新风胶囊改善类风湿关节炎脾虚湿盛证患者感受的临床数据挖掘

Clinical Data Mining of Xinfeng Jiaonang(新风胶囊)in Improving the Feeling of Patients with Rheumatoid Arthritis with Spleen Deficiency and Dampness Excess Syndrome

目的:运用临床数据挖掘观察新风胶囊(XFC)对类风湿关节炎(RA)脾虚湿盛证患者感受(SPP)的影响。方法:填写安徽中医药大学第一附属医院风湿科RA脾虚湿盛证SPP评分量表,按照住院期间是否应用XFC治疗,分为中药组和中药+XFC组,运用关联规则、随机行走等方法分析XFC对SPP、实验室指标的影响。结果:①240例RA脾虚湿盛证患者口服中药主要分为健脾化湿类、清热解毒类、活血化瘀类及祛风除湿类。②与治疗前比较,2组RA患者脾虚湿盛证证候积分、28个关节疾病活动度评分(DAS28评分)、RA症状积分、视觉模拟评分法(VAS)评分、焦虑自评量表(SAS)评分、红细胞沉降率(ESR)、C反应蛋白(CRP)、类风湿因子(RF)、抗环瓜氨酸肽抗体(抗CCP抗体)等均显著下降(P<0.05),一般健康状况(GH)评分、生理职能(RP)评分、生理功能(PF)评分、躯体疼痛(BP)评分等均显著升高(P<0.05);与中药组治疗后比较,中药+XFC组脾虚湿盛证证候积分、RA症状积分、SDS评分、ESR、RP、MH、活力(VT)等指标显著改善(P<0.05)。③关联规则结果显示,XFC联合中药与SPP、实验室指标改善的支持度均>50%、置信度均>70、提升度均>1。④随机行走模型显示,中药+XFC组改善脾虚湿盛证证候积分、DAS28评分、MH和GH显著优于中药组,且与指标的改善存在长程关联。结论:XFC能显著改善SPP,降低免疫炎症指标,提高生活质量,其机制有待进一步研究。

Objective:To observe the effect of Xinfeng Jiaonang(新风胶囊,XFC)on the feeling of patients with rheumatoid arthritis(RA)with spleen deficiency and dampness excess syndrome using clinical data mining.Methods:Fill in the score scale for RA spleen deficiency and dampness excess syndrome in the Rheumatology Department of the First Affiliated Hospital of Anhui University of Chinese medicine.Patients were divided into Chinese medicine group(CM group)and Chinese medicine and XFC group(CM+XFC group).The effects of XFC on the score scale and laboratory indexes were analyzed by association rules and random walking method.Results:①Two hundred and forty patients with spleen deficiency and dampness excess syndrome of RA were treated with oral Chinese medicine mainly divided into invigorating the spleen and removing dampness,clearing heat and detoxification,promoting blood circulation and removing blood stasis,dispelling wind and dehumidification.②Compared with before treatment,the syndrome score of spleen deficiency and dampness excess,28 joint disease activity score(DAS28 score),RA symptom score,visual analogue scale(VAS),self-rating Anxiety Scale(SAS),erythrocyte sedimentation rate(ESR),C-reactive protein(CRP),rheumatoid factor(RF)and anti cyclic citrullinated peptide antibody(anti CCP antibody)of RA patients in the two groups decreased(P<0.05).The general health(GH),physiological function(PF),and body pain(BP)were significantly increased(P<0.05);Compared with the CM group after treatment,the spleen deficiency and dampness syndrome score,RA symptom score,SAS,ESR,RF,MH,vitality(VT)and other indexes in the CM+XFC group were significantly improved(P<0.05).③The results of association rules showed that the support,confidence and improvement of XFC combined with Chinese medicine,score scale and laboratory indicators were more than 50%,70 and 1 respectively.④The random walking model showed that the CM+XFC group improved the syndrome score of spleen deficiency and dampness excess,DAS28 score,MH and GH significantly better than the CM group,and there was a long-term correlation with the improvement of indicators.Conclusion:XFC can significantly improve spleen deficiency and dampness excess syndrome,reduce immune and inflammatory indexes and improve quality of life,whose mechanism needs to be further studied.