| Objective: Diabetic constipation is a common complication of digestive autonomic neuropathy secondary to diabetes.It is more common in middle-aged and elderly diabetic patients.It will not only affect people’s quality of life,but also cause many diseases such as cardiovascular and cerebrovascular diseases,and consume a lot of medical and health resources.This study uses the traditional Chinese medicine inheritanee support system to collect,organize,summarize and analyze the prescriptions in the literature on the treatment of diabetic constipation with traditional Chinese medicine and the traditional Chinese medicine prescriptions of the inpatients with diabetes and constipation in the Affiliated Hospital of Shandong University of Traditional Chinese Medicine.Excavate the potential law of traditional Chinese medicine in the treatment of diabetic constipation,and summarize the experience of traditional Chinese medicine in the treatment of diabetic constipation.To provide reference for the clinical application of traditional Chinese medicine in the treatment of diabetic constipation.Methods: In this study,a total of 70 literatures on TCM treatment of diabetes and constipation selected from China National Knowledge Network and Wanfang database and 231 cases of inpatients in the Affiliated Hospital of Shandong University of Traditional Chinese Medicine from 2013 to 2022 that met the inclusion and exclusion criteria were included.After standardizing the data,it contains 75 and 369 TCM prescriptions respectively.Separately enter the " traditional Chinese medicine inheritanee support system V2.5" developed by the China Academy of Chinese Medical Sciences.Mining the data of the two studies respectively through the statistical report system and data analysis system of the software.Comparative analysis of literature research and real-world research results.In order to excavate the medication rules of traditional Chinese medicine in the treatment of diabetic constipation.Results: 1.Most of the literature research lacks detailed statistical data on the gender and age of patients,but the approximate range is 40-70 years old.A total of 231 patients were included in the real-world study,and the gender statistics showed that the male to female ratio was 1:1.36(98 males and 133 females);the average age was 71.76±20.24 years old.2.A total of 70 literatures were screened for literature research,75 prescriptions,involving 115 traditional Chinese medicines,and a total of 749 times of medication frequency,of which 42 Chinese medicines with a frequency ≥ 5times accounted for 84.11% of the total frequency.The order from high to low is astragalus,Rehmannia glutinosa,angelica,hemp seed,Cistanche,Atractylodes macrocephala,Ophiopogon japonicus,Scrophulariaceae,peach kernel,citrus aurantium.A total of 369 prescriptions were screened in the real-world study,involving 278 traditional Chinese medicines,with a total of 5892 times of medication frequency.Among them,78 traditional Chinese medicines with a frequency ≥ 20 times accounted for 82.81% of the total frequency.Magnolia bark,roasted licorice,Poria cocos,aurantium citrus,angelica,radish seed,astragalus,rehmannia glutinosa,etc.Most of the traditional Chinese medicines are tonic and heat-clearing.3.Both studies found that the four qi and five flavors of the drug are warm,cold,flat,sweet,bitter,and pungent,and mainly belong to the spleen,stomach,and lung meridians.4.Literature research summarizes 14 commonly used drug combinations,mainly including Ophiopogon japonicus-Rehmannia glutinosa-Scrophulariae scrophulariae,Astragalus-Cistanche,Astragalus-Atractylodes macrocephala,etc.Real-world research summarizes23 commonly used drug combinations,mainly including Atractylodes macrocephala-Magnolia,Atractylodes-Atractylodes aurantium,Atractylodes-Poria,Magnolia-citrus aurantium,Zhilicorice-Atractylodes,Laifuzi-Atractylodes,Pinellia-Atractylodes,etc.5.Literature research has unearthed 9 new prescriptions,namely: Citrus aurantium-Cimicifuga-Citrus aurantium-Laifuzi,Hempseed-Poria cocos-Chinese yam-Licorice-Paeoniae Alba,Polygonatum-Anemarrhena-Forsythia-Puerariae-Atractylodes macrocephala,Salvia miltiorrhiza-Chuanxiong-rhubarb-litchi core,Yu Liren-tangerine peel-bellflower-dendrobium-coptis-notoginseng,Poria cocos-yam-Codonopsis-polygonatum,rehmannia root-Anemarrhena-Scrophulariaceae-Ophiopogon japonicus-Adenophora,Angelica-Cimicifuga-Alisma-peony bark,trichosanthes-Anemarrhena-forsythia-kudzu root-Atractylodes macrocephala.Real-world research has unearthed 13 new prescriptions,namely: inula-ochre-fritillary fritillary-octopus,bamboo-astragalus-pinellia-sandalwood,woody-sand ginseng-Polygonum multiflorum-curcuma-hawthorn,Radix Ginseng-Ophiopogon japonicus-polygonatum-polygonatum-rehmannia-scrophulariaceae,forsythia-honeysuckle-dandelion-cork-cork-Alismas-Tianbacao,Dipsacus-aconite-morinda officinalis-dogwood-dried ginger,curcuma-hawthorn-six Divine Comedy-Hedyotis diffusa,Rehmannia glutinosa-Pinellia-Poria cocos-Coix seed-cardamom,Plantago seed-Polyporus cocos-Gorgon fruit-Imperata rhizome-Duhuo-Sunburned Astragalus,Licorice-Sunburnt licorice-Malt-Gubu-Raisin seed,Panax notoginseng-Bletilla striata-burnet-huangjing-flour wheat,Chonglou-sandalwood-salvia miltiorrhiza-Bletilla striata-burnet.Conclusion: 1.Although the pathogenesis of diabetes and constipation is the conduction dysfunction of the large intestine,it is based on spleen deficiency and yin deficiency,dryness,heat,phlegm,blood stasis and Qi stagnation.2.The combination of cold and warm medicine is mainly used for tonifying,and it is also used for clearing away heat.Laxatives should not be abused.3.The treatment focuses on invigorating the spleen,mainly nourishing qi and nourishing yin,and also clearing heat and regulating qi,supplemented by purging.Strengthening the body and eliminating pathogenic factors,taking into account both the specimen and the specimen.4.A total of 22 new prescriptions were obtained through software mining,which can be flexibly applied based on clinical syndrome differentiation. |
