摘要:
Objective To explore the clinical diagnosis and treatment law of autoimmune hepatitis (AIH) by analyzing the medical records of contemporary Chinese medicine physicians.Methods The medical records of Chinese medicine or integrative traditional and western medicine in diagnosing and treating AIH from January of 1990 to February of 2016 were searched from China National Knowledge Infrastructure,Chinese Biological Medical Literature Database,VIP Database,Wanfang Database and Famous Doctor Database of Guangzhou University of Chinese Medicine.Detailed information in the medical records,including Chinese medicine syndrome type,Chinese medicine syndrome elements of disease location,Chinese medicine syndrome elements of disease nature,and used herbs,was extracted.Data was analyzed with descriptive statistics,frequency analysis and cluster analysis.Meanwhile,core herb network map was drawn with complex network analysis.Results Totally,80 medical records were included.There were thirteen Chinese medicine syndrome types were involved in,and the top 3 syndrome types with the highest frequency of occurrence were static blood blocking collaterals (29),internal retention of damp-heat (24) and stagnation of liver Qi and spleen deficiency (17).There were thirteen Chinese medicine syndrome elements of disease nature were included,and the top 3 syndrome elements with the highest frequency of occurrence were blood stasis (33),dampness (32) and heat (31).There were twenty-eight prescriptions were involved in the records,and the top 3 prescriptions with the highest frequency of occurrence were Yinchenhao Decoction (茵陈蒿汤) (22),selfdesigned prescriptions (20) and Chaihu Shugan San (柴胡疏肝散) (7).Totally,169 herbs were used.The average herbs used in each record were 14.6.The top 5 herbs with the highest frequency of occurrence were Yinchen [Herba Artemisiae Scopariae,茵陈] (45),Gancao [Radix Glycyrrhizae,甘草] (42),Chishao [Radix Paeoniae Rubra,赤芍] (37),Chaihu [Radix Bupleuri,柴胡] (34) and Baizhu [Rhizoma Atractylodis Macrocephalae,白术] (31).There were 84 herbs with the used frequency > 3,which could be classified into 9 categories by cluster analysis.By complex network analysis,the core herbs in treating AIH without jaundice were Chaihu,Baizhu,Baishao [Radix Paeoniae Alba,白芍],Fuling [Poria,茯苓],Gancao,Danggui [Radix Angelicae Sinensis,当归] and Huangqi [Radix Astragali seu Hedysari,黄芪];the core herbs in treating AIH with jaundice were Yinchen,Dahuang [Radix et Rhizoma Rhei,大黄],Chishao and Huangqin [Radix Scutellariae,黄芩].Conclusion In AIH,the common Chinese medicine syndromes include syndrome of static blood blocking collaterals and syndrome of internal retention of damp-heat,and the common Chinese medicine disease natures are blood stasis,dampness and heat.For the treatment,herbs that replenishing deficiency,clearing heat,diuresis,diffusing dampness,promoting blood circulation and removing blood stasis are mostly applied.