基于中医传承辅助平台的中药内服治疗原发性骨质疏松症组方用药规律研究

Rules of Prescription and Medication of Oral Administration of Chinese Medicine in Treating Primary Osteoporosis Based on Traditional Chinese Medicine Inheritance Support System

目的:基于数据挖掘方法探讨中医药治疗原发性骨质疏松症的组方用药规律。方法:检索中国知网、维普、万方等中文数据库2006—2022年中药内服治疗原发性骨质疏松症的中药方剂,通过中医传承辅助平台系统软件(TCMISS)运用关联规则算法、复杂系统熵聚类方法,统计处方中药物的性味归经、使用频率、药物之间的关联规则、核心药物组合和高频中药组合。结果:纳入文献共计210篇,涉及224首方剂,168味中药。总结高频证候分型,居于前4位的分别是肾虚血瘀证、脾肾亏虚证、肝肾阴虚证、肾虚证。性味归经最多为温性药,五味频次最多为甘味药。药物归经前4位的是肝、肾、脾及心经。单味中药使用频次居于前10位的是熟地黄、淫羊藿、当归、杜仲、黄芪、骨碎补、补骨脂、山茱萸、山药、枸杞子。关联规则分析得到45个药对组合及44条关联规则。聚类分析得到20个药物核心组合,优化出10个新方组合。结论:原发性骨质疏松症病因以肾、脾亏虚为主,兼有血瘀,中医药治疗以补益肝肾、健脾益气、活血补血为主。

Objective:To discuss the rules of prescription and medication of oral administration of Chinese medicine in treating primary osteoporosis based on data mining.Methods:Oral administration Chinese medicine prescriptions in the treatment of primary osteoporosis from 2006 to 2022 were retrieved from CNKI,VIP,Wanfang,and other Chinese databases.Traditional Chinese Medicine Inheritance Support System(TCMISS)combined with association rule algorithm and complex system entropy clustering method were used to calculate and analyze the nature,flavors,and channel entries of Chinese medicinals used in the prescriptions,their frequency of use,the association rules between Chinese medicinals,core medicinal combinations,and high-frequency medicinal couplets.Results:A total of 210 articles were included,involving 224 prescriptions and 168 Chinese medicinals.As for the high-frequency syndrome types,the top four syndrome types were the kidney deficiency and blood stasis syndrome,the spleen-kidney depletion syndrome,the liver-kidney yin deficiency syndrome,and the kidney deficiency syndrome.In terms of the nature of Chinese medicinals,warm medicinals accounted for the most,and sweet flavor of medicinals had the largest proportion among the five flavors.The top four channel entries of Chinese medicinals were the liver,kidney,spleen,and heart meridians.The top 10 most frequently used Chinese medicinals were Rehmanniae Radix Praeparata,Epimedii Folium,Angelicae Sinensis Radix,Eucommiae Cortex,Astragali Radix,Drynariae Rhizoma,Psoraleae Fructus,Corni Fructus,Dioscoreae Rhizoma,and Lycii Fructus.Association rule analysis resulted in 45 medicinal couplets and 44 association rules.A total of 20 core medicinal combinations and 10 new prescription combinations were obtained by cluster analysis.Conclusion:The main causes of primary osteoporosis is the kidney and spleen depletion,accompanied by blood stasis.The Chinese medicine treatment mainly focuses on supplementing the liver and kidney,fortifying the spleen and boosting qi,and invigorating and supplementing blood.