1. 上海中医药大学附属龙华医院风湿科,上海,200032
2. 上海中医药大学附属龙华医院信息中心,上海,200032
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龚蓓, 苏励, 董亮, 等. 基于大数据的风湿科常用中药饮片肾毒性初探[J]. 上海中医药杂志, 2015,49(3):7-9.
GONG Bei, SU Li, DONG Liang, et al. Discussion on renal toxicity of pieces of Chinese herbs used in department of rheumatology based on big data[J]. Shanghai Journal of Traditional Chinese Medicine, 2015,49(3):7-9.
目的:运用大数据方法,探讨在中医理论指导下的临床真实环境中,风湿科常用中药(泽泻、细辛、寻骨风、威灵仙)饮片的肾毒性情况及其相关影响因素。 方法:将储存于计算机系统中的龙华医院近5年间使用过泽泻、细辛、寻骨风、威灵仙的所有患者的个人资料(年龄、用药记录等)、处方以及肾功能(肌酐、尿素氮、24 h尿蛋白定量)等信息共1 256万条,通过大数据系统处理,分析肾毒性情况及其相关影响因素。 结果:使用泽泻、细辛、寻骨风、威灵仙四味中药的患者肾毒性的发生率分别为,泽泻1.15%,细辛2.46%,威灵仙1.50%,寻骨风0.00%。泽泻肾毒性的发生随着累积用药剂量的增加呈现上升趋势,而威灵仙、细辛未出现此情况。5年间临床使用寻骨风者仅有1例,累积用量300 g,未发生肾毒性情况。泽泻、威灵仙、细辛肾毒性的发生有随着年龄增加而上升的趋势。 结论:在中医理论指导下,通过君臣佐使配伍使用泽泻、细辛、威灵仙较为安全,肾毒性的发生率远低于相关的文献报道。
Objective: On the basis of big data, this paper aims to discuss renal toxicity of the common herbs in department of rheumatology, such as Alismatis Rhizoma, Asari Radix et Rhizoma, Dutchmanspipe Herba Aristolochiae Mollissimae and Clematidis Radix et Rhizoma. Methods The personal data (gender, medicine dosage, frequency, etc.) of all patients of Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine taking Alismatis Rhizoma, Asari Radix et Rhizoma, Dutchmanspipe Herba Aristolochiae Mollissimae and Clematidis Radix et Rhizoma from January 1,9 to December 31,3 as stored in computers, prescriptions and renal function (creatinine, blood urea nitrogen, 24-hour urine protein) and other information total 12 560 000 were compared and sorted based on big data processing. Results: The renal dysfunction incidence of patients taking Alismatis Rhizoma, Asari Radix et Rhizoma, Dutchmanspipe Herba Aristolochiae Mollissimae and Clematidis Radix et Rhizoma was 1.15%, 2.46%, 1.50% and 0% respectively. Alismatis Rhizoma:Among patients taking Alismatis Rhizoma, proportion of those with renal dysfunction increased with the increase of cumulative dosage. Only one person clinically took Dutchmanspipe Herba Aristolochiae Mollissimae in recent five years, with cumulative dosage up to 300 g, and did not show renal dysfunction phenomenon. The renal dysfunction incidence was increased with the age of patients who took Alismatis Rhizoma, Asari Radix et Rhizoma and Clematidis Radix et Rhizoma. Conclusion: It is safe to use Alismatis Rhizoma, Asari Radix et Rhizoma and Clematidis Radix et Rhizoma by properly combining them under the guidance of traditional Chinese medicine theory. Renal dysfunction incidence is far less than that reported in relevant literature on experimental study.
大数据泽泻细辛威灵仙肾毒性
big dataAlismatis RhizomaAsari Radix et RhizomaClematidis Radix et Rhizomarenal toxicity
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