国际生殖健康/计划生育杂志 ›› 2024, Vol. 43 ›› Issue (5): 361-367.doi: 10.12280/gjszjk.20240156

• 论著 • 上一篇    下一篇

基于数据挖掘探讨中医药在辅助生殖技术中的分期应用

宫政, 王聪, 宋佳怡, 夏天()   

  1. 300381 天津中医药大学第一附属医院/国家中医针灸临床医学研究中心生殖医学科(宫政,王聪,夏天);宁波大学附属第一医院生殖医学中心(宋佳怡)
  • 收稿日期:2024-04-03 出版日期:2024-09-15 发布日期:2024-09-19
  • 通讯作者: 夏天 E-mail:xiatian76@163.com
  • 基金资助:
    国家自然科学基金(82274570)

The Phased Application of Traditional Chinese Medicine in Assisted Reproductive Technology: A Data Mining

GONG Zheng, WANG Cong, SONG Jia-yi, XIA Tian()   

  1. Department of Reproductive Medicine, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin 300381, China (GONG Zheng, WANG Cong, XIA Tian); Reproductive Medicine Center, First Affiliated Hospital of Ningbo University, Ningbo 315012, Zhejiang Province, China (SONG Jia-yi)
  • Received:2024-04-03 Published:2024-09-15 Online:2024-09-19
  • Contact: XIA Tian E-mail:xiatian76@163.com

摘要:

目的: 基于数据挖掘技术整合分析名医名家临证应用中医药配合辅助生殖技术(assisted reproductive technology,ART)的各期方药分布规律。方法: 计算机系统检索中国知网、维普中文科技期刊数据库、万方数据库和中国生物医学文献数据库中名医名家临证应用中医药配合ART的相关文献,建立文献分析数据库进行整合归纳,获得其中药物分布规律。结果: 本研究纳入合格文献共112篇,涉及名家36人。降调期药物共获得总类别13种,相关药物77味,累计出现频次224次,频率较高者为“补虚药”(55.94%)、“活血化瘀药”(10.89%)、“清热药”(6.44%)、“收涩药”(5.45%)、“利水渗湿药”(5.45%)等;促排期药物共获得总类别13种,相关药物92味,累计出现频次398次,频率较高者为“补虚药”(61.34%)、“活血化瘀药”(8.68%)、“收涩药”(8.40%)、“清热药”(5.88%)、“利水渗湿药”(5.32%)等;移植期药物共获得总类别14种,相关药物70味,累计出现频次372次,频率较高者为“补虚药”(68.78%)、“祛风湿药”(5.80%)、“活血化瘀药”(5.52%)等;确认妊娠后用药物共获得总类别11种,相关药物47味,累计出现频次182次,频率较高者为“补虚药”(59.88%)、“祛风湿药”(9.30%)、“清热药”(7.56%)、“收涩药”(5.23%)等。四期用药关联分析显示降调期分析得18组药物组合,促排期分析得14组药物组合,移植期分析得41组药物组合,确认妊娠后分析得22组药物组合。四期用药聚类分析结果显示降调期得到核心药物组:党参-甘草-白术-黄芪-酸枣仁、菟丝子-枸杞子-熟地黄-当归-香附、熟地黄-白芍-阿胶-菟丝子-生地黄;促排期得到核心药物组:菟丝子-熟地黄-山药-枸杞子-桑椹、菟丝子-熟地黄-当归-枸杞子-丹参、熟地黄-山茱萸-山药-菟丝子-生地黄;移植期得到核心药物组:白术-续断-桑寄生-党参-菟丝子、桑寄生-菟丝子-续断-黄芩-阿胶、当归-菟丝子-甘草-山药-巴戟天;确认妊娠后得到核心药物组:白术-黄芪-甘草-党参-续断、菟丝子-续断-白术-桑寄生-阿胶、白术-续断-甘草-苎麻根-杜仲。结论: “补虚药”是四期主要应用的药物种类,药物主要归肝肾脾经,“以补为主,攻补兼施,性以温平,味以甘苦”是四期用药的共同特点,临床应根据四期不同特点进行相应的遣方用药以提高疗效,降调期以防气血躁动为主;促排期应以补肾精为主,同时应加用少量温阳药物,在补肾的同时应涩促结合,防止肾精过耗;移植期与胚胎着床后中药的功效主要在于“稳固胎元”,应注重补养母体气血。

关键词: 生殖技术,辅助, 中药, 名家经验, 中医药学文献

Abstract:

