方坚治疗腰椎间盘突出症用药规律探讨

Discussion on the Medication Rules of FANG Jian in the Treatment of Lumbar Disc Herniation

【目的】采用数据挖掘方法探讨方坚教授治疗腰椎间盘突出症的组方用药规律。【方法】收集整理方坚教授于2014年3月至2021年1月门诊收治且有效的腰椎间盘突出症患者的病案资料,基于中医传承辅助平台(V3.0)的统计分析功能模块对中医证型分布及处方药物的四气五味、归经、功效分类等进行统计;基于平台的方剂分析功能模块进行药物的关联规则分析与聚类分析,以探讨其用药模式及提取核心药物组合。【结果】共得到方坚教授治疗腰椎间盘突出症的处方981首,涉及中药191味。处方药物使用频次≥100次的药物有24味,居前10位的中药为当归、熟地黄、淫羊藿、桂枝、牛膝、炙甘草、茯苓、鸡血藤、木瓜、白术;所用药物性味多甘温,主要归肝、脾、肾经;药物按其功效主要可归为补虚类、活血化瘀类、祛风湿类、解表类、利水渗湿类等。关联规则分析与聚类分析结果显示,常用药物组合有14个,药物组合关联规则有22条,核心方药组合7个。【结论】方坚教授治疗腰椎间盘突出症具有从肝脾肾论治、重视养血补虚、兼顾活血祛湿的用药特点,其用药规律可为中药治疗腰椎间盘突出症的临床用药提供参考。

Objective To explore the medication rules of Professor FANG Jian in the treatment of lumbar disc herniation based on the data mining method.Methods The clinical data of the effective cases of outpatients with lumbar disc herniation treated by Professor FANG Jian from March 2014 to January 2021 were collected and collated.The statistical analysis of the distribution of tradition Chinese medicine(TCM)syndrome patterns,and the properties and flavors,meridian tropism and therapeutic-action classification of the prescription drugs was conducted based on the statistical analysis function module of the Traditional Chinese Medicine Inheritance Support System(V3.0)platform.The platform's prescription analysis function module was used to perform association rule analysis and cluster analysis for the exploration of the drug use patterns and the extraction of the core drug combinations.Results A total of 981 prescriptions for lumbar disc herniation treated by Professor FANG Jian were obtained,involving 191 Chinese medicines.There were 24 herbs with the frequency≥100 times,and the top10 herbs were Angelicae Sinensis Radix,Rehmanniae Radix Praeparata,Epimedii Folium,Cinnamomi Ramulus,Achyranthis Bidentate Radix,Glycyrrhizae Radix et Rhizoma Praeparata cum Melle,Poria,Spatholobi Caulis,Chaenomelis Fructus,and Atractylodis Macrocephalae Rhizoma.The drugs used were mostly sweet in flavor and warm in nature and mainly had the meridian tropism of the liver,spleen and kidney meridians.According to their efficacy,the drugs can be classified as herbs for supplementing the deficiency,herbs for activating blood and resolving blood stasis,herbs for dispelling wind-damp,herbs for releasing the exterior,herbs for promoting urination and draining dampness.The association rule analysis and cluster analysis yield14 commonly-used drug combinations,22 drug combination association rules and 7 core prescription combinations.Conclusion The medication rules of Professor FANG Jian in treating lumbar intervertebral disc herniation are characterized by the thoughts of treatment from the perspective of liver,spleen and kidney,and by mainly adopting the herbs for emphasis on nourishing blood and supplementing deficiency,together with the herbs for activating blood to dispel dampness.The medication rules will provide reference for the clinical use of Chinese medicine in the treatment of lumbar disc herniation.