芙蓉膏外敷联合中药治疗活动期痛风性关节炎的临床数据挖掘及关联规则研究

Study on clinical data mining and association rules in the treatment of active gouty arthritis with Furong ointment combined with traditional Chinese medicine

目的应用临床数据挖掘技术及关联规则分析芙蓉膏外敷联合中药治疗活动期痛风性关节炎对患者免疫、炎症及氧化指标的影响,为优化治疗提供依据。方法搜集并整理安徽省中医药大学第一附属医院病例采集系统所录入的急性痛风性关节炎湿热蕴结型患者的资料。采用SPSS22.0、SPSS Modeler 14.2软件和Aprior模块分析中药配伍、芙蓉膏治疗效果与实验室指标变化的关系。结果 (1)芙蓉膏组患者的住院时间小于中药组患者。(2)治疗后内治组患者的免疫指标补体C3(C3);炎症指标超敏C反应蛋白(hs-CRP)、α1酸性糖蛋白(α1-AGP);尿酸(UA)UA均有所降低,差异有统计学意义(P<0.05);内外合治组患者免疫指标补体C3、补体C4(C4)、免疫球蛋白A(Ig A);炎症指标血沉(ESR)、hs-CRP、α1-AGP;UA均有所降低,差异有统计学意义(P<0.05或P<0.01);内治组与内外合治组治疗前后实验室指标的差值t检验分析,内外合治组患者ESR、hs-CRP、α1-AGP、UA相对于内治组患者改善更为明显,差异有统计学意义(P<0.05);(3)所用中药多集中在健脾利湿、清热解毒、活血化瘀、祛风除湿四类,提取每类使用频次前五位的中药共20味;(4)在关联规则设定最小置信度为70%,最小支持度为20%。经Aprior模块分析,发现芙蓉膏与健脾利湿药配伍UA、C3、C4、Ig G、免疫球蛋白M(Ig M)下降及超氧化物歧化酶(SOD)上升关联,与活血药配伍与Ig A下降关联,与祛风除湿药配伍与α1-AGP下降关联,与清热解毒药配伍与ESR、CRP下降相关联。结论芙蓉膏外敷联合中药可改善活动期痛风性关节炎患者临床症状、实验室指标和缩短住院时间。

Objective To analyze the immune effects,inflammation and oxidative index in the treatment of ac- tive gouty arthritis in patients with Furong ointment combined with traditional Chinese medicine using the technology of clinical data mining and association rules and provide the basis for the optimization of treatment. Methods The acute gouty arthritis of damp heat accumulation type in the data acquisition system of the First Affiliated Hospital of Anhui Medical University were eolleeted and sorted. SPSS22.0, SPSS Modeler 14.2 and Aprior software module were used to analyze the relationship of traditional Chinese medicine, Furong ointment and changes of laboratory indexes. Results The length of stay of the patients in the lotus paste group was smaller than that of the traditional Chinese medicine group. The immune indexes of complement C3 group after treatment ; inflammatory markers hs-CRP, 1-AGP ; UA were lower, the difference was statistically significant （ P 〈 0.05 ） ; Combined internal and external treatment group of immune function in patients with C3, CA, IgA ; ESR hs-CRP, a marker of inflammation, 1 -AGP; UA were lower, the difference was statistically significant （ P 〈 0.05 ）. Combined internal and external treatment group＇s ESR, hs-CRP, alpha 1 -AGP, UA compared with the traditional internal group were improved more significantly, the difference was statistically significant （P 〈 0.05 ）. The use of traditional Chinese medicine and more concentrated in the spleen dampness, detoxification, blood stasis, Qufengchnshi four categories,each one of the top five frequency of use of traditional Chinese medicine 20 flavor; （4） set the minimum confidence as 70% in association rules, the minimum support for 20%. Aprior module anal- ysis found Furong ointment and compatibility of spleen dampness medicine UA, C3, C4, IgG, IgM and SOD decreased and increased, associated with the IgA compatibility with blood activating drugs associated with decreased drug compati- bility with alpha Qufengchushi 1-AGP and ESR decreased, and the compatibility of drug detoxification, CRP decline is associated. Conclusion Application of Furong ointment combined with traditional Chinese medicine can improve the activity of patients with gouty arthritis clinical symptoms, laboratory indicators, shorten the hospitalization time.