姜泉治疗类风湿关节炎组方用药规律研究
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摘要
应用数据挖掘方法,分析和总结姜泉主任治疗类风湿关节炎组方用药规律,为临床治疗类风湿关节炎提供借鉴。筛选2007—2017年姜泉主任门诊治疗类风湿关节炎处方121首,录入中医传承辅助系统,采用软件"统计报表"系统的"方剂统计"功能、"数据分析"系统的"方剂分析"功能的规则分析、集成关联、复杂系统熵聚类、无监督的熵层次聚类等数据挖掘方法,分析姜泉治疗类风湿关节炎处方用药规律。共纳入方剂121首,涉及中药144味,使用频率较高的药物有30味,频次均在20次以上;频次59次以上常用药物组合20个;演化得到核心组合14个,新处方7个。治疗类风湿关节炎方剂中,以清利热湿、活血化瘀药频次较高,其核心处方为"清热活血方""二妙丸"加减。演化得出的新方除了体现姜泉主任治疗类风湿关节炎清热利湿活血的方法,还包含祛风除湿、通络化痰散结、养阴清热、滋阴补肾、养血益气的治疗方法,可以分析出痹症日久痰瘀互结,损伤气血,久及肝肾的病机变化。同时也体现了治痹扶正祛邪的治疗原则。
The data mining method was used to analyze and summarize the prescription and medicate regularities of chief physician Jiang Quan in the treatment of rheumatoid arthritis,in order to provide references for the clinical treatment of rheumatoid arthritis. Totally 121 prescriptions of rheumatoid arthritis treated by chief physician Jiang Quan from 2007 to 2017 were collected and input into the Chinese medicine inheritance auxiliary system. The " prescription statistics" function of the software " statistical report" system,and the " prescription analysis" function of the " data analysis" system,the data mining methods such as rule analysis,integration correlation,complex system entropy clustering,and unsupervised entropy hierarchical clustering,were used to analyze the prescription regularity of chief physician Jiang Quan. A total of 121 prescriptions were included,involving 144 herbs,in which 30 herbs had a higher frequency of more than 20 times,20 two-herb combinations had a frequency of more than 59 times; after evolution,14 core combinations and 7 new prescriptions were obtained. Among the prescriptions in the treatment of rheumatoid arthritis,those for clearing heat and dampness,promoting blood circulation and removing blood stasis had a higher frequency,and the core prescriptions were modified " Qingre Huoxue Decoction" and modified " Ermiao Pills". The newly evolved prescriptions not only reflected director Jiang Quan' s method of treating rheumatoid arthritis by clearing away heat and dampness and promoting blood circulation by the,but also included the treatment methods of removing wind and removing dampness,dredging collaterals and removing phlegm,nourishing Yin and clearing heat,nourishing Yin and nourishing kidney,nourishing blood and nourishing Qi. The method can be used to analyze the pathogenetic changes of the mutual knot of phlegm and blood stasis,injury of Qi and blood,long-term implication on liver and kidney. At the same time,it also reflects the treatment principles of treating phlegm and strengthening the evil.
The data mining method was used to analyze and summarize the prescription and medicate regularities of chief physician Jiang Quan in the treatment of rheumatoid arthritis,in order to provide references for the clinical treatment of rheumatoid arthritis. Totally 121 prescriptions of rheumatoid arthritis treated by chief physician Jiang Quan from 2007 to 2017 were collected and input into the Chinese medicine inheritance auxiliary system. The " prescription statistics" function of the software " statistical report" system,and the " prescription analysis" function of the " data analysis" system,the data mining methods such as rule analysis,integration correlation,complex system entropy clustering,and unsupervised entropy hierarchical clustering,were used to analyze the prescription regularity of chief physician Jiang Quan. A total of 121 prescriptions were included,involving 144 herbs,in which 30 herbs had a higher frequency of more than 20 times,20 two-herb combinations had a frequency of more than 59 times; after evolution,14 core combinations and 7 new prescriptions were obtained. Among the prescriptions in the treatment of rheumatoid arthritis,those for clearing heat and dampness,promoting blood circulation and removing blood stasis had a higher frequency,and the core prescriptions were modified " Qingre Huoxue Decoction" and modified " Ermiao Pills". The newly evolved prescriptions not only reflected director Jiang Quan' s method of treating rheumatoid arthritis by clearing away heat and dampness and promoting blood circulation by the,but also included the treatment methods of removing wind and removing dampness,dredging collaterals and removing phlegm,nourishing Yin and clearing heat,nourishing Yin and nourishing kidney,nourishing blood and nourishing Qi. The method can be used to analyze the pathogenetic changes of the mutual knot of phlegm and blood stasis,injury of Qi and blood,long-term implication on liver and kidney. At the same time,it also reflects the treatment principles of treating phlegm and strengthening the evil.
引文
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[33]晁利平,刘艳霞,瞿璐,等.绵萆薢的化学成分及药理作用研究进展[J].药物评价研究,2015,38(3):325.
