治疗膝骨关节炎的中成药的组方规律分析

Analysis of Formulation Regularity of Chinese Patent Medicine for Knee Osteoarthritis

目的:分析治疗膝骨关节炎的中成药的组方规律,为其临床规范使用及治疗膝骨关节炎的新药研发提供参考。方法:收集2015年版《中国药典》(一部)、2017年版《国家医保目录》、2017年版《国家基本药物目录》、1992年版《卫生部药品标准中药成方制剂》、2002年版《国家中成药标准汇编》、2010年版《外科与骨伤科中成药合理应用手册》中功能主治出现"膝骨关节炎""骨关节炎""痹症""活血化瘀、祛风除湿、补益肝肾"的中成药品种及处方,并采用临床专家问卷调查的方法补充治疗膝骨关节炎的中成药品种及处方,然后借助中医传承辅助平台V 2.5软件对中成药处方中使用的药材种类、性味、归经、用药频次及药材组合进行统计,并使用关联规则与熵聚类的方法进行组方规律分析。结果:共收集190种中成药,涉及中药289味。用药频次排名前10的依次为当归(75次)、乳香(55次)、红花(53次)、没药(51次)、牛膝(49次)、羌活(47次)、独活(45次)、防风(45次)、白芷(39次)、川芎(39),药材性味以辛温为主,主归肝脾两经;常用药材组合出现频率排名前5的依次为没药-乳香、乳香-当归、当归-羌活、牛膝-当归、川芎-当归;共挖掘出核心药材组合14个及新方组合7首。结论:本研究借助中医传承辅助平台V 2.5软件对治疗膝骨关节炎中成药的组方规律进行分析,可为临床辨证用药以及相关新药的研发提供参考。

OBJECTIVE:To analyze the formulation regularity of Chinese patent medicine for knee osteoarthritis(KOA),and to provide reference for the clinical standard use of Chinese patent medicine for KOA and the research and development of new drugs.METHODS:Chinese Pharmacopoeia(2015 edition,part I),National Drug Reimbursement List(2017 edition),National Essential Drug List(2017 edition),Chinese Materia Medica Preparation(1992 version),Compilation of National Standard for Chinese Patent Medicines(2002 edition),Handbook of Rational Application of Chinese Patent Medicines in Surgery and Orthopedics(2010 edition)were searched to collect the type and formulation of Chinese patent medicines for "KOA","osteoarthritis","Bi syndrome","promoting blood circulation and removing blood stasis,dispelling wind and removing dampness,tonifying liver and kidney".Supplementary the type and formulations of Chinese patent medicines for KOA by questionaire survey of clinial experts.The types,properties,meridian tropism,frequency and combination of medicinal materials used in Chinese patent medicine formulations were counted by using TCM inheritance auxiliary platform software V 2.5.The association rules and entropy clustering method were used to analyze the formulation regularity.RESULTS:A total of 190 Chinese patent medicines were collected,involving 289 TCM.With the top 10 used frequency being Angelica sinensis(75 times),Boswellia carterii(55 times),Carthamus tinctorius(53 times),Commiphora myrrha(51 times),Achyranthes bidentata(49 times),Notopterygium incisum(47 times),Angelica pubescens(45 times),Saposhnikovia divaricata(45 times),Angelica dahurica(39 times),Ligusticum chuanxiong(39 times).Medicinal material were mainly Xinwen in properties field and mainly liver meridian and spleen meridian in meridian entry field.Top 5 frequency of medicinal material combinations were C. myrrha-B.carterii,B.carterii-A.sinensis,A.sinensis-N.incisum,A.bidentata-A.sinensis,L.chuanxiong-A.sinensis.14 core medicinal material combinations and 7 new developed formulations were concluded.CONCLUSIONS:This study analyzed the formulation regularity of Chinese patent medicines for KOA with the help of TCM inheritance auxiliary platform software V 2.5,which can provide reference for clinical differentiation of symptoms and signs and research and development of related new medicines related to KOA.