近20年中医药治疗骨关节炎临床用药规律分析

An analysis of clinical medication rule in traditional Chinese medicine treatment of osteoarthritis in recent 20 years

目的:通过数据挖掘探讨中医药治疗骨关节炎的用药规律。方法:检索中国知网、万方数据库、维普数据库中中医药治疗骨关节炎的文献,构建骨关节炎方药数据库,通过数据挖掘技术(频次统计、关联规则、聚类分析)对核心药物、核心处方进行分析。结果:筛选出符合条件的文献95篇,共纳入方剂251首,所用药物225味,使用频次共计3726次。用药频次排名前十的依次是当归、白芍、甘草、牛膝、黄芪、桂枝、熟地黄、鸡血藤、茯苓、川芎;药物性味以甘温为主,主归肝(胆)、脾(胃)两经。核心药物聚类分析结果形成9个类别。核心处方以四物汤和黄芪桂枝五物汤为主。结论:中医药治疗骨关节炎标本兼顾,本虚重在裨益肝肾,兼顾治脾,标实以祛风散寒、化痰除湿、活血祛瘀、通络止痛诸法为主。

Objective:To explore the medication rule in the traditional Chinese medicine(TCM)treatment of os⁃teoarthritis through data mining.Methods:CNKI,Wanfang Data,and VIP were searched for studies on TCM treat⁃ment of osteoarthritis to establish a database of prescriptions for osteoarthritis.Core drugs and core prescriptions were analyzed by data mining techniques(frequency statistics,association rules,and cluster analysis).Results:A total of 95 eligible studies were screened out,involving 251 prescriptions and 225 drugs,which were used a total of 3726 times.The ten most frequently used drugs were Angelica sinensis,Radix Paeoniae Alba,Radix Glycyrrhi⁃zae,Radix Achyranthis Bidentatae,Astragalus membranaceus,Ramulus Cinnamomi,prepared Radix Rehmanni⁃ae,Spatholobi Caulis,Poria cocos,and Rhizoma Chuanxiong.The flavor and nature of drugs were mostly sweet and warm,primarily acting on the liver(gallbladder)and spleen(stomach)meridians.The cluster analysis of core drugs suggested nine categories.The core prescriptions mainly included Siwu Decoction and Huangqi Guizhi Wuwu Decoc⁃tion.Conclusion:TCM treatment of osteoarthritis addresses both the symptoms and root causes;it benefits the liver and kidney,as well as treats the spleen,to improve deficiency in origin,and dispels pathogenic wind and cold,re⁃moves phlegm and dampness,activates blood circulation and removes blood stasis,and dredges collaterals and re⁃lieves pain to improve excess in superficiality.