目的:分析中医治疗布鲁氏菌病瘀血阻络证的方药特征信息,探索组方用药规律,挖掘有效的药物组合及新处方.方法:检索相关数据库并查阅资料,收集关于布鲁氏菌病瘀血阻络证的文献和医案,筛选治疗该病证的方剂.基于中医传承辅助平台V2.5建立方药特征数据库,并通过关联规则分析法、改进互信息法、熵层次聚类等方法,对处方用药进行数据分析,包括药物四气、五味、归经分布以及用药频次统计,组方规律和新方等.结果:筛选出关于布鲁氏菌病瘀血阻络证的组方41首,中药64味,使用频次最高的五味中药为桃仁、川芎、当归、红花、秦艽,并获得核心药物组合14个,用药规则以红花、川芎、丹参、桃仁、当归、地龙、秦艽之间的配合为主,得出7个新的处方.结论:布鲁氏菌病瘀血阻络证主要以补血活血,疏经行气通络为治疗原则,且活血药与补血药、活血药与祛风湿药、活血药与通络药之间多以"相须""相使"为主,为临床用药规律及科学研究提供数据支撑.

Objective:To analyze the changes of spatial, seasonal, and age distribution of brucellosis among humans and animals in Gansu Province and to provide a reference for the next step in formulating prevention and control measures.Methods:Reported data of brucellosis of humans and animals in Gansu Province from 2018 to 2020 were collected. The human epidemic data were obtained from "China Disease Control and Prevention Information System", and the positive data of animals were obtained from the monthly report provided by Gansu Animal Disease Control Center. Human brucellosis was classified and analyzed according to year, month, age and region, and livestock brucellosis was classified according to year, month, population and region. ArcGIS 10.2 software was used to analyze the spatial epidemiological characteristics of the data. Measuring Geographic tool was used to calculate the shifting distance of the center of the disease incidence in humans and animals from 2018 to 2020.Results:From 2018 to 2020, a total of 6 375 cases of human brucellosis were reported in Gansu Province. The 40 - 59 age group accounted for 54.96% (3 504/6 375), 1 584 cases were reported in 2018, 1 787 cases were reported in 2019, and 3 004 cases were reported in 2020. The high incidence time of human brucellosis was July and November. A total of 48 180 brucellosis-positive animals (heads) were detected, of which 47 342 were positive sheep, accounting for 98.26% (47 342/48 180). The high incidence time of brucellosis among animals was October. Among the 14 cities (prefectures), the top cities of livestock brucellosis reported were Qingyang City, Zhangye City and Jiuquan City. The center of disease incidence among humans was located in Gulang County, Wuwei City. The center of disease incidence among animals was located in Wuwei City in 2018 and Qingyang City in 2020.Conclusions:The cases of brucellosis in humans and animals in Gansu Province are on the increase. In some areas, there are problems of separation of human and animal epidemics. It is necessary to actively strengthen monitoring and implement measures to prevent and control brucellosis in humans and animals in high-risk areas to curb the spread of the epidemic.

目的 观察改进的中药布病逐淤丸(1号丸)针对血瘀阻络,毒邪留滞型慢性布病肌肉关节疼痛的疗效.方法 将91例血瘀脉络型慢性布病患者随机分为治疗组51例和对照组40例.治疗组给"1号布病丸"治疗4个疗程,对照组空白,观察时间同治疗组相同,分别观察记录中医症候变化,录入Excel数据库,采用spss22.0进行统计学处理分析治疗效果.结果 通过对51例患者的治疗观察,近期有效率为90.19％,远期有效率82.35％,疗效较好,且近期与远期疗效比较,差异无统计学意义(P＞0.05),疗效稳定.结论 中药"1号布病丸"采取活血化瘀,祛风通络止痛治则对表现为肌肉关节疼痛的布鲁氏菌病患者有显著疗效,值得临床推广应用.

目的 探讨中医辨证论治人间布鲁杆菌病规律,有助于祖国医学在后续临床治疗布病过程中提高辨证准确性和疗效提供参考依据.方法 整理中医辨证分型、论治方法、遣方用药等方面文献,进行归纳录入Excel表格,建立中医药治疗布病数据库,进行统计学处理.结果 布鲁氏杆菌病人根据病程和主要症状体征可以分为8类,依据中医理论分析,急性期分为3类,分别是寒热夹杂证型类、湿热内蕴证型类、热淤阻型证类;慢性期分为5类,分别为虚证型,湿浊型、湿热型、血瘀脉络型、痹症型.结论 布鲁氏杆菌病的症状组合规律和中医辨证密切相关,准确科学发热证候特征可为其临床诊断和治疗提供一定的依据.

目的 观察改进后的2号布病丸对气阴两虚型慢性布病的治疗疗效,为下一步治疗慢性布病提供参考依据.方法 给予41例气阴两虚型慢性期布病患者2号布病丸,共治疗4个疗程,统计学处理并分析2号布病丸的治疗效果.结果 从单个症状和体征改善情况统计结果显示,其乏力、自汗、盗汗、手足发热、口燥咽干、肌肉关节酸痛、虚烦不眠症状等症状及体征明显减轻(包括消失),其改善率分别为94.87％、89.29％、90.48％、94.12％、91.30％、90.32％、95.45％;2号布病丸治疗近期有效率为95.12％,远期有效率87.80％,近期与远期疗效相比,差异无统计学意义.结论 具有扶正固本,益气养阴之功效的2号布病丸对表现为乏力、多汗、五心烦热、肌肉关节疼痛的慢性布鲁氏菌病患者有显著疗效,且服用简便且经济,值得临床推广应用.

目的 了解2018年甘肃省人间布鲁氏菌病流行特征,客观评价甘肃省人间布鲁氏菌病疫情现状,为进一步做好布鲁氏菌病防控提供科学依据.方法 采用描述流行病学方法分析2018年甘肃省人问布鲁氏菌病疫情.结果 2018年甘肃人间布鲁氏菌病新发病人1 584例,发病率为6.03/10万,每月均有人间布鲁氏菌病发生,其中5-7月发病469例、占29.61％;白银市、张掖市和武威市共发病830例、占52.40％,以农民发病为丰、占83.96％.结论 与历年发病水平比较,2018年甘肃省布鲁氏菌病疫情处于高发状态;各级政府应加大财政投入,明确部门职责、密切配合,切实落实各项综合防控措施.