基于聚类分析研究膝骨关节炎中药组方的用药规律(1)
【摘 要】目的：挖掘中医药治疗膝骨关节炎的用药规律。方法：计算机检索中国知网(CNKI)、万方、维普(VIP)等数据库，纳入1979年1月1日至2019年5月1日中药治疗膝骨关节炎的临床研究文献，使用Excel 2003、SPSS Statistics 21.0统计软件，对符合纳入标准的中药进行频次分析和聚类分析。结果：在符合纳入标准的134首方剂中，使用频数≥15次的高频药物共32种，其中牛膝(96次，6.29%)、当归(75次，4.91%)、甘草(64次，4.19%)、熟地黄(56次，3.67%)、杜仲(53次，3.47%)、川芎(53次，3.47%)最为常见，使用最多的药物功效类别为祛风湿药(36次，20.57%)、补虚药(33次，18.86%)、活血化瘀药(24次，13.71%)、清热药(17次，9.71%)和解表药(13次，7.43%)。聚类分析得出杜仲-川芎-熟地黄-白芍-茯苓-当归-甘草-牛膝等3个聚类方。结论：历代医家治疗膝骨关节炎按照标本兼治的原则，以牛膝、当归、杜仲等活血化瘀类、补益类和祛风湿类药物为主，再依据辨证论治佐以清热类、理气类等药物。
【关键词】 骨关节炎，膝;频次分析;系统聚类分析;用药规律;数据挖掘
【ABSTRACT】Objective：To explore the rules of medication of Chinese medicine in the treatment of knee osteoarthritis.Methods：Databases such as CNKI，Wanfang and VIP were searched by computer to find the clinical research literature(from January 1，1979 to May 1，2019)on treating knee osteoarthritis with Chinese medicine.Excel 2003 and SPSS Statistics 21.0 were used to carry out frequency analysis and cluster analysis for selected Chinese medicine.Results：Among the 134 prescriptions，32 kinds of high frequency medicinals were used more than 15 times，including Niuxi(Radix Achyranthis Bidentatae，96 times，6.29%)，Danggui(Radix Angelicae Sinensis，75 times，4.91%)，Gancao(Radix et Rhizoma Glycyrrhizae，64 times，4.19%)，Shudihuang(Radix Rehmanniae Praeparata，56 times，3.67%)，Duzhong(Cortex Eucommiae，53 times，3.47%)，and Chuangxiong(Rhizoma Chuanxiong，53 times，3.47%).The most common，and the most commonly used drug category are wind-dampness-dispelling medicinals(36 times，20.57%)，supplement-deficiency medicinals(33 times，18.86%)，blood-invigorating and stasis-dissolving medicinals(24 times，13.71%)，heat-clearing medicinals(17 times，9.71%)and exterior-releasing medicinals(13 times，7.43%).Three cluster formulas were got from cluster analysis.Conclusion：According to the principle of treating knee osteoarthritis for the root and branch simultaneously，the physicians in the past mainly used blood-invigorating and stasis-dissolving medicinals such as Niuxi，Danggui and Duzhong，supplement medicinals and wind-dampness-dispelling medicinals，and modified them with heat-clearing medicinals and qi-regulating medicinals.
【Keywords】 osteoarthritis，knee;frequency analysis;system cluster analysis;medication rule;data mining
膝骨關节炎(knee osteoarthritis，KOA)属于慢性进行性骨关节疾病，以关节软骨退行性病变和关节周围骨质增生为病理特征，临床主要表现为膝关节疼痛、肿胀、僵硬，严重者可出现膝关节积液、活动受限等症状[1]。本病病程进展缓慢，好发于中老年人，尤以女性居多，且发病率呈上升趋势，治疗一直是医学界的热点问题。西医学治疗KOA主要以抗炎镇痛和保护关节软骨药物为主，缓解患者症状效果虽好，但伴随的不良反应发生率也较高，而且远期疗效得不到保证[2]。中医对KOA研究较久，并将其归属于“痹证”“骨痹”“历节风”“膝痹”等范畴[3]，依据辨证论治原则遣方用药，疗效确切，伴随不良反应少，且远期效果佳。本研究运用聚类分析法，分析中医药治疗KOA的用药规律，为临床选方用药提供参考。, 百拇医药(邱晓莲 李鑫 曹建中)
【关键词】 骨关节炎，膝;频次分析;系统聚类分析;用药规律;数据挖掘
【ABSTRACT】Objective：To explore the rules of medication of Chinese medicine in the treatment of knee osteoarthritis.Methods：Databases such as CNKI，Wanfang and VIP were searched by computer to find the clinical research literature(from January 1，1979 to May 1，2019)on treating knee osteoarthritis with Chinese medicine.Excel 2003 and SPSS Statistics 21.0 were used to carry out frequency analysis and cluster analysis for selected Chinese medicine.Results：Among the 134 prescriptions，32 kinds of high frequency medicinals were used more than 15 times，including Niuxi(Radix Achyranthis Bidentatae，96 times，6.29%)，Danggui(Radix Angelicae Sinensis，75 times，4.91%)，Gancao(Radix et Rhizoma Glycyrrhizae，64 times，4.19%)，Shudihuang(Radix Rehmanniae Praeparata，56 times，3.67%)，Duzhong(Cortex Eucommiae，53 times，3.47%)，and Chuangxiong(Rhizoma Chuanxiong，53 times，3.47%).The most common，and the most commonly used drug category are wind-dampness-dispelling medicinals(36 times，20.57%)，supplement-deficiency medicinals(33 times，18.86%)，blood-invigorating and stasis-dissolving medicinals(24 times，13.71%)，heat-clearing medicinals(17 times，9.71%)and exterior-releasing medicinals(13 times，7.43%).Three cluster formulas were got from cluster analysis.Conclusion：According to the principle of treating knee osteoarthritis for the root and branch simultaneously，the physicians in the past mainly used blood-invigorating and stasis-dissolving medicinals such as Niuxi，Danggui and Duzhong，supplement medicinals and wind-dampness-dispelling medicinals，and modified them with heat-clearing medicinals and qi-regulating medicinals.
【Keywords】 osteoarthritis，knee;frequency analysis;system cluster analysis;medication rule;data mining
膝骨關节炎(knee osteoarthritis，KOA)属于慢性进行性骨关节疾病，以关节软骨退行性病变和关节周围骨质增生为病理特征，临床主要表现为膝关节疼痛、肿胀、僵硬，严重者可出现膝关节积液、活动受限等症状[1]。本病病程进展缓慢，好发于中老年人，尤以女性居多，且发病率呈上升趋势，治疗一直是医学界的热点问题。西医学治疗KOA主要以抗炎镇痛和保护关节软骨药物为主，缓解患者症状效果虽好，但伴随的不良反应发生率也较高，而且远期疗效得不到保证[2]。中医对KOA研究较久，并将其归属于“痹证”“骨痹”“历节风”“膝痹”等范畴[3]，依据辨证论治原则遣方用药，疗效确切，伴随不良反应少，且远期效果佳。本研究运用聚类分析法，分析中医药治疗KOA的用药规律，为临床选方用药提供参考。, 百拇医药(邱晓莲 李鑫 曹建中)
参见：首页 > 医疗版 > 疾病专题 > 骨科 > 慢性非化脓性关节炎或关节病 > 骨关节炎