基于数据挖掘的中医药治疗糖皮质激素相关型股骨头坏死用药规律分析

Analysis of Medication Law of Traditional Chinese Medicine Treatment for Glucocorticoid-Associated Osteonecrosis ofFemoral Head Based on Data Mining

目的使用Excel软件和SPSS软件分析治疗糖皮质激素相关型股骨头坏死(glucocorticoid-associated osteonecrosis of the femoral head,GA-ONFH)的中医组方用药规律。方法收集近20年PubMed、EMbase、the Cochrane Library、CBM、CNKI、万方、维普中中医药治疗GA-ONFH的方剂,利用Excel软件分析GA-ONFH的证型、证候要素、方剂及用药频数、性味归经,挖掘药物的核心组成;用SPSS Clementine 12.0软件所提供的Apriori模板进行关联规则分析;用SPSS软件对药物的性味归经进行系统聚类分析、因子分析。结果从筛选出的53篇文章,共收集糖皮质激素相关型股骨头坏死证型16个,其中肾阳虚、肾虚血瘀、气滞血瘀为主要证型;证候要素8个,以肾虚、血瘀、痰浊为主要证候要素;方剂30余首,以右归饮、桃红四物汤、补肾活血汤为主;规则分析结果显示共得到药对关联规则9条,3味中药药组关联规则60条;聚类分析得到药组9个,因子分析适应型检验表明适合进行因子分析,共提取出7个公因子。关联规则体现出补肾活血的治法特点,在治疗GA-ONFH上以右归饮为基础进行配伍,佐以活血化瘀;聚类分析和因子分析共同体现出补肾助阳、活血化瘀的治法特点,此外因子分析尚可反应健脾益气、化痰除湿的特点。结论糖皮质激素相关型股骨头坏死的中药治疗的主要药物配伍是补肾助阳和活血通络,并以甘味,归肝、肾和脾、胃经的药物居多,这一结果将对中医临床治疗GA-ONFH提供相关理论指导。

Objective To use Excel software and SPSS software analysis to study the medication law of traditional Chinese medicine treatment for glucocorticoid-associated osteonecrosis of the femoral head necrosis(GA-ONFH).Methods Traditional Chinese medicine prescriptions for GA-ONFH in PubMed,EMbase,the Cochrane Library,CBM,CNKI,WanFang and WIP over the past 20 years were collected.The syndrome types,syndrome elements,prescriptions,medication frequency and nature and taste of GA-ONFH were analyzed by using Excel software to explore the core components of the drugs.Association rule analysis was conducted with the Apriori template provided by SPSS Clementine 12.0 software.SPSS software was used for systematic cluster analysis and factor analysis of the nature and tastes of drugs.Results A total of 16 hormone type femoral head necrosis syndrome types were collected from 54 articles,among which kidney Yang deficiency,kidney deficiency and blood stasis,Qi stagnation and blood stasis were the main syndrome types.There were 8 syndrome elements,with kidney deficiency,blood stasis and phlegm turbidity as the main syndrome elements.There were more than 30 prescriptions,mainly Yougui Decoction,Siwu Decoction and Bushen Huoxue Decoction.The results of rule analysis showed that there were 9 association rules of drug pairs and 60 association rules of 3 traditional Chinese medicine groups.Nine drug groups were obtained by cluster analysis,and the fitness test of factor analysis showed that it was suitable for factor analysis,and a total of 7 common factors were extracted.Association rules reflected the characteristics of the treatment of tonifying kidney and activating blood.In the treatment of GA-ONFH,the combination was based on Yougui Decoction,accompanied by activating blood and removing blood stasis.Cluster analysis and factor analysis showed the characteristics of tonifying kidney and promoting Yang,activating blood circulation and resolving blood stasis.In addition,factor analysis could reflect the characteristics of warming the meridians and dispelling cold as well as clearing damp and resolving phlegm.Conclusion The main drugs used in traditional Chinese medicine treatment of GA-ONFH are tonifying kidney and promoting Yang and activating blood circulation,and most of the drugs used in the treatment of liver,kidney,spleen and stomach meridians are sweet.This result would provide theoretical guidance for the clinical treatment of GA-ONFH in traditional Chinese medicine.