DOI:
10.12174/j.issn.2096-9600.2024.07.14
文献标志码:
A
摘要:
目的利用量效关系探讨陈友芝运用“二参一仙汤”辨治癌症方证用药及其方药衍化规律，为临证辨治癌症提供借鉴。 方法筛选陈友芝治癌医案中含“二参一仙汤”的中药复方，应用SPSS Statistics 26.0软件、Aprior算法及多尺度backbone网络算法，对所选治癌医案中的主治疾病、证型、治法、用药剂量、药物分类、性味归经等进行统计分析，并通过关联规则、聚类分析、复杂网络分析筛选出高频药物组合、核心组方及药物聚类。 结果选取含“二参一仙汤”的治癌方剂172首，并总结出以本虚标实、癌毒内蕴，扶正祛邪、攻补兼施为主的22种证型治法。运用“二参一仙汤”辨治肿瘤从15～60 g分为9个剂量等次，而30 g剂量使用频次最多，主治胃癌12.21%（21/172）、肺癌9.88%（17/172）、卵巢癌4.65%（8/172）等10种癌症，医案中使用频次前8位的药物有半枝莲、薏苡仁、茯苓等。使用频次≥18次的药物在四气五味及归经上分别以寒、温、平，甘、苦、辛；胃、脾、肝为主。其功效可分为9类，使用频次最高者为清热药。药物关联分析组合为“白花蛇舌草→半枝莲”等43.60%（75/172）。复杂网络分析筛选出以白花蛇舌草、半枝莲、薏苡仁、茯苓、绞股蓝、苦参、瓜蒌、白芍、藤梨根、象贝为核心组方；衍化出7首“一参一仙汤”“二参一仙汤”和“三参一仙汤”，功效主治各有侧重。 结论对“二参一仙汤”治癌主证、治法及药物进行量效分析表明，陈友芝临证时常灵活运用半枝莲、薏苡仁、白花蛇舌草、茯苓、白芍及象贝等药，配合衍化方“一参一仙汤”“二参一仙汤”和“三参一仙汤”治疗胃癌、肺癌、卵巢癌等癌症。
Abstract:
ObjectiveTo provide the reference for syndrome differentiation and treatment of cancer by discus-sing professor Chen Youzhi's medication laws and the laws of prescription derivation of differentiation and treatment of cancer with "Ershen Yixian Tang" based on dose-effect relationship. MethodsHerbal compounds of containing "Ershen Yixian Tan" in Chen Youzhi's medical cases of treating cancer were screened, SPSS Statistics 26.0 software, Aprior algorithm and multiscale backbone network algorithm were applied to perform statistical analysis of the disease, patterns, therapeutic methods, dosage, the classification of the medicine, nature, flavor and meridian tropism in the selected medical cases of treating cancer, to screen out high-frequency medicine combinations, core prescriptions and drug clustering using association rules, cluster analysis and complex network analysis. ResultsAll 172 prescrip-tions for the treatment of cancer that contain "Ershen Yixian Tang" have been selected, and 22 therapeutic methods have been summarized, including asthenia in origin and asthenia in superficiality, internal accumulation of cancer toxin, enhancing healthy Qi and eliminating the pathogenic factors, tonification and purgation in combination. The treatment of cancer using "Ershen Yixian Tang" is divided into nine dosage levels from 15 to 60 g, with the 30 g dosage being used most frequently, and the prescription is applied in the treatment for ten types of cancer such as gastric cancer (12.21%,21/172), lung cancer (9.88%,17/172), ovarian cancer (4.65%,8/172) and others, the top eight most frequently used drugs in medical cases are Banzhilian (Scutellariae barbatae herba), Yiyiren (coicis semen), Fuling (poria) and others. Drugs with a frequency of use ≥ 18 times were predominantly cold, warm and flat, sweet, bitter and pungent in terms of the four Qi and five flavours, entering stomach, spleen and liver meridians respectively. The effectiveness can fall into nine categories, the drugs of clearing away heat are the most frequently used. There were 75 pairs (43.60%,75/172) of drug association analysis combinations in 23 groups, including "Baihua Sheshecao (hedyotis diffusa)-Banzhilian". Complex network analysis screened out the core grouping of Baihua Sheshecao, Banzhilian, Yiyiren, Fuling, Jiaogulan (fiveleaf gynostemma herb), Kushen (sophorae flavescentis radix), Gualou (trichosanthis fructus), Baishao (paeoniae radix alba), Tengligen [actinidia arguta (Sieb. & Zucc) Planch. ex Miq.] and Xiangbei (bulbus fritillariae thunbergii); seven prescriptions were derived, such as "Yishen Yixian Tang", "Ershen Yixian Tang" and "Sanshen Yixian Tang", they have different functions and could be applied in different therapies. ConclusionDose-effect analysis of the main syndrome, therapeutic methods and medicines of "Ershen Yixian Tang" shows that Professor Chen Youzhi often treats the cancer such as gastric cancer, lung cancer, ovarian cancer by flexibly adopting Banzhilian, Yiyiren, Baihua Sheshecao, Fuling, Baishao and Xiangbei in clinical application, combined with the modified prescriptions including "Yishen Yixian Tang", "Ershen Yixian Tang" and "Sanshen Yixian Tang".

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备注/Memo

备注/Memo:
王贵民（1976—），男，副主任医师。研究方向：中医内科学。E-mail：LTB813@126.com。甘肃省自然科学基金（23JRRA1722）；甘肃中医药大学中医学一级学科“岐黄英才”导师基金项目（ZYXKSD-202205）。
更新日期/Last Update: 2024-07-15