基于国家专利的中药复方治疗膝骨关节炎的用药规律研究

Study on the medication rule of traditional Chinese medicine compounds with national patents for the treatment of knee osteoarthritis

目的分析基于国家专利的中药复方治疗膝骨关节炎(knee osteoarthritis,KOA)的用药规律,为临床诊治及新药复方研发提供参考。方法通过检索国家知识产权局专利库获取自2001年1月至2022年6月治疗KOA的内服中药复方专利,对其规范、整理后,进行用药频数、类别及性味归经分析,关联规则分析,聚类分析及构建中药共现网络,提取核心药物,总结用药规律。结果共纳入105项治疗KOA的专利复方,包含278味中药,累积用药频次1387次。高频中药主要有牛膝、当归、骨碎补、甘草、川芎及独活等,药物类别主要以活血化瘀药、补虚药及祛风湿药比例最高。药性以温性为主,药味以辛、甘、苦为主,主归肝经、肾经、脾经。关联规则结果显示主要有9个药物组合,其中菟丝子与牛膝为核心药物配伍。聚类分析可得到8类中药组方。结论KOA与肝、肾、脾三脏有关,多为本虚标实之证。治疗本病的核心药物为牛膝、杜仲、当归等,治则为扶正祛邪;临床治疗以补益肝肾、强筋健骨、活血通络、祛风除湿为主。

Objective To analyze the medication rule of knee osteoarthritis(KOA)based on national patent,and provide reference for clinical diagnosis and treatment and research and development of new drug compounds.Methods By searching the Chinese patent database,the patents of oral Chinese medicine compounds for KOA from January 2001 to June 2022 were obtained.After standardizing and sorting it out,the frequency,category,taste and tropism analysis,association rule analysis,cluster analysis and the construction of the co-occurrence network were carried out to extract the core drugs and summarize the law of drug use.Results A total of 105 patent prescriptions for KOA were included,including 278 Chinese medicines,with a cumulative frequency of 1387 times.High-frequency Chinese medicines mainly included Niuxi,Danggui,Gusuibu,Gancao,Chuanxiong,and Duhuo,among which drugs for promoting blood circulation and removing blood stasis,tonic drugs and rheumatism drugs had the highest proportion.The nature of medicine was mainly warm,and the taste of medicine was mainly pungent,sweet and bitter,which belonged to the liver meridian,kidney meridian,and spleen meridian.The results of association rules showed that there were 9 drug combinations,among which Tusizi and Niuxi were the core drugs.Eight kinds of TCM prescriptions can be obtained by cluster analysis.Conclusion KOA was related to the liver,kidney,and spleen.It was characterized by deficiency in essence and excess in outer.The core drugs for the treatment of this disease were Niuxi,Duzhong,Danggui,etc.The treatment principle is strengthening vital qi to eliminate pathogenic factor.The commonly used clinical methods were tonifying the liver and the kidney,strengthening tendons and bones,promoting blood circulation and dredging collaterals,and expelling wind and removing dampness.