基于中医传承系统探索丁治国治疗桥本氏病用药规律研究

李心爱 祁烁 陈晓珩 李哲 李会龙 张磊 黄盛 付金香 丁治国

摘要 目的：处方是中医临床诊疗过程的最终体现，该文借助中医传承辅助系统分析丁治国教授治疗慢性淋巴细胞性甲状腺炎的组方用药规律。方法：通过整理近2017年至今中药治疗单纯性慢性淋巴细胞性甲状腺炎的处方为数据源，筛选出符合要求的109首初诊治疗慢性淋巴细胞性甲状腺炎的新处方，并建立数据库，运用频数统计、关联规则等进行数据挖掘，对核心药物及其归经、性味、组方规律等进行分析研究。结果：处方中涉及中药84味，处方中药物出现频次≥75次的药物得到13个，演化得到核心组合6个，新处方3个;核心药物主要归经肺、脾二经，性味分别为苦、甘。结论：对丁治国教授治疗CLT的用药规律进行探索与总结，为中医药治疗CLT开拓了新思路，对桥本患者的治疗提供了新的方案。

关键词 慢性淋巴细胞性甲状腺炎;用药规律;中医传承辅助系统;中医药

Exploration of the Medication Rule for the Use of Ding Zhiguo in the Treatment of Hashimoto′s Disease Based on the Inheritance System of Traditional Chinese Medicine

LI Xin′ai，QI Shuo，CHEN Xiaoheng，LI Zhe，LI Huilong，ZHANG Lei，HUANG Sheng，FU Jinxiang，DING Zhiguo

（The First Clinical Medical College of Beijing University of Chinese Medicine/Dongzhimen Hospital，Beijing University of Chinese Medicine，Beijing 100700，China）

Abstract Objective：Prescription is the final embodiment of traditional Chinese medicine（TCM）clinical diagnosis and treatment process.This paper analyzes the prescription law of Professor DING Zhiguo in the treatment of chronic lymphocytic thyroiditis with the aid of TCM inheritance system.Methods：By sorting out the prescriptions of traditional Chinese medicine for the treatment of simple chronic lymphocytic thyroiditis from 2017 to the present as a data source，109 new prescriptions for the treatment of chronic lymphocytic thyroiditis that meet the requirements were screened out，and a database was established.Frequency statistics and correlation were used for data mining.The core drugs and their meridian，nature and flavor，and prescription rules were analyzed and studied.Results：A total of 84 Chinese medicines were involved in the prescription.The number of prescription drugs with a frequency of ≥75 times received 13 drugs，6 core combinations and 3 new prescriptionsere were evolved; the core drugs mainly belonged to the lung and spleen channels，and their nature and flavor were bitter and sweet.Conclusion：The drug law of Professor DING Zhiguo in the treatment of CLT were explored and summarized，opening up new ideas for the treatment of CLT with TCM，and to provide a new scheme for the treatment of Hashimoto patients.

Keywords Chronic lymphocytic thyroiditis; Law of drug use; Traditional Chinese medicine inheritance assistance system; Traditional Chinese medicine

中圖分类号：R242文献标识码：Adoi：10.3969/j.issn.1673-7202.2021.01.027

慢性淋巴细胞性甲状腺炎（Chronic Lymphocytic Thyroiditis，CLT）又称自身免疫性甲状腺炎，是一种以自身甲状腺组织为抗原的慢性炎症性自身免疫性疾病。包括2种类型：一为甲状腺肿型，即桥本甲状腺炎[1]（Hashimoto Thyroiditis，HT）;另一为甲状腺萎缩性，即萎缩性甲状腺炎（Atrophic Thyroiditis，AT）。临床上以HT常见。近年来CLT发病有增多趋势，在人群中的发病率可高达22.5～40.7/10万，西方国家CLT占甲状腺疾病的10%，我国所占比例为3%左右[2-3]。各个年龄段均可发病，但以30～50岁多见，90%发生于女性，且有家族多发倾向。

本病发展缓慢病程较长，主要表现为甲状腺肿大，多为弥漫性，少数可为局限性，部分以颜面、四肢肿胀感起病。……