陈纪藩治疗强直性脊柱炎的组方用药规律探讨

Prescription and Medication Rules for Ankylosing Spondylitis Treated by CHEN Ji-Fan

收集陈纪藩教授门诊治疗强直性脊柱炎的有效病例的中药处方,采用中医传承辅助平台(V2.5)录入处方,通过关联规则分析和复杂系统熵聚类等方法,分析陈纪藩教授治疗强直性脊柱炎的组方规律,探索新组方。结果共纳入278首中药处方,使用中药95味;用药频次大于50次的有17味,其中杜仲、牛膝、七叶莲、桑寄生、巴戟天、炙甘草、丹参、宽筋藤、川萆薢、茯苓、鹿衔草等11味中药使用频次超过100次,为高频用药;高频药对组合124组,强关联组合56个,从中推演得到核心组合12个,新组方6首。分析结果提示陈纪藩教授治疗强直性脊柱炎的处方用药以攻补兼施为原则,重在补益肝肾、利湿化痰,辅以祛风除湿、渗利湿邪、活血化瘀,以达到缓解症状、预防筋伤骨损、调理体质的治疗目标。分析结果可为临床治疗强直性脊柱炎提供参考。

The prescriptions for the ankylosing spondylitis outpatients effectively treated by professor CHEN JiFan were collected, and the data of the prescriptions were input to Traditional Chinese Medicine Inheritance Support Platform System(V2.5). Methods of association rule analysis and complex system entropy-based clustering were applied for the exploration of the prescription and medication rules for ankylosing spondylitis treated by professor CHEN Ji-Fan. The analysis results showed that a total of 278 prescriptions were obtained and the medication involved 95 kinds of herbs. Of the 95 herbs,17 herbs had the medication frequency over 50 times,and the 11 herbs with the medication frequency over 100 times were Cortex Eucommiae, Radix Achyranthis Bidentatae, Caulis et Folium Schefflerae Arboricolae, Herba Taxilli, Radix Morindae Officinalis, Radix Glycirrhizae Preparata, Radix Salviae Miltiorrhizae, Caulis Tinosporae Sinensis, Rhizoma Dioscoreae Hypoglaueae,Poria,and Herba Pyrolae,which were the frequenctly-used herbs for the treatment of ankylosing spondylitis. There were 124 frequently-used herbal pairs for the treatment of ankylosing spondylitis,and 56 herbal combinations were highly associated. A total of 12 core herbal combinations were obtained, and then 6 new candidate prescriptions for ankylosing spondylitis were derived from the core herbal combinations. The analysis results indicated that the therapeutic principles for ankylosing spondylitis treated by professor CHEN Ji-Fan were to purge and to tonify simultaneously, which were characterized by tonifying liver and kidney, draining dampness and resolving phlegm,assisted by dispelling wind and eliminating dampness,inducing diuresis and draining dampness,and activating blood and resolving stasis. The simultaneous utilization of purging and tonifying therapy can achieve the actions of relieving the symptoms, preventing the injury of tendons and bones, and improving the physique. The analysis results will provide a reference for clinical treatment of ankylosing spondylitis.