目的 采用真實世界方法分析芍藥甘草湯加減治療抗結核藥物性肝損傷（ATB-DILI）的中醫(yī)辨證特點及臨床用藥特征。方法 挖掘分析武漢市肺科醫(yī)院2020年8月—2021年8月診斷為ATB-DILI且使用芍藥甘草湯加減的患者真實世界數據，總結歸納其辨治特點及用藥規(guī)律。結果 納入病案66例，處方199張，證型11種，主要癥狀10種。涉及212味中藥，性味以甘溫、苦寒，歸肝、肺、脾經藥物為主，功效以補虛、清熱等為主。關聯(lián)分析得到3 294條關聯(lián)規(guī)則，高頻中藥聚類分析得到3類核心藥物組合。結論 ATB-DILI的真實世界特征為：肝脾兩虛證最為常見，其次為肝膽濕熱證、肝氣不足證等，臨床譴方用藥既要補脾益氣、疏肝清熱又要祛濕、化痰，在芍藥甘草湯基礎上對癥加減，標本兼治。

Objective To analyze the clinical dialectical and medication characteristics of Shaoyao Gancao Decoction in treatment of anti-tuberculosis drug induced liver injury (ATB-DILI). Methods Mined andanalyzed the data of patients who were diagnosed with ATB-DILI and used Shaoyao Gancao Decoction from August 2020 to August 2021 in Wuhan Pulmonary Hospital, and summarized the characteristics of the diagnosis, the treatment and the rule of medication. Results This study included 66 medical records, 199 prescriptions, 11 types of syndromes, and 10 main symptoms. Involved 212 traditional Chinese medicines (TCM), their tropism of taste:sweet and warm, bitter and cold. In the liver, lung, and spleen, and the effects of the TCM pieces were tonic and heat-clearing. 3 294 association rules were obtained through association analysis, and three core drug combinations were got through highfrequency cluster analysis. Conclusion The most common syndrome was liver and spleen asthenia, followed by damp-heat in liver and gallbladder, insufficient liver qi, etc. Medication should not only invigorate the spleen and replenish qi, soothe the liver and clear heat, but also clear damp and reduce phlegm. On the basis of Shaoyao Gancao Decoction, added or subtracted other TCM pieces, treated diseases both symptoms and root causes.

R974

武漢市衛(wèi)生健康科研基金資助（WZ21Q23）