膝骨性关节炎外敷中药方关联规则的研究

Study of externally applied traditional Chinese medicine prescription in treament of knee osteoarthritis on the association rules

目的:探讨治疗膝骨性关节炎的外敷中药方中各组成药物间的关联规则和用药规律,为临床应用中药外敷法治疗膝骨性关节炎提供循证医学依据。方法:应用计算机检索中国知网期刊全文数据库收录的1996年1月至2011年9月发表的关于中药外敷治疗膝骨性关节炎的文章,收集文章中所载的外敷用中药方128个,应用Access2003数据库软件,录入各药方的组成药物、剂量和用法,并记录文章发表的时间和期刊名称。对数据库中的数据进行统计、分析,找到使用频次最多的药物,然后进行关联规则计算。结果:128个膝骨性关节炎中药外敷方中,药物的总使用频次为1 491次,使用频次最多的15种药物依次为草乌、川乌、山药、当归等;关联规则计算后,支持度>16%、置信度>60%的药对共有6对,分别是川乌和草乌、乳香和没药、当归和牛膝、威灵仙和川乌、伸筋草和透骨草、伸筋草和红花。结论:中药外敷治疗膝骨性关节炎,外敷方的药物组成主要为具有温经散寒、搜风通络、活血散瘀、胜湿止痛、舒筋活络等功效的药物,临床可根据具体证型灵活配伍应用。

Objective ：To explore the association rules and pharmic method of externally applied traditional Chinese medicine （TCM） prescription in the treatment of knee osteoarthritis, so as to provide evidence from the standpoint of Evidence-Base-Medicine. Methods ： Literatures of external application of TCM in knee osteoarthritis published from January 1996 to September 2011 were retrieved from Science Direct On Site of China national knowledge infrastructure（CNKI） through computers. One hundred and twenty-eight kinds of externally ap- plied TCM prescriptions were collected from the literatures. The ingredients, dosage and usage of the 128 kinds of TCM were input into database through Access2003 software, and the publication dates of literatures and journal names were recorded. The drugs with the most times of usage were found through the statistics and analysis of the data in the database, then they were processed with association rules calculation. Results：The total frequency of the drugs in the 128 prescriptions was 1 491 ,and the following 15 kinds of drugs were found with the highest occurrence frequency as radix aconiti kusnezoffii, radix aconiti, dioscorea opposita, angelica sinensis, etc. The result of association rules calculation showed that there were following 6 couples of drugs with support above 16% and confidence above 60% as radix aconiti kusnezoffii coupled with radix aconiti, olibanum coupled with myrrha, angelica sinensis coupled with achyranthes bidentata, clematis chinchsis coupled with radix aconiti, herba lycopodii coupled with tuberculate speranskia herb and radix aconiti, herba lycopodii coupled with carthamus tinctorius. Conclusion： For external application of TCM in the treatment of knee osteoarthritis, the main phaimic ingredients of the prescriptions are the drugs with the effect of warming meridian and vessels, dispelling wind-evil,removing the wind, dredging collaterals, activating blood, removing blood stasis, eliminating dampness for relieving pain, relieving muscle and tendon and dredging the channels and collaterals, which can be compatible appllied flexibly according to the specific type of syndrome in clinic.