基于关联规则与熵聚类分析的髋关节置换术后外敷方用药规律研究

Study on Medication Rules of External Application Prescription after Hip Replacement Based on Association Rules and Entropy Cluster Analysis

目的:分析髋关节置换术后疼痛肿胀的外敷方用药规律。方法:通过检索万方、重庆维普、中国知网、中国生物医学文献数据库搜集2011—2018年含全髋及股骨头置换术后外敷药物的处方。使用中医传承辅助平台软件(TCMISS)对收集到的处方中各药物的使用频次、四气五味归经、归类进行统计分析,并且分析各药物之间的关联规则。结果:共搜集分析处方101条,其中使用频率较高的中药有红花、伸筋草、透骨草、乳香、海桐皮、当归、牛膝、威灵仙、没药等。其中,温、平为药物的主要四气分布;辛、苦、甘为主要的五味分布,主要归经为肝经、脾经及肾经。药物科属主要为伞形科、毛茛科、菊科。结论:髋关节置换术后外敷方以“活血化瘀,舒筋通络,兼以养血补血”为主要治法;常用药物为红花、伸筋草、透骨草、乳香、海桐皮、当归、牛膝、威灵仙、没药;关键药物组合为红花与舒筋草;处方用药以“行气活血祛瘀,舒筋通络止痛,补血养血生血”为治则。

Objective:To analyze the medication rules of external application prescription for pain and swelling after hip replacement.Methods:The prescriptions containing the drugs for external application after total hip and femoral head replacement were retrieved from 2011 to 2018 in Wanfang,VIP,CNKI and CBM.The frequency,four natures and five flavors,meridian tropism and the classifications of the drugs in the collected prescriptions were statistically analyzed using TCMISS,and association rules between different herbs were analyzed.Results:All 101 pieces of prescriptions were collected and analyzed,among them,the drugs with higher frequency were red flower(Carthami flos),Shenjincao(Herba Lycopodii),Tougucao(Speranskiatuberculata(Bunge)Baill),Ruxiang(Olibanum),Haitongpi(Cortex Erythrinae),Danggui(Angelicae Sinensis Radix),Niuxi(Radix Achyranthis Bidentatae),Weilingxian(Radix Clematidis)and myrrh.The drugs were warm and neutral in light of four natures;spicy,bitter and sweet according to five flavors,mainly entered into the meridians of liver,spleen and kidney,and mainly belonged to umbelliferae,ranunculaceae and compositae.Conclusion:External application prescription mainly adopts“blood-activating stasis-eliminating,tendon-relaxing collateral-dredging,and nourishing blood”as the main therapeutic method after hip replacement;the common drugs contain Honghua,Shenjincao,Tougucao,Ruxiang,Haitongpi,Danggui,Niuxi,Weilingxian and Moyao;key drug combinations are Honghua and Shenjincao;the prescriptions use the drugs of“moving qi,activating blood and eliminating stasis,relaxing tendon,dredging collaterals and relieving pain,tonifying blood,nourishing blood and producing blood”.