[1]张辽,邓颖萍,金甬,等.基于数据挖掘法的叶海教授治疗膝骨关节炎用药规律研究[J].中医正骨,2020,32(02):36-41.
　ZHANG Liao,DENG Yingping,JIN Yong,et al.A study of medication rule of Professor YE Hai in treatment of knee osteoarthritis based on data mining approach[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2020,32(02):36-41.
点击复制

基于数据挖掘法的叶海教授治疗膝骨关节炎用药规律研究()
分享到：

《中医正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第32卷
期数:
2020年02期
页码:
36-41
栏目:
调查研究
出版日期:
2020-02-20

文章信息/Info

Title:
A study of medication rule of Professor YE Hai in treatment of knee osteoarthritis based on data mining approach
作者:
张辽; 邓颖萍; 金甬; 许旻鸣
(宁波市中医院,浙江 宁波 315010)
Author(s):
ZHANG Liao; DENG Yingping; JIN Yong; XU Minming
Ningbo Hospital of Traditional Chinese Medicine,Ningbo 315010,Zhejiang,China
关键词:
数据挖掘;  骨关节炎; 膝;  名医经验;  方剂分析; 计算机辅助
Keywords:
data mining;  osteoarthritis; knee;  famous doctor's experience;  formula anal; comput assist
摘要:
目的:分析叶海教授治疗膝骨关节炎(knee osteoarthritis,KOA)的用药规律。方法:收集2017年9月至2019年5月,叶海教授为首次到宁波市中医院门诊就诊的211例KOA患者开具的211首中药处方。所有患者后期均获得定期复诊,且疗效肯定。将中药处方信息录入中国中医科学院中药研究所研制的中医传承辅助系统(V2.5),由2人负责数据审核,确保数据准确。使用软件进行频次统计分析,并基于关联规则和熵聚类进行组方规律分析,最终预测新的处方。结果:叶海教授开具的211首治疗KOA的处方中,使用频次居前6位的中药分别为防风(205次)、炒谷芽(205次)、延胡索(202次)、茯苓(200次)、制川乌(167次)、桑寄生(167次),使用频次居前3位的药物组合为防风-炒谷芽(200次)、延胡索-防风(197次)、延胡索-炒谷芽(197次)。挖掘出22个核心药物组合,分别为仙茅-姜半夏-怀牛膝、鸡内金-荆芥-炒白术、鸡内金-炒白芍-炒白术、芡实-炒白芍-肉苁蓉、芡实-炒白芍-炒白术、黄芩-蝉蜕-党参、龙骨-浮小麦-牡蛎、桑寄生-苍术-重楼、甘草-桂枝-酸枣仁、荆芥-姜半夏-细辛、酸枣仁-首乌藤-钩藤、太子参-党参-巴戟天、炒白芍-肉苁蓉-薏苡仁、炒白芍-肉苁蓉-火麻仁、怀牛膝-薏苡仁-通草、柴胡-熟地黄-陈皮、黄芩-甘草-桂枝、灯心草-甘草-酸枣仁-首乌藤、黄芩-甘草-桂枝-党参、黄芩-桂枝-太子参-党参、荆芥-柴胡-细辛-熟地黄、荆芥-细辛-熟地黄-炒白术。预测出6个新处方,处方1药物组成包括仙茅、姜半夏、怀牛膝、薏苡仁、通草,处方2药物组成包括鸡内金、荆芥、炒白术、炒白芍,处方3药物组成包括芡实、炒白芍、肉苁蓉、炒白术,处方4药物组成包括甘草、桂枝、酸枣仁、黄芩,处方5药物组成包括黄芩、甘草、桂枝、党参、太子参,处方6药物组成包括荆芥、柴胡、细辛、熟地黄、炒白术。结论:叶海教授治疗KOA用药注重个体化差异和顾护中焦,常以健脾益肾、益气养血、祛风散寒、行气化湿、疏肝和胃、豁痰化瘀立法。
Abstract:
Objective:To analyze the medication rule of Professor YE Hai in treatment of knee osteoarthritis(KOA).Methods:Two hundred and eleven traditional Chinese medicine(TCM)prescriptions issued by Professor YE Hai for 211 outpatients with KOA who were firstly treated in Ningbo Hospital of Traditional Chinese Medicine from September 2017 to May 2019 were collected.All patients were regularly followed up in the later period,and the positive curative effects were found.The information of TCM prescriptions were input into traditional Chinese medicine inheritance support system(TCMISS)(V2.5)developed by Institute of Chinese Materia Medica of China Academy of Chinese Medical Sciences,and the data was reviewed by 2 person for ensuring their accuracy.Frequency analysis was performed by using software and the prescription rules were analyzed based on association rules and entropy clustering for predicting new prescriptions.Results:In 211 TCM prescriptions issued by Professor YE Hai for KOA,the top 6 Chinese drugs with high occurrence frequency included saposhnikovia divaricata(205 times),parched fructus setariae germinatus(205 times),rhizoma corydalis(202 times),poria cocos(200 times),radix aconiti preparata(167 times),Chinese taxillus herb(167 times); and the top 3 drug combinations with high occurrence frequency included saposhnikovia