[1]包伟东,胡静,李焕香,等.基于数据挖掘技术分析初次全膝关节置换术后下肢肿胀的中医证型和用药规律[J].中医正骨,2024,36(11):21-25,61.
　BAO Weidong,HU Jing,LI Huanxiang,et al.TCM syndrome types and clinical medication rules for lower limb swelling after primary total knee arthroplasty:a data mining-based analysis[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2024,36(11):21-25,61.
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基于数据挖掘技术分析初次全膝关节置换术后下肢肿胀的中医证型和用药规律()
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《中医正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第36卷
期数:
2024年11期
页码:
21-25,61
栏目:
文献研究
出版日期:
2024-11-20

文章信息/Info

Title:
TCM syndrome types and clinical medication rules for lower limb swelling after primary total knee arthroplasty:a data mining-based analysis
作者:
包伟东1; 胡静2; 李焕香3; 王涵玉4; 邢鹏飞4; 王帅亚3; 孙永强1; 曹向阳1; 童培建5
1.河南省洛阳正骨医院/河南省骨科医院,河南 郑州 450016; 2.郑州卫生健康职业学院,河南 郑州 450122; 3.禹州市中医院,河南 禹州 461670; 4.河南中医药大学,河南 郑州 450046; 5.浙江中医药大学,浙江 杭州 310053
Author(s):
BAO Weidong1; HU Jing2; LI Huanxiang3; WANG Hanyu4; XING Pengfei4; WANG Shuaiya3; SUN Yongqiang1; CAO Xiang-yang1; TONG Peijian5
1.Luoyang Orthopedic-Traumatological Hospital,Zhengzhou 450016,Henan,China 2.Zhengzhou Health Vocational College,Zhengzhou 450122,Henan,China 3.Yuzhou Hospital of Traditional Chinese Medicine,Yuzhou 461670,Henan,China 4.Henan University of Chinese Medicine,Zhengzhou 450046,Henan,China 5.Zhejiang Chinese Medical University,Hangzhou 310053,Zhejiang,China
关键词:
关节成形术; 置换; 膝;  肿胀;  下肢;  证候;  方剂分析; 计算机辅助;  数据挖掘
Keywords:
arthroplasty; replacement; knee;  swelling;  lower extremity;  syndrome complex;  formula analysis; computer assisted;  data mining
摘要:
目的:分析初次全膝关节置换术(total knee arthroplasty,TKA)后下肢肿胀的中医证型和用药规律。方法:应用计算机检索中国知网、维普网、万方数据库,搜集有关中医药治疗TKA后下肢肿胀的文献,检索时限均为建库至2024年2月。从符合要求的文献中提取数据,以Microsoft Office Excel2019软件建立数据库,对涉及的中医证型名称、方剂名称、方剂功能分类、中药名称及中药功能分类规范化处理后进行频次统计,对筛选出的高频药物进行聚类分析和关联规则分析。结果:①文献检索及筛选结果。共检索到2131篇文献,经过筛选最终纳入57篇文献。②中医证型分析结果。纳入的57篇文献共涉及7种中医证型,出现频次较高的中医证型为气滞血瘀、瘀水互结、气虚血瘀。③方剂分析结果。纳入的57篇文献共涉及57首方剂。按照功能分类,理血剂43首、补血剂8首、祛湿剂5首、温里剂1首。出现频次较高的方剂为桃红四物汤、身痛逐瘀汤和复元活血汤。④药物分析结果。57首方剂共涉及115味中药,其中出现频次≥5的中药(高频药物)共32味,出现频次较高的中药为当归、川芎、红花、甘草; 按照中药功能分类,活血化瘀药和补虚药出现频次较高。32味高频药物可聚为3类,第1类5味中药,功效以活血化瘀为主,适用于气滞血瘀证; 第2类6味中药,功效以补气养血健脾为主,适用于气虚血瘀证; 第3类21味中药,功效以利水渗湿祛痰、滋补肝肾为主,适用于肝肾亏虚、痰瘀互结证。对32味高频药物进行关联规则分析,设置支持度为30%、置信度为90%,得到6味核心药物(红花、桃仁、当归、川芎、甘草、赤芍),共涉及19条关联规则,其中当归-桃仁-红花为核心药物组合。结论:初次TKA后下肢肿胀的常见证型为气滞血瘀、瘀水互结、气虚血瘀,临床用药以活血化瘀药和补虚药为主,核心药物为红花、桃仁、当归、川芎、甘草、赤芍,核心药物组合为当归-桃仁-红花。
Abstract:
Objective:To analyze the TCM syndrome types and medication rules for lower limb swelling following primary total knee arthroplasty(TKA).Methods:The articles concerning TCM treatment of lower limb swelling after TKA included from database's inception to February 2024 were retrieved from China National Knowledge Infrastructure,Vip Database,and Wanfang Database through computer.The eligible articles were screened according to the predefined inclusion and exclusion criteria,and the data were extracted from the included articles and then input into the Microsoft Office Excel 2019 software to build a database,based on which,the involved TCM syndrome types,prescriptions,prescription function classifications,Chinese herbs(CHs)and CHs function classifications were normalized and standardized,followed by frequency statistics.The selected high-frequency CHs were then subjected to cluster analysis and association rule analysis.Results:①Article retrieval and screening results.Two thousand one hundred and thirty-one articles were searched out.After screening,57 ones were included in the final analysis.