近30年中药外用治疗痛风性关节炎用药规律研究

Study on the Medication Rules of External Use of Herbal Medicines for Gouty Arthritis Based on Nearly Thirty Years of Literature

目的通过搜集中药外用治疗痛风性关节炎文献中的选方用药,探索用药规律和组方原则,为临床提供参考依据。方法收集、整理1990年至2019年中英文数据库内中药外用治疗痛风性关节炎的临床文献,将符合要求的文献建立数据库,应用SAS9.1统计分析软件对中药频数、功效分类的高频药物、敷溶介质等进行频次统计,运用关联规则算法得出核心药物组合,并深度分析得出外治痛风的用药规律。应用SPSS25.0数据软件对频数大于20的高频药物进行聚类分析,以挖掘潜在药物组方。结果共纳入215首处方,涉及232味中药,总频数1725次。中药频数前5位是大黄、黄柏、冰片、苍术、白芷;最常用功效前三类为清热药、活血化瘀药、祛风湿药,并对药物功效细化。敷溶介质常用且有效的为蜂蜜、醋、凡士林。根据关联规则得出核心药物组合10对。聚类分析出5个药物组方。结论中药外用治疗痛风性关节炎的用药,总治则以清热利湿,化瘀止痛为主,兼有解表散结。

Objective:To explore the prescription rules and principles of traditional Chinese medicine for external use in the treatment of gouty arthritis by collecting the prescriptions in literature on external use of herbal medicines for gouty arthritis,so as to provide reference for clinical medication.Methods:The clinical literatures on relevant external application of traditional Chinese medicine for treating gouty arthritis were collected and reorganized from Chinese and English databases from 1990 to 2019.The databases were established according to the included literature.Based on the Statistical Analysis System 9.1,the frequency of each herbs,high-frequency medicines in accordance with the efficacy classifications,solution medium were counted,and the medicine core combinations and medication rules of external treatment of gouty arthritis were analyzed with association rule algorithm.Based on SPSS 25.0,the potential composition of prescription were concluded by clustering analysis of more than20 high frequency drugs.Results:215 prescriptions were included,containing 232 Chinese herbs and 1725 frequencies.The top five Chinese herbal medicines were rhubarb,cork,borneol,atractylodes,and angelica;the top three kinds of frequently used drugs by the efficacy were for clearing heart,dispelling rheumatism,activating blood and resolving stasis,and precipitating medicinal,and they were refined in drug efficacy;the most frequently and effectively solution mediums were honey,vinegar and vaseline.10 medicine core combinations were analyzed by association rules,and 5 potential composition of prescription were concluded by cluster analysis methods.Conclusion:The importance herbs of external use on the treatment of gouty arthritis are clearing heat and removing humidity,and dissipating blood stasis and relieving pain;the herbs of dispelling surface evil and resolving accumulation are of secondary importance.