基于关联规则和复杂系统熵聚类的老年性股骨粗隆间骨折用药规律研究

Analysis on Medication Rule in Herbal Prescriptions for Senile Femoral Intertrochanteric Fracture

目的:分析老年股骨粗隆间骨折中药内服处方的用药规律。方法:搜集中国知网、重庆维普、万方、中国生物医学文献数据库2011—2016年治疗老年股骨粗隆间骨折的中药处方,采用TCMISS中医传承辅助平台软件提取分析处方中各药物的使用频次、四气五味归经、归类以及药物之间的关联规则等。结果:对232个中药处方进行分析,使用频率较高的中药有当归、红花、川芎、续断、桃仁、骨碎补、赤芍、牛膝、熟地黄、白芍等。药物的四气分布主要为温、平、凉;五味分布主要为苦、辛、甘;归经分布主要为肝、脾、心、肾;药物归类分布主要为伞形科、毛茛科、菊科。当归、红花、川芎、桃仁、熟地黄、白芍等均为临床治疗老年股骨粗隆间骨折最常用的中药。结论:中药治疗老年股骨粗隆间骨折以活血化瘀为主要治法,常用处方为桃红四物汤,关键药物组合是当归与红花,处方用药应以"活血通络不致血亏,养血化瘀不致脉损"为则。

Objective： To analyze the medication rule in herbal prescriptions for senile femoral in- tertrochanteric fracture. Methods： Herbal prescriptions for senile femoral intertrochanteric fracture were searched from Chinese National Knowledge Infrastructure, VIP database, Wanfang database and Chinese Biomedical Database, from 2011 to 2016. We used Chinese medicine inheritance support system （TCMISS） to analyze the frequency, four natures, five flavors, meridian entry, plant classification of drugs, and the association rules be- tween drugs. Results： Based on the analysis of 232 herbal prescriptions, herbs used with high frequency were Danggui （Radix Angelicae Sinensis）, Honghua （Flos Carthami）, Chuanxiong （Rhizoma Chuanxiong）, Xuduan （radix dipsaci）, Taoren （Semen Persicae）, Gusuibu （Rhizoma Drynariae）, Chishao （Radix Paeoniae Rubra）, Niuxi （Radix Achyranthis Bidentatae）, Shudihuang （Radix Rehmanniae Praeparata）, Baishao （Radix paeoniae Alba）, et al. Four natures of drugs were mainly consisting of warmth, neutral and coolness. Five flavors of drugs were mainly consisting of bitter, pungent and sweet. Meridian entries were mainly consisting of liver, spleen, heart and kid- ney. Plant classification of drugs was mainly consisting of Apiaceae, Ranunculaceae and Asteraceae. Danggui （Radix Angelicae Sinensis）, Honghua （Flos Carthami）, Chuanxiong （Rhizoma Chuanxiong）, Taoren （Semen Persi- cae）, Shudihuang （Radix Rehmanniae Praeparata）, Baishao （Radix paeoniae Alba） were the most commonly used traditional Chinese Medicine for senile femoral intertrochanteric fracture. Conclusion： The main principles of treatment for senile femoral intertrochanteric fracture is promoting blood circulation for removing blood stasis, the most commonly used traditional Chinese medicine prescription was Taohong Siwu Decoction （桃红四物汤）. The key drug combination are Dangui （Radix Angelicae Sinensis） and Honghua （Flos Carthami）. We emphasize the medication principle that the medicine should promote blood circulation, dredge blood vessels and prevent the loss of blood while nourish new blood, remove blood stasis but not damage blood vessels.