中药联合中成药改善骨关节炎脂代谢、免疫炎性指标的数据挖掘研究

Data Mining Study on the Improvement of Lipid Metabolism and Immune Inflammation in Osteoarthritis by Chinese Traditional Medicine combined with Chinese Patent Medicine

目的应用关联规则、随机行走及统计学方法探究中药联合中成药对骨关节炎(OA)脂代谢、免疫炎性指标的干预改善作用。方法整理安徽中医药大学第一附属医院2010年12月—2020年6月OA患者的临床诊疗资料,分为单纯中药组和联合用药组,单纯用药组742例,联合用药组315例。结果(1)两组OA住院患者,在性别、年龄及住院天数方面比较,差异无统计学意义(P>0.05);(2)取两组使用频次前20味的中药,以利水消肿药、活血化瘀药、清热解毒药、清热利湿、祛寒湿药5类为主;聚类分析得出,当欧式距离为12时,可将药物分为3类;(3)与治疗前比较,单纯用药组对C_(3)、C_(4)、hs-CRP、IgA、IgG、ESR、LDL-C、TG、TC的下降具有统计学差异,联合用药组对C_(3)、C_(4)、hs-CRP、IgA、IgG、LDL-C、TG的降低的差异有统计学意义,对HDL-C的升高有统计学意义,两组治疗后相比联合用药组对C_(4)、IgG、ESR的降低较单纯用药组明显;(4)由关联规则分析得出中成药&红花关联于hs-CRP降低、中成药&红花关联于TG降低;(5)随机行走模型评价联合用药组hs-CRP、TG较对照组改善显著。结论中药联合中成药组对OA患者脂代谢、免疫炎性指标的改善效果优于单纯服用中药组。

Objective Association rules,random walk and statistical methods were used to explore the intervention and improvement of lipid metabolism and immune inflammation in osteoarthritis.Methods After sorting out the clinical diagnosis and treatment data of OA inpatients in the First Affiliated Hospital of Anhui University of Chinese Medicine from December 2010 to June 2020,according to the exclusion criteria,742 patients were divided into the single drug group and the combined drug group according to the treatment methods,including 742 patients and 315 patients.Results(1)there were no statistically significant differences between the two groups in terms of gender,age,length of stay(P>0.05).(2)The first 21 traditional Chinese medicines of the two groups were selected,and the five categories were mainly water and edema removing drugs,blood circulation and blood stasis removing drugs,heat clearing and antidotes,heat clearing and dampness removing drugs and cold and dampness removing drugs.Cluster analysis shows that when Euclidean distance is 12,drugs can be divided into three categories.(3)compared with before treatment,the simple drug group of C_(3),C_(4)and hs-,ESR,CRP,IgA,IgG,TG,TC,LDL-C decreased statistically difference,combination of C_(3),C_(4)and hs-CRP,IgA,IgG,TG,LDL-C,reduce the difference was statistically significant,to the rise of HDL-C was statistically significant,and the combination of C_(4),IgG,low ESR is pure medicine group obviously;(4)According to the analysis of association rules,it was concluded that Chinese patent medicine&Safflower was correlated with the decrease of HS-CRP and Chinese patent medicine&safflower was correlated with the decrease of TG.(5)Randomized walking model was used to evaluate that hS-CRP and TG were significantly improved in the combined treatment group compared with the control group.Conclusion The intervention effect of traditional Chinese medicine combined with Chinese patent medicine on the improvement and reduction of lipid metabolism and immune inflammation in OA patients was stronger than that of the group taking traditional Chinese medicine alone.