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蒋泉治疗类风湿关节炎的用药规律研究

[Regularity of prescription and medication of Jiang Quan in treating rheumatoid arthritis].

作者信息

Xiao Hong, Jiang Quan, Tang Xiao-Po, Jiao Juan, Ge Lin

机构信息

Guang'anmen Hospital,China Academy of Chinese Medical Sciences Beijing 100053,China.

出版信息

Zhongguo Zhong Yao Za Zhi. 2019 Jan;44(2):381-387. doi: 10.19540/j.cnki.cjcmm.20181101.014.

Abstract

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.

摘要

采用数据挖掘方法分析和总结蒋泉主任医师治疗类风湿关节炎的用药规律,为类风湿关节炎的临床治疗提供参考。收集蒋泉主任医师2007年至2017年治疗类风湿关节炎的121首方剂,并录入中医传承辅助系统。运用该软件“统计报表”系统的“方剂统计”功能及“数据分析”系统的“方剂分析”功能,采用规则分析、关联分析、复杂系统熵聚类、无监督熵层次聚类等数据挖掘方法,分析蒋泉主任医师的用药规律。共纳入121首方剂,涉及144味中药,其中使用频次较高(超过20次)的中药有30味,药对频次超过59次的有20个;经演化得到14个核心组合及7首新方剂。治疗类风湿关节炎的方剂中,清热祛湿、活血化瘀类方剂使用频次较高,核心方剂为加减清热活血汤和加减二妙丸。新演化出的方剂不仅体现了蒋泉主任医师清热祛湿、活血化瘀治疗类风湿关节炎的思路,还包含了祛风除湿、通络化痰、养阴清热、滋阴补肾、养血益气等治法。该方法可用于分析痰瘀互结、气血损伤、肝肾久虚的病机变化,同时也体现了治痰扶正的治疗原则。

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