基于数据挖掘探讨龚保文治疗痛风性关节炎用药规律

Medication Rules of GONG Baowen Treating Gouty Arthritis Based on Data Mining

目的:基于数据挖掘探讨龚保文教授治疗痛风性关节炎用药规律。方法:收集龚教授治疗痛风性关节炎的病案处方,整理方药信息,并录入古今医案云平台,采用频数分析、关联分析、聚类分析及复杂网络分析挖掘龚教授治疗痛风性关节炎的用药规律。结果:共收录处方279首,涉及200味中药,临床证型以湿热蕴结证为主。龚教授治疗痛风性关节炎以补气、利尿通淋、活血止痛、清热解毒药物为主,常用中药有甘草、萆薢、牛膝、土茯苓、葛根、车前草等。治疗药物以甘、苦、辛味居多,药性以平、温、寒性为主,多归于肝、脾、胃、肺经。龚教授临床常用的药物组合有萆薢-土茯苓、萆薢-葛根-牛膝。聚类分析得到牛膝-土茯苓-葛根-萆薢-甘草、车前草-威灵仙-马齿苋-薏苡仁-淫羊藿-苍术-杜仲、丹参-黄芪-党参-海螵蛸-半夏-山药-牡蛎-桂枝等3首新处方。复杂网络分析得到常用处方为萆薢-土茯苓-葛根-牛膝-车前草-威灵仙-薏苡仁-苍术-海螵蛸。结论:龚教授认为痛风性关节炎的病机以湿热为主,常采用通利关节、清热祛湿法治疗,临床以萆薢-土茯苓-牛膝-葛根-甘草为底方加减,用药和缓,五脏兼顾。

Objective:To summarize the medication rules of Professor GONG Baowen treating gouty arthritis with data mining.Methods:Medical records and prescriptions of Professor GONG for treating gouty arthritis were collected,organized,and inputted into the Ancient and Modern Medical Records Cloud Platform.Frequency analysis,correlation analysis,cluster analysis,and complex network analysis were used to explore the medication rules of Professor GONG in the treatment of gouty arthritis.Results:A total of 279 prescriptions were included,involving 200 Chinese medicinals.The clinical syndrome type was mainly damp-heat accumulation syndrome.Professor GONG's treatment for gouty arthritis mainly involved tonifying qi,promoting urination and relieving strangury,invigorating blood and alleviating pain,clearing heat and detoxifying,and the commonly used Chinese medicinals included Glycyrrhizae Radix et Rhizoma,Rhizoma Dioscoreae Hypoglaueae,Achyranthis Bidentatae Radix,Smilacis Glabrae Rhizoma,Puerariae Lobatae Radix,and Plantaginis Herba.The main flavors of the medicinals were sweet,bitter,and acrid;the main nature was neutral,warm,and cold;the main meridian entries were the liver,spleen,stomach,and lung meridians.Professor GONG's commonly used medicinal combinations in clinical practice included Rhizoma Dioscoreae Hypoglaueae-Smilacis Glabrae Rhizoma,and Rhizoma Dioscoreae Hypoglaueae-Puerariae Lobatae Radix-Achyranthis Bidentatae Radix.Cluster analysis obtained three new prescriptions,including Achyranthis Bidentatae Radix-Smilacis Glabrae Rhizoma-Puerariae Lobatae Radix-Rhizoma Dioscoreae Hypoglaueae-Glycyrrhizae Radix et Rhizoma,Plantaginis Herba-Clematidis Radix et Rhizoma-Portulacae Herba-Coicis Semen-Epimedii Folium-Atractylodis Rhizoma-Eucommiae Cortex,and Salviae Miltiorrhizae Radix et Rhizoma-Astragali Radix-Codonopsis Radix-Sepiae Endoconcha-Pinelliae Rhizoma-Dioscoreae Spongiosae Rhizoma-Ostreae Concha-Cinnamomi Ramulus.The common prescription obtained from complex network analysis was Rhizoma Dioscoreae Hypoglaueae-Smilacis Glabrae Rhizoma-Puerariae Lobatae Radix-Achyranthis Bidentatae Radix-Plantaginis Herba-Clematidis Radix et Rhizoma-Coicis Semen-Atractylodis Rhizoma-Sepiae Endoconcha.Conclusion:Professor GONG believes that the pathogenesis of gouty arthritis is mainly characterized by damp and heat.It is often treated with the method of promoting joint mobility,clearing heat and removing dampness.In clinical practice,Rhizoma Dioscoreae Hypoglaueae-Smilacis Glabrae Rhizoma-Achyranthis Bidentatae Radix-Puerariae Lobatae Radix-Glycyrrhizae Radix et Rhizoma were used as the base formula for further adjustment,with mild medication and a general consideration of the five viscera.