基于中医传承辅助平台研究寒湿痹阻型膝骨关节炎的用药规律

Study on the medication law of cold dampness obstruction type knee osteoarthritis based on Traditional Chinese Medicine Inheritance Support System

目的:膝骨关节炎是一种常见的退行性疾病,以膝关节周围骨质增生、软骨磨损为主要表现的病理表现,影像学表现主要为关节间隙狭窄、骨质增生、软骨下骨质硬化等。随着我国老龄化社会现状日益加重,膝骨关节炎发病率及人民的疾病负担也会随之增高。本研究基于中医传承辅助平台V2.5分析寒湿痹阻型膝骨关节炎的用药规律,探求中医中药个性化、阶梯化治疗,可为中医骨伤科临床提供参考。方法:整理在中国知网、中国生物医学文献数据库、维普、万方数据库中治疗寒湿痹阻型膝骨关节炎的内服方剂;应用中医传承辅助平台管理系统V2.5构建组方数据库;并利用该平台的关联规则Apriori算法、改进的互信息法、复杂系统熵聚类等方法进行数据统计和分析。结果:共纳入处方49首,包含中药109味。处方中使用频次≥12的中药18味;其中温性药使用频次最高;归经以肝经、脾经、肾经为主。频次≥12的药物组合28个;衍化得到核心药物组合10个,新方5个。结论:寒湿痹阻型膝骨关节炎的外邪主要为寒邪、湿邪入侵。寒湿痹阻型膝骨关节炎用药以祛风湿、补肝肾、强筋骨及健脾化湿等中药配伍为主,其组方多为温经散寒、养血通脉的组方规律。

Objective:Knee osteoarthritis(KOA)is a common degenerative disease,with bone hyperplasia and cartilage wear around the knee joint as the main pathological manifestations,imaging manifestations mainly joint space stenosis,bone hyperplasia,subchondral osteosclerosis,etc..With the increasing status quo of China’s aging society,the incidence of KOA andO the disease burden of the people will also increase.Based on the Traditional Chinese Medicine Inheritance Support System,this study analyzes the medication rules of KOA with cold dampness obstruction type,and explores the personalized and stepped treatment of TCM,which can provide a reference for the clinical practice of orthopedics and traumatology of TCM.Methods:The internal prescription of cold dampness obstruction type KOA was collected from CNKI,CBM,VIP,Wanfang databases,TCMISS(V2.5)was used to construct the prescription database,and the data statistics and analysis were conducted by using the association rule Apriori algorithm,improved mutual information method,complex system entropy clustering and other methods of the platform.Results:A total of 49 prescriptions were included,including 109 TCM medicines.A total of 18 TCM medicines with frequency≥12 in the prescription;warm medicine were used most frequently.The meridians are mainly liver meridians,spleen meridians and kidney meridians.A total of 28 medicines combinations with frequency≥12,with 10 core medicine combinations and 5 new prescriptions were derived.Conclusion:The external causes of cold dampness obstruction type KOA are mainly cold and damp.The main medicine for knee osteoarthritis of cold dampness obstruction type are TCM medicine such as dispelling rheumatism,tonifying liver and kidney,strengthening muscles and bones,strengthening spleen and removing dampness.Most of the prescriptions are composed according to the law of warming meridians,dispersing cold,nourishing blood and activating pulse.