国医大师李济仁教授治疗类风湿关节炎用药规律研究

Study on Medication Laws of TCM Master LI Ji-ren in Treating Rheumatoid Arthritis

目的分析国医大师李济仁教授治疗类风湿关节炎的辨证思路与用药规律,为临床用药提供参考。方法收集李济仁教授2014年1月-2015年6月于皖南医学院第一附属医院门诊治疗类风湿关节炎的医案。采用SPSS18.0统计软件对纳入数据进行频数分析、相关性分析、聚类分析。结果纳入医案共涉及患者123例、处方199张、211味药物。用药总频次为3503次,其中高频(>10%)药物52味,有黄芪、当归、全蝎、鸡血藤、大血藤等。高频药物归足厥阴肝经的有36味(69.2%),其次为足少阴肾经21味(40.4%)、足太阴脾经20味(38.5%)、手少阴心经16味(30.8%)等;高频药物药性以甘、辛、苦为主;高频药物主要为清热药、补益药(包括补气药、补血药、补阳药、补阴药)、活血化瘀药、祛风湿药;高频药物中有127对药物呈正相关,其中相关系数>0.9的有36对药物;高频药物聚类分析主要分为6大类。结论本研究用药规律与李济仁教授治疗类风湿关节炎重视固本培元、偏于寒热、祛风除湿、活血化瘀止痛等思想相符合,可为临床提供参考。

Objective To analyze dialectical thinking and medication laws of TCM master LI Ji-ren in treating rheumatoid arthritis(RA);To provide references for clinical medication.Methods Medical cases of RA in outpatient department of the First Affiliated Hospital of Wannan Medical College during January2014to June2015treated by Professor LI Ji-ren.SPSS18.0statistical software was used to carry out frequency analysis,correlation analysis,and cluster analysis.Results The included medical cases covered123cases,199prescriptions and211kinds of medicine.The total medication frequency was3503,with52kinds of high frequency medicine(>10%),including Astragali Radix,Angelicae Sinensis Radix,Scorpio,Spatholobi Caulix,and Sargentodoxae Caulix.36kinds of medicine belonged to Liver Meridian of Foot-Jueyin(69.2%);21kinds of medicine belonged to Kidney Meridian of Foot-Shaoyin(40.4%);20kinds of medicine belonged to Spleen Meridian of Foot-Taiyin(38.5%);16kinds of medicine belonged to Heart Meridian of Hand-Shaoyin(30.8%).High frequency medicine was mainly to be sweet,spicy and bitter.High frequency medicine was mainly to be medicine with the functions of clearing heat,tonifying(tinifying qi,blood,yang and yin),activating blood and expelling stasis,and expelling rheumatism.127pairs of high frequency medicine was in positive correlation,among which36pairs showed the correlation coefficient>0.9.High frequency cluster analysis could be mainly divided into6categories.Conclusion The medication laws in this study and Professor LI Ji-ren's treatment for RA emphasize consolidating basis,and are in accordance with the ideas of expelling wind and humidity,activating blood and expelling stasis and stopping pain,which can provide references for clinic.