Objective: To integrate and analyze the application of traditional Chinese medicine (TCM) with assisted reproductive technology (ART) at the different periods of the treatment from those famous TCM experts, based on a data mining. Methods: To search the related documents of the application of TCM and ART from famous TCM experts in the CNKI、CQVIP、Wanfang、CBM databases of Chinese. We aimed to establish a literature analysis database for the integration and induction to obtain the distribution of commonly used drugs. Results: This study included 112 qualified documents, involving 36 famous TCM experts. The total number of drugs in the down-regulation period was 13, with 77 flavors of related drugs and 224 cumulative frequencies of occurrence. The higher frequencies were 55.94% of "drugs for tonifying deficiency", 10.89% of "drugs for activating blood circulation and removing blood stasis", 6.44% of "heat-clearing drugs", 5.45% of "astringent drugs", and 5.45% of "water-inducing and dampness-expelling drugs". In the ovulation promotion period, the total number of drugs was 13, with 92 flavors of related drugs and 398 cumulative frequencies of occurrence. In this period, the higher frequencies were of 61.34% of "drugs for tonifying deficiency", 8.68% of "drugs for activating blood circulation and removing blood stasis", 8.40% of "astringent drugs", 5.88% of "heat-clearing drugs", 5.32% of "water-inducing and dampness-expelling drugs", etc. In the transplantation period, the total number of drugs was 14, with 70 flavors of the relevant drugs and 372 cumulative frequencies. In the transplantation period, the higher frequencies were 68.78% of "drugs for tonifying deficiency", 5.80% of "drugs for dispelling wind-dampness" and 5.52% of "drugs for activating blood circulation and removing blood stasis". The drugs used after pregnancy were confirmed to have a total of 11 categories, with 47 flavors and 182 cumulative frequencies. During pregnancy, the higher frequencies were 59.88% of "drugs for tonifying deficiency", 9.30% of "drugs for dispelling wind-dampness", 7.56% of "heat-clearing drugs" and 5.23% of "astringent drugs". The correlation analysis of drugs of the four phases showed that there were 18 drug combinations in the down-regulation period, 14 drug combinations in the ovulation promotion period, 41 drug combinations in the transplantation period and 22 drug combinations after confirmation of pregnancy. Cluster analysis of the drugs used in the four periods showed that the core drug group was obtained in the down-regulation period: codonopsis pilosulae-licorice-atractylodes macrocephala-astragalus-jujube seed, radix dipsaci-fructus lycii -prepared rehmannia root-radix angelicae sinensis-rhizoma cyperi, prepared rehmannia root-radix paeonia lactiflora-donkey hide gelatin-radix dipsaci-rehmannia root. Ovulation promotion period got the core drug group including radix dipsaci-prepared rehmannia root-Chinese yam-fructus lycii-mulberry, radix dipsaci-prepared rehmannia root-radix angelicae sinensis-fructus lycii-salvia miltiorrhiza, prepared rehmannia root-fructus corni-Chinese yam-radix dipsaci-rehmannia root. The core drug groups obtained during the transplantation period were atractylodes macrocephala-radix dipsaci-Chinese taxillus herb-codonopsis pilosula-semen cuscutae, Chinese taxillus herb-semen cuscutae-radix dipsaci-scutellaria baicalensis-donkey hide gelatin, radix angelicae sinensis-semen cuscutae-liquorice-Chinese yam-morinda officinalis. The core group of drugs obtained after confirmation of pregnancy was atractylodes macrocephala-astragalus-liquorice-codonopsis pilosulae-radix dipsaci, semen cuscutae-radix dipsaci-atractylodes macrocephala-Chinese taxillus herb-donkey hide gelatin, atractylodes macrocephala-radix dipsaci-liquorice-radix boehmeriae- tuchung. Conclusions: The "drugs for tonifying deficiency" are commonly used in the four periods, which belong to the liver, kidney and spleen meridian. The common drug characteristics of the four periods is "Based on tonic, laxative and tonic used together, mainly with warm, flat, sweet and bitter nature of TCM". According to the different characteristics of the four periods, TCM with different prescription drugs can be used to improve the curative effect. In the period of down regulation, preventing the agitation of qi and blood is the main focus. In the period of ovulation induction, tonifying the kidney essence is the main focus. At the same time, a small amount of warming drugs should be added. Tonifying the kidney should be combined with astringent and promotion, so as to prevent the excessive depletion of the kidney essence. After the transplantation and embryo implantation, the efficacy of TCM lies in the "stabilization of the fetus" and the tonicity of mother′s qi and blood.

Key words: Reproductive techniques, assisted, Traditional Chinese drugs, Experiences of famous artists, Medicine pharmacologic literature (TCM)