中药治疗类风湿关节炎用药特点初探

On Medication Characteristics of TCM for Rheumatoid Arthritis

目的:探究中药治疗类风湿关节炎潜在用药规律,为临床治疗类风湿关节炎提供中药用药参考。方法:检索口服中药治疗类风湿关节炎的中英文数据库文献,通过统一的纳入标准、排除标准,合并和删除重复文献,采用聚类统计分析类风湿关节炎的中药用药潜在规律。结果:从57篇有效文献中整理出使用频率最高的前30味中药依次是:桂枝、川芎、甘草、当归、没药、栀子、伸筋草、牛膝、川乌、附子、麻黄、细辛、防风、秦艽、鸡血藤、三七、全蝎、地龙、草乌、土鳖虫、熟地黄、淫羊藿、白芍、桑寄生、苍术、延胡索、威灵仙、姜黄、土茯苓、穿山甲。结论:文献中中药治疗类风湿关节炎的主要功效以祛风散寒、缓急止痛(桂枝、川芎、甘草),活血通络、祛瘀消肿(当归、没药、牛膝、土鳖虫、延胡索,姜黄),清热泻火、凉血止痛(栀子),温经散寒、祛风除湿通痹(伸筋草、川乌、附子、麻黄、细辛、防风、秦艽、草乌、苍术、威灵仙、土茯苓),消肿止痛、舒筋活络(鸡血藤、三七、全蝎、地龙、白芍),以及温肾助阳、强筋健骨(熟地黄、淫羊藿、桑寄生)类中药为主,而禁用的穿山甲频次最少。

Objective:To explore the potential law of medication in traditional Chinese medicine(TCM)in the treatment of rheumatoid arthritis to provide clinical reference.Methods:Chinese and English literature on treating rheumatoid arthritis with oral administration of Chinese medicine was searched.After screening,the standard literature was analyzed by clustering analysis to find the potential law of medication.Results:Thirty Chinese medicines with the highest frequency of use out of 57 literature were as follows:Guizhi(Ramulus Cinnamomi),Chuanxiong(Rhizoma Chuanxiong),Gancao(Radix et Rhizoma Glycyrrhizae),Danggui(Radix Angelicae Sinensis),Moyao(Myrrha),Zhizi(Fructus Gardeniae),Shenjincao(Herba Lycopodii),Niuxi(Radix Achyranthis Bidentatae),Chuanwu(Radix Aconiti),Fuzi(Radix Aconiti Lateralis Praeparata),Mahuang(Herba Ephedrae),Xixin(Radix et Rhizoma Asari),Fangfeng(Radix Saposhnikoviae),Qinjiao(Radix Gentianae Macrophyllae),Jixueteng(Caulis Spatholobi),Sanqi(Radix et Rhizoma Notoginseng),Quanxie(Scorpio),Dilong(Pheretima),Caowu(Radix Aconiti Kusnezoffii),Tubiechong(Eupolyphaga seu Steleophaga),Shudihuang(Radix Rehmanniae Praeparata),Yinyanghuo(Herba Epimedii),Baishao(Radix Paeoniae Alba),Sangjisheng(Herba Taxilli),Cangzhu(Rhizoma Atractylodis),Yanhusuo(Rhizoma Corydalis),Weilingxian(Radix et Rhizoma Clematidis), Jianghuang( Rhizoma Curcumae Longae),Tufuling(Rhizoma Smilacis Glabrae)and Chuanshanjia(Squama Manitis).Conclusion:The main efficacy and related Chinese medicines are as follows:Dispelling wind cold,relieving pain (Guizhi,Chuanxiong,Gancao);activating blood circulation and dredging collaterals,removing blood stasis and relieving swelling(Danggui,Moyao,Niuxi,Tubiechong,Yanhusuo,Jianghuang);clearing heat and purging fire,cooling blood and relieving pain(Zhizi);warming meridians and dispelling cold,dispelling wind,removing dampness and dredging bi(Shenjincao,Chuanwu,Fuzi,Mahuang,Xixin,Fangfeng,Qinjiao,Caowu,Cangzhu,Weilin gxian,Tufuling);relieving swelling and pain,relaxing tendons and activating collaterals(Jixueteng,Sanqi,Quanxi e,Dilong,Baishao);warming kidney to strengthening yang,strengthening tendons and bones(Shudihuang,Yinyan ghuo,Sangjisheng).Chuanshanjia is rarely used.