divaricata-parched fructus setariae germinatus(200 times),rhizoma corydalis-saposhnikovia divaricata(197 times)and rhizoma corydalis-parched fructus setariae germinatus(197 times).Twenty-two core TCM combinations were found out,including curculigo orchioides-ginger processed pinellia-achyranthes bidentata,endothelium corneum gigeriae galli-schizonepeta tenuifolia-parched atractylodes macrocephala,endothelium corneum gigeriae galli-parched radix paeoniae alba-parched atractylodes macrocephala,euryale ferox-parched radix paeoniae alba-cistanche deserticola,euryale ferox-parched radix paeoniae alba-parched atractylodes macrocephala,scutellaria baicalensis-periostracum cicadae-codonopsis pilosula,os draconis-fructus tritici levis-concha ostreae,taxillus chinensis-atractylodes chinensis-paris polyphylla,glycyrrhiza uralensis-ramulus cinnamomi-semen ziziphi spinosae,schizonepeta tenuifolia-ginger processed pinellia-asarum heterotropoides,semen ziziphi spinosae-caulis polygoni multiflori-ramulus uncariae cum uncis,pseudostellaria heterophylla-codonopsis pilosula-morinda officinalis,parched radix paeoniae alba-cistanche deserticola-semen coicis,parched radix paeoniae alba-cistanche deserticola-fructus cannabis,achyranthes bidentata-semen coicis-medulla tetrapanacis,bupleurum chinense-radix rehmanniae praeparata-pericarpium citrus reticulata,scutellaria baicalensis-glycyrrhiza uralensis-ramulus cinnamomi,juncus effusus-glycyrrhiza uralensis-semen ziziphi spinosae-caulis polygoni multiflori,scutellaria baicalensis-glycyrrhiza uralensis-ramulus cinnamomi-codonopsis pilosula,scutellaria baicalensis-ramulus cinnamomi-pseudostellaria heterophylla-codonopsis pilosula,schizonepeta tenuifolia-bupleurum chinense-asarum heterotropoides-radix rehmanniae praeparata and schizonepeta tenuifolia-asarum heterotropoides-radix rehmanniae praeparata-parched atractylodes macrocephala.Six new predicted TCM prescriptions were obtained,and the drug combinations of the prescriptions were(1)curculigo orchioides,ginger processed pinellia,achyranthes bidentata,semen coicis and medulla tetrapanacis,(2)endothelium corneum gigeriae galli,schizonepeta tenuifolia,parched atractylodes macrocephala and parched radix paeoniae alba,(3)euryale ferox,parched radix paeoniae alba,cistanche deserticola and parched atractylodes macrocephala,(4)glycyrrhiza uralensis,ramulus cinnamomi,semen ziziphi spinosae and scutellaria baicalensis,(5)scutellaria baicalensis,glycyrrhiza uralensis,ramulus cinnamomi,codonopsis pilosula and pseudostellaria heterophylla,(6)schizonepeta tenuifolia,bupleurum chinense,asarum heterotropoides,radix rehmanniae praeparata and parched atractylodes macrocephala respectively.Conclusion:Professor YE Hai attaches importance to individual differences and middle-jiao protection and he often takes the medication rule as the policy in treatment of KOA,including invigorating spleen and replenishing kidney,reinforcing qi and nourishing blood,expelling wind and dispersing cold,activating qi-flowing and dissipating dampness,soothing liver and harmonizing stomach and resolving stasis and eliminating phlegm.

