中药治疗慢性痛风性关节炎的规律及其Logistic回归分析

Treatment regularity with traditional Chinese medicine for chronic gouty arthritis and its Logistic regression analysis

目的研究中药治疗慢性痛风性关节炎的用药规律,建立中药特征与治疗慢性痛风性关节炎效应的数学模型,为临床用药提供参考。方法检索近30年公开发表的临床疗效良好的中药治疗慢性痛风性关节炎文献,对文献中出现的115味中药中使用频率最高的前50味药的功效、归经、药性和药味进行统计,并建立多元Logistic回归数学模型。结果补虚药的使用率较高,其使用率为21.65%,归经统计中归肝经的使用率为21.12%,药味统计中味甘的使用率为30.50%,药性统计中性温的使用率为45.97%。采用逐步Logistic回归综合筛选主要因素,表明归肺经、小肠经的药和苦味、辛味、性寒的药是慢性痛风性关节炎中药方剂的重要成分(回归系数>0,且P<0.05)。结论运用多因素Logistic回归分析可探寻中医治疗慢性痛风性关节炎的用药规律,分析影响疗效的主要因素。高频药是其所在功效、归经的代表用药,临床选方可参考。

Objective From modem medical research literatures to analyze the treatment regularity of traditional Chinese medicine for chronic gouty arthritis and to establish a mathematic model in order to provide a reference for clinical medication use. Method The articles of chronic gouty arthritis treatment during the past 30 years were collected. 50 medicines were identified as high frequently used in 115 prescriptions for chronic gouty arthritis. Their different function, channel entry, property and flavor were summarized. A Logistic mathematic model was established on the multivariate analysis. Result Above all these medicines, Tonics for deficiency syndromes （21.65%）, liver meridian （21.12%）, sweet flavor （30.50%） and warm-natured （45.97%） were relatively active for treatment of chronic gouty arthritis. According to the observation of logistic regression screen, Lung meridian, small intestine meridian, bitter taste, pungent and cold- natured taste were important factors with therapeutic effect on chronic gouty arthritis （regression coefficient〉0 and P〈 0.05）. Conclusion There are certain relationships between Chinese medicine characteristics and its therapeutic effect on chronic gouty arthritis. The high frequency medicines are the representative on treatment of chronic gouty arthritis and they provide an important reference for clinician.