基于聚类分析和关联分析的脑性瘫痪中药用药规律研究

Medication of traditional Chinese medicine in cerebral palsy based on cluster analysis and correlation analysis

目的分析中药治疗脑性瘫痪的用药规律,为临床用药提供参考依据。方法检索中国知网、万方、维普、Pubmed、Web of science、Cochrane library等数据库,分别筛选中药内服、外用治疗脑性瘫痪的临床研究类文章,对内服、外用中药分别从使用频次、功效、药性和药味、归经等方面进行统计,并对高频中药进行聚类分析和关联分析。结果纳入文献205篇,涉及方剂206首,用法分为内服、外用2种。内服中药79首,四君子汤出现频次最多,147味中药纳入统计,使用频次较高的中药为当归、黄芪、茯苓、益智仁、川芎。外用中药方剂126首,108味中药纳入统计,使用频次最高的中药为伸筋草、透骨草、当归、红花、牛膝。内服中药中补虚药所占比例最大,为24.5%,外用中药中祛风湿药所占比例最大,为21.3%。内服及外用中药均以药性为温性者最多,分别占42.9%和46.3%。内服中药中出现频次较高的药物分别是甘味、辛味、苦味,外用中药中出现频次较高的药物分别是辛味、苦味、甘味。内服和外用中药均以归肝经、肾经、脾经为主。对高频药物进行关联分析和聚类分析,高频内服中药得出10对高频药物组合,高频外用中药得出10对高频药物组合。高频内服中药和外用中药均可形成3个聚类方。结论使用中药治疗脑性瘫痪时,内服中药多用补虚、祛风湿、解表类药物,外用中药则以祛风湿、补虚及活血化瘀药为主。高频中药关联分析和聚类分析的结果,可为临床用药提供一定的参考依据。

Objective To analyze the medication regularity of traditional Chinese medicine in the treatment of cerebral palsy, so as to guide clinical medication. Methods The databases of CNKI, Wanfang medical network, PubMed, Web of science and Cochrane library were searched to screen the clinical research articles on the treatment of cerebral palsy by oral and external use of traditional Chinese medicine. The statistics were made on the frequency of use, efficacy, property, taste and meridian tropism of internal and external use of traditional Chinese medicine, and the cluster analysis and correlation analysis were conducted on high-frequency traditional Chinese medicine. Results Two hundred and five research articles were included, involving 206 prescriptions. There were two kinds of usage: oral and external. There were 79 formulas for oral administration, and Sijunzi Decoction appeared most frequently. A total of 147 traditional Chinese medicines were included in the statistics, and Danggui(Angelica sinensis), Huagnqi(Astragalus membranaceus), Fulin(Poria cocos), Yizhiren(Fructus Alpiniae Oxyphyllae) and Chuanxiong(Rhizoma Chuanxiong) were used frequently. There were 126 prescriptions for external use, and 108 herbs were included in the statistics. The most frequently used herbs were Shenjincao(Herba Lycopodii), Tougucao(Herba Vaccinii Urophylli), Danggui(Angelica sinensis), Honghua(Flos Carthami) and Niuxi(Radix Achyranthis Bidentatae). The most frequently-used internal herbs were tonifying drugs, accounting for 24.5%, and The most frequently-used external Chinese medicine were wind-and dampness-dispelling drugs, accounting for 21.3%.The most commonly used Chinese herbal medicines for internal and external use were warm in nature, accounting for 42.9% and 46.3% respectively. The drugs with a higher frequency in oral Chinese medicine were sweet, pungent and bitter in taste, while the drugs with a higher frequency in external Chinese medicine were pungent, bitter and sweet. Both the internal and external use of traditional Chinese medicine were mainly for the liver, kidney and spleen meridians. Through correlation analysis and cluster analysis of high-frequency drugs, 10 pairs of high-frequency drug combinations can be obtained from high-frequency oral Chinese medicine and 10 pairs of high-frequency drug combinations can be obtained from high-frequency external Chinese medicine. Both high frequency oral and external Chinese medicine can form three clustering formulas. Conclusions In the treatment of cerebral palsy with traditional Chinese medicine, tonifying deficiency, expelling wind and dampness and relieving exterior syndrome drugs are mainly used for internal use, while dispelling wind-dampness, tonifying deficiency and promoting blood circulation and removing blood stasis drugs are mainly used for external use. The results of high frequency correlation analysis and cluster analysis can provide some reference and guidance for clinical medication.