凌昌全教授治疗肝癌用药分析.docx

凌昌全教授治疗肝癌用药分析【摘要】在建立门诊肝癌专病病历的基础上，收集经凌昌全教授诊治的552例肝癌患者合计2020张门诊有效处方，使用频数法总结凌教授的临床常用药物及其性味归经。运用logistic回归方法分析其辨证用药特点，聚类分析归纳其临床常用对药，结合专家体会对数据结果进行分析。凌教授治疗肝癌临床常用药物以健脾开胃、解毒抗癌和活血化瘀类为主，药性多平、凉，药味主以甘、苦、辛。气虚多选用黄芪、白术、太子参；血虚多用鸡血藤、大枣；阴虚多选用山茱萸、麦门冬；水湿多用藿香、车前子、茯苓皮；实热多选用山栀、黄芩；血瘀多选用桃仁、赤芍；气滞多用郁金、八月札、柴胡。聚类分析共总结出19对临床常用对药。【关键词】凌昌全;肝癌;数学分析,统计;名医经验Abstract:Onthebasisofoutpatients‘medicalrecordsconcerningprimarylivercancer(PLC),dataof552patients(with2020effectiveprescriptions)fromtheOutpatientDepartmentofChanghaiHospitaltreatedbyProfessorLingChangquanwerecollected.Thenature,flavorandmeridiandistributionoftheherbsusedintheprescriptionsweresummarizedbyfrequencymethod,andthefeaturesoftheherbsusedaccordingtosyndromedifferentiationwereanalyzedbylogisticregression.Thecoupleherbsusedwereanalyzedbyclusteranalysis.Allthedatawereanalyzedincombinationwiththeexperienceofthespecialist.Itshowedthatmostofthefrequentlyusedherbswereherbsforinvigoratingthespleentopromoteappetite,removingtoxicmaterialstoinhibittumorgrowth,andactivatingbloodcirculationtodissipatebloodstasis.Theseherbsaremostlyofplainorcoolnature,andmainlyofsweet,bitter,oracridtaste.ItalsoshowedthatthemostfrequentlyusedherbsforqideficiencywereAstragalusmembranaceus,Atractylodesmacrocephala,andPseudostellariae;CaulisSpatholobiandChinesejujubeforbloodasthenia;FructusCorniandOphiopogonjaponicusforyindeficiency;Agastacherugosa,SemenPlantaginisandPoriaforwaterdampness;capejasminefruitandbaikalskullcaprootforheatexcess;peachseedandRadixPaeoniaeRubraforbloodstasis;Curcumawenyujin,AkebiatrifoliataandBupleurumchinenseforqistagnation.Atotalof19pairsofcoupleherbsweresummarizedbytheclusteranalysis.Keywords:LingChangquan;livercancer;dataanalysis,statistical;famousdoctor‘sexperience凌昌全教授是国内知名的中医肿瘤专家、上海市名中医和军队第一批中医药“国医名师”。他从20世纪90年代初开始致力于原发性肝癌的中西医结合防治研究。为总结凌教授治疗肝癌的经验，我们在建立门诊肝癌专病病历的基础上，通过收集和分析其门诊病例资料，对其用药规律进行了初步研究。1资料与方法资料来源所有病例均来源于第二军医大学长海医院中医科2003年4月～2006年10月由凌昌全教授门诊诊治的原发性肝癌患者。共收集552例患者2088人次的门诊资料，中药处方2020张。其中男性438例，占79％，女性114例，占21％，男女比例为∶1；年龄25～87岁，平均岁；按临床分