卵巢功能减退相关月经异常的病证用药关联分析

Association analysis of diseases，traditional Chinese medicine syndromes and herbal prescriptions for menstrual disorders related to diminished ovarian reserve

关键词:  卵巢功能减退  月经异常  复杂网络  用药规律  关联分析

Key words:  diminished ovarian reserve  menstrual disorders  complex network  medication pattern  association analysis

摘要:

[目的] 基于《中华医典》数据，分析卵巢功能减退相关月经异常的“病-证-药”关联特征，为临床辨证论治提供参考。[方法] 检索月经过少、月经后期、闭经/经水早断相关条文，按照纳入及排除标准筛选并完成术语标准化与完整性核验，最终纳入261条。采用描述性统计、中药共现网络及Phi系数分析证型/证素分布与用药关联。[结果] 条文分布为月经过少63条（24.1%）、月经后期74条（28.4%）、闭经124条（47.5%，含经水早断）。病名组间证型结构差异明显：月经过少组以气血亏虚、脾肾阳虚为主（73.0%）；月经后期组以肾虚肝郁、气机郁滞为主（72.9%）；闭经组以肾虚血瘀、肝肾阴虚为主（71.8%）。证素分布亦呈现分化：月经过少组偏虚，月经后期组突出气滞，闭经组多见阴虚、血瘀、精亏等。用药方面，当归、熟地黄、白芍、川芎处于共现网络核心，提示基础用药核心较为集中；不同证型的关联用药呈现一定分化。[结论] 研究基于条文共现与关联分析结果，提示卵巢功能减退相关月经异常在不同病名组的证型/证素构成及用药组合上存在差异，可以为临床辨证分型与处方思路提供参考。

Abstract:

[Objective] To investigate the associations among disease names，traditional Chinese medicine（TCM） syndromes，and herbal prescriptions in menstrual disorders related to ovarian functional decline based on entries from Zhonghua Yidian，and to provide literature-level evidence for clinical pattern differentiation and treatment planning. [Methods] Entries concerning scanty menstruation，delayed menstruation，and amenorrhea were retrieved and screened according to predefined inclusion and exclusion criteria，followed by terminology standardization and completeness verification. A total of 261 entries were included. Descriptive statistics were used to summarize the distributions of syndrome types and syndrome elements. Herbal co-occurrence network analysis and Phi coefficient analysis were performed to explore herb-syndrome associations and prescription patterns. [Results] Among the 261 entries，63（24.1%）were classified as scanty menstruation，74（28.4%）as delayed menstruation，and 124（47.5%） as amenorrhea（including early cessation of menses）. Marked differences in syndrome-type structures were observed across disease-name groups：the scanty menstruation group was dominated by qi-blood deficiency and spleen-kidney yang deficiency（73.0% combined）；the delayed menstruation group mainly presented kidney deficiency with liver constraint and qi stagnation（72.9% combined）；and the amenorrhea group was characterized by kidney deficiency with blood stasis and liver-kidney yin deficiency（71.8% combined）. Syndrome-element distributions also differed： the scanty menstruation group was deficiency-predominant，the delayed menstruation group featured prominent qi stagnation，and the amenorrhea group commonly involved yin deficiency，blood stasis，and essence depletion. In the herbal co-occurrence network，Danggui，Shudihuang，Baishao，and Chuanxiong occupied central positions， indicating a concentrated core prescription framework，while syndrome-associated herbs showed differentiation across syndrome types. [Conclusion] Co-occurrence and association analyses based on Zhonghua Yidian entries suggest that menstrual disorders related to ovarian functional decline differ across disease-name groups in their syndrome-type/element compositions and herb combinations. These findings may inform clinical pattern differentiation and prescription strategies；however，they reflect literature-level co-occurrence/association patterns rather than causal effects and should be interpreted cautiously.