[34]周永芹,韩莉.中药蜈蚣的研究进展[J].中药材,2018,31(2):315.
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[2]李波,姜泉.中医防治类风湿性关节炎骨破坏的研究进展[J].山西中医学院学报,2015,12(5):74.
[3]张华东,曹炜.中医对类风湿关节炎发病机制的认识[J].现代中西医结合杂志,2013,12(13):1365.
[4]姜泉,蒋红,曹炜,等.475例类风湿关节炎患者中医临床证候分析[J].中医杂志,2007,48(3):253.
[5]姜泉,焦娟.治痹:辛温向辛凉转变[N].中国中医药报,2013-9-4(004).
[6]姜泉,冯兴华,王承德,等.清热活血方治疗类风湿关节炎患者71例临床观察[J].中医杂志,2012,53(6):488.
[7]周新尧,王雷,余卫,等.清热活血方药治疗类风湿关节炎1年后双手X线变化临床观察[J].中国骨伤,2011,24(12):992.
[8]李波,姜泉,巩勋,等.清热活血方药对CIA大鼠Wnt信号通路成骨细胞相关因子的影响[J].中国中医基础医学杂志,2017,23(1):75.
[9]中国药典.一部[S]. 2010.
[10]国家中医药管理局中华本草编委会.中华本草(精选本)[M].上海:上海科学技术出版社,1998.
[11]张瓅方,刘暖,杨雷,等.黄芪丹参提取物配伍对大鼠骨髓源性EPCs中VEGF,KDR,Ang-1及e NOS表达的影响[J].中国实验方剂学杂志,2018,24(10):150.
[12]朱莉萍.黄芪的药理研究及进展[J].内蒙古中医药,2018,37(3):98.
[13]余玮,金奕.张锡纯对黄芪认识之探[J].中国中医基础医学杂志,2018,24(3):390.
[14]李时珍.本草纲目.中册[M].北京:人民卫生出版社,2005.
[15]谭政委,夏伟,余永亮,等.金银花化学成分及其药理学研究进展[J].安徽农业科学,2018,46(9):26.
[16]兰茂.滇南本草[M].昆明:云南科学技术出版社,2004.
[17]张白嘉,刘亚欧,刘榴,等.土茯苓及落新妇苷抗炎、镇痛、利尿作用研究[J].中国药理与临床,2004,20(1):11.
[18]赵磊,梁茂新.丹参临床应用中的潜在功能发掘[J].中国实验方剂学杂志,2016,22(18):197.
[19]崔燎,邹丽宜,刘钰瑜,等.丹参水提物和丹参促进成骨细胞活性和防治泼尼松所致大鼠骨质疏松[J].中国药理学通报,2004,20(3):286.
[20]孔一凡,史克莉.莪术研究概述[J].湖北中医药大学学报,2011,13(1):47.
[21]姜建萍.莪术抗肿瘤研究概况[J].吉林中医药,2000,62(2):62.
[22]神农本草经[M].尚志钧校注.北京:学苑出版社,2002.
[23]向楚兵,倪彩霞,陈林.赤芍二基原药材的抗炎、镇痛作用比较研究[J].中药与临床,2011,2(1):46.
[24]谢文光,马晓昌,邵宁生,等.赤芍治疗热毒血瘀证的血清蛋白质组变化的初步究[J].中国中西医结合杂志,2005,25(6):520.
[25]雷玲,胡竟一,余悦,等.赤芍的抗内毒素作用研究[J].中药药理与临床,2006,22(6):32.
[26]姜泉.痹病必挟瘀[J].北京中医,1994(5):12.
[27]刘溦溦,朱尧,汪悦.青风藤生物碱的活性成分及药理作用研究进展[J].辽宁中医杂志,2016,43(8):1765.
[28]张梦颖,葛卫红,姚瑶.青风藤醇提液对关节炎大鼠关节骨破坏的影响[J].医药导报,2013,32(5):565.
[29]邓爱平,李颖,吴志涛,等.苍术化学成分和药理的研究进展[J].中国中药杂志,2016,41(21):3904.
[30]神农本草经[M].清·顾观光辑.杨鹏举校注.北京:学苑出版社,2007.
[31]刘雨晴,梁婧,杨梓晨,等.薏苡仁的药理作用研究进展[J].安徽农业科学,2010,38(20):10678.
[32]李丹丹,江培,杨书美,等.黄柏的化学成分、药理作用及临床应用研究进展[J].黑龙江医药,2014,7(3):601.
[33]晁利平,刘艳霞,瞿璐,等.绵萆薢的化学成分及药理作用研究进展[J].药物评价研究,2015,38(3):325.
[34]周永芹,韩莉.中药蜈蚣的研究进展[J].中药材,2018,31(2):315.
[35]张志海,王彩云,杨天鸣,等.陈皮的化学成分及药理作用研究进展[J].西北药学杂志,2005,20(1):47.