②The TCM syndrome type.Seven TCM syndrome types were involved in the 57 included articles,among which the qi-stagnation and blood-stasis syndrome,blood-stasis and water-retention syndrome,as well as qi-deficiency and blood-stasis syndrome appeared most frequently.③The prescription.Fifty-seven prescriptions were involved in the 57 included articles,including 43 blood-regulating formulas,8 blood-supplementing formulas(TCD),5 desiccating formulas,and 1 interior-warming formulas,among which the Taohong Siwu Tang(桃红四物汤),Shentong Zhuyu Tang(身痛逐瘀汤),and Fuyuan Huoxue Tang(复元活血汤)appeared most frequently.④The CHs.One hundred and fifteen CHs were involved in the 57 prescriptions,among which 32 ones(high-frequency CHs)displayed a occurrence frequency≥5,and the top 4 ones with high occurrence frequency were Angelicae Sinensis Radix(TCD),Chuanxiong Rhizoma,Carthami Flos(TCD),and Glycyrrhizae Radix et Rhizoma(TCD).Furthermore,sorted by efficacy,the blood-activating and stasis-resolving CHs,as well as deficiency-reinforcing CHs appeared most frequently.As revealed by the cluster analysis,the 32 high-frequency CHs were clustered into three categories,with 5 CHs into Category I,mainly the ones for activating blood and removing stasis,which were suitable for qi-stagnation and blood-stasis syndrome; 6 CHs into CategoryⅡ,mainly the ones for reinforcing qi,nourishing blood and strengthening spleen,which were suitable for qi-deficiency and blood-stasis syndrome; and 21 CHs into CategoryⅢ,mainly the ones for diuresis,removing Dampness,expelling Phlegm,and reinforcing liver-kidney,which were suitable for liver-kidney deficiency syndrome,as well as intermingled phlegm and blood stasis syndrome.In addition,with a support of 30% and a confidence of 90%,the associ-ation rule analysis on the 32 high-frequency CHs yielded 6 core CHs(Carthami Flos(TCD),Persicae Semen,Angelicae Sinensis Radix(TCD),Chuanxiong Rhizoma,Glycyrrhizae Radix et Rhizoma(TCD),Paeoniae Radix Rubra),involving 19 association rules,with Angelicae Sinensis Radix(TCD)-Persicae Semen-Carthami Flos(TCD)as the core herb combination.Conclusion:The common TCM syndromes are qi-stagnation and blood-stasis syndrome,blood-stasis and water-retention syndrome,as well as qi-deficiency and blood-stasis syndrome for lower limb swelling in patients who underwent primary TKA.The clinical medication are centred on the blood-activating and stasis-re-solving CHs,as well as the deficiency-reinforcing CHs.The Carthami Flos(TCD),Persicae Semen,Angelicae Sinensis Radix(TCD),Chuanxiong Rhizoma,Glycyrrhizae Radix et Rhizoma(TCD)and Paeoniae Radix Rubra are usually used as the core CHs,and Angelicae Sinensis Radix(TCD)-Persicae Semen-Carthami Flos(TCD)as the core herb combination in treating lower limb swelling after primary TKA.

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备注/Memo

备注/Memo:
基金项目:河南省中医药科学研究专项课题(2023ZY1019,2024ZY2119)
通讯作者:孙永强 E-mail:joint99@126.com
更新日期/Last Update: 1900-01-01