参考文献/References:

[1] 方亮,董睿,金红婷,等.富血小板血浆关节腔注射联合补肾活血方口服治疗膝骨关节炎肝肾亏虚证的临床研究[J].中医正骨,2018,30(11):1-5.
[2] WALLACE I J,WORTHINGTON S,FELSON DT,et al.Knee osteoarthritis has doubled in prevalence since the mid-20th century[J].Proc Natl Acad Sci U S A,2017,114(35):9332-9336.
[3] 吴权,李启运,王素英,等.活血、温经、补益肝肾类中药对膝骨关节炎兔关节软骨形态的影响[J].中医正骨,2014,26(6):15-18.
[4] 柯高峰,卢建华,吴权.活血、温经及补肝肾药物对兔膝骨关节炎滑膜NO及TL-6浓度的影响[J].中国中医骨伤科杂志,2013,21(11):11-13.
[5] 何海军,王荣田,陈志伟,等.膝骨关节炎“从筋论治”的临床研究[J].北京中医药,2016,35(5):451-455.
[6] 高欢欢,薛志鹏,李泰贤, 等.治疗膝骨关节炎的中成药的组方规律分析[J].中国药房,2019,30(15):2096-2100.
[7] 张辽,韩晶晶,邓颖萍,等.叶海教授基于“经纬辨证”理论治疗膝骨关节炎的临证经验[J].中国中医骨伤科杂志,2019,27(4):69-70.
[8] 叶海,韩晶晶,许旻鸣.简析伤科“经纬辨证”基本理论[J].中医学报,2018,33(9):1675-1678.
[9] 韩晶晶.叶海“经纬辨证”法简介[J].浙江中医杂志,2018,53(5):322.
[10] 张辽,金甬,王焕明,等.“经纬辨证”理论指导下针刀配合手法及蚌式开合功能锻炼治疗髌股关节外侧高压综合征的临床研究[J].中医正骨,2018,30(4):23-27.
[11] 郑筱萸.中药新药临床研究指导原则[M].北京:中国医药科技出版社,2002:349-353.
[12] 中国中医药研究促进会骨科专业委员会,中国中西医结合学会骨伤科专业委员会关节工作委员会.膝骨关节炎中医诊疗专家共识(2015年版)[J].中医正骨,2015,27(7):4-5.
[13] 季青青,张国梁,刘雨香,等.数据挖掘技术在名老中医学术经验研究的应用[J].中医药临床杂志,2018,30(4):587-590.
[14] 唐仕欢,申丹,卢朋,等.中医传承辅助平台应用评述[J].中华中医药杂志,2015,30(2):329-331.
[15] 吴嘉瑞,唐仕欢,郭位先,等.基于数据挖掘的名老中医经验传承研究述评[J].中国中药杂志,2014,39(4):614-617.
[16] 万全庆,金甬.活血搜风治疗颈椎间盘突出症[J].中国乡村医生,1999(9):40.
[17] 金甬,万全庆.膝关节退行性骨关节病的治疗[J].中国骨伤,1998,11(5):36-37.
[18] 韩晶晶.叶海治疗伤科痰瘀证经验浅析[J].浙江中医杂志,2019,54(5):372-373.

相似文献/References:

[1]樊庆阳,任凯晶.定制3D打印切模辅助全膝关节置换术治疗 膝骨关节炎合并股骨干骨折畸形愈合[J].中医正骨,2015,27(11):37.
[2]应俊,张元斌,罗程,等.核转录因子-κB在骨关节炎炎症反应中的作用[J].中医正骨,2015,27(07):40.
[3]冯荣,王平,李炳奇,等.铍针刺络拔罐结合中药口服治疗膝骨关节炎合并 原发性血小板增多症1例[J].中医正骨,2015,27(12):73.
[4]高宁阳,丁立,庞坚,等.miRNAs与骨关节炎关系的研究进展[J].中医正骨,2015,27(12):74.
[5]蔡云仙.围手术期耳穴按压联合平衡针疗法 在全膝关节置换术后镇痛中的应用[J].中医正骨,2015,27(06):41.
[6]魏瑄,宋树春,王金良.术前精确测量和评估在全髋关节置换治疗 成人发育性髋关节发育不良继发骨关节炎中的价值[J].中医正骨,2015,27(01):30.
[7]李显,顾敏琪.蜂毒与蜂针疗法的作用机制及其在类风湿关节炎 和骨关节炎治疗中的应用[J].中医正骨,2016,28(02):69.
[8]刘飞,刘刚,郭浩山,等.化瘀渗湿汤对全膝关节置换术后血浆D-二聚体 和纤维蛋白原含量的影响[J].中医正骨,2016,28(03):30.
　LIU Fei,LIU Gang,GUO Haoshan,et al.Effect of Huayu Shenshi Tang(化瘀渗湿汤)on plasma contents of D-dimer and fibrinogen after total knee arthroplasty[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2016,28(02):30.
[9]赵明明,蔡一强,丁永利,等.无柄人工全髋关节置换术治疗髋关节疾患的临床研究[J].中医正骨,2016,28(04):37.
[10]徐方琪,孙奇,朱星瑜,等.不同生理磁共振成像技术在早期膝骨关节炎诊断中的应用进展[J].中医正骨,2016,28(04):64.

备注/Memo

备注/Memo:
(收稿日期:2019-08-29 本文编辑:李晓乐)基金项目:国家中医药管理局全国名老中医药专家传承工作室建设项目(国中医药人教发[2016]42号); 浙江省中医药科技计划项目(2018ZB119); 浙江省“十三五”中医重点专科建设项目(浙卫办中医[2019]1号) 通讯作者:张辽 E-mail:drzhangliao@163.com
更新日期/Last Update: 2020-02-15