基于数据挖掘王平教授治疗腰椎间盘突出症的临床用药规律研究
Clinical Medication Rule of Professor Wang Ping in Treating Lumbar Disc Herniation Based on Data Mining
DOI: 10.12677/PI.2023.122008, PDF,    科研立项经费支持
作者: 于大伟, 杨宇航, 霍路遥, 冯天笑, 张久国：天津中医药大学第一附属医院，天津;国家中医针灸临床医学研究中心，天津；吴 思, 王 平：天津中医药大学第一附属医院，天津;国家中医针灸临床医学研究中心，天津;国家中医药管理局区域中医骨伤科诊疗中心，天津
关键词: 腰椎间盘突出症；中医传承辅助平台；用药经验；数据挖掘；王平；Lumbar Disc Herniation； TCM Inheritance Support Platform； Medication Experience； Data Mining； Wang Ping
摘要: 目的：运用中医传承辅助平台(V2.5)软件的核心算法对王平教授治疗腰椎间盘突出症(Lumbar Disc Herniation, LDH)的用药组方规律、配伍特点、核心理念进行深度挖掘与探索，为中医药治疗LDH的临床应用提供新思路。方法：收集王平教授在2021年2月至2022年7月于骨伤科门诊中治疗LDH患者的信息，将收集到的中药方剂作为研究对象进行记录，采用中医传承辅助平台(V2.5)挖掘统计处方中药物的使用频次、性味归经、核心方剂的聚类及关联度与中药配伍规律。结果：筛选出有效中药方剂233个，共计92味中药饮片。从药物使用频次方面分析，共计用药2648次，其中用药频率 ≥ 50次的药物有川芎、生地黄、当归、白芍、甘草、黄芪、桂枝等12味，中药药性主用温性(57.6%)和寒性(27.48%)，平性(14.31%)则次之；药味以甘味(30.63%)、辛味(29.67%)、苦味(29.28%)居多；主要归经为肝经(1441次)、脾经(1197次)、心经(1157次)，频率高于200的药物组合有17组，中药核心配伍组合12组，新方方剂2首。结论：王平教授治疗LDH以“本虚标实”为本病核心病机，认为气血不足为本，风寒痹阻、瘀血阻滞为标；以益气补血、健脾养肝、化瘀行气为主要治法，用药首重川芎，多用甘温、辛散之品；同时注重调理肝脾、濡润宗筋。处方多由黄芪桂枝五物汤合四物汤加减为本病的核心处方。
Abstract: Objective: The core algorithm of traditional Chinese medicine inheritance assistance platform (V2.5) software was used to deeply excavate and explore the prescription rules, compatibility characteristics and core concepts of Professor Wang Ping in the treatment of lumbar disc herniation (LDH), so as to provide new ideas for the clinical application of traditional Chinese medicine in the treatment of LDH. Methods: The information of LDH patients treated by Professor Wang Ping from February 2021 to July 2022 in the outpatient department of orthopedics and traumatology was collected. The collected prescriptions of traditional Chinese medicine were recorded as the research objects. The frequency of drug use, the meridian attribution of nature and taste, the clustering and correlation degree of core prescriptions and the compatibility law of traditional Chinese medicine were excavated and counted by the traditional Chinese medicine inheritance assistance platform (V2.5). Results: 233 effective Chinese medicine prescriptions were screened out with a total of 92 Chinese herbal pieces. From the analysis of the frequency of drug use, a total of 2648 medications were used, of which 12 drugs were used more than 50 times, including Chuanxiong, Rehmannia glutinosa, Angelica sinensis, Paeonia lactiflora, Glycyrrhiza uralensis, Astragalus membranaceus and Guizhi. The main temperature (57.6%) and coldness (27.48%) of the medicinal properties of traditional Chinese medicine were followed by the level (14.31%). The medicinal flavors were mainly sweet (30.63%), pungent (29.67%) and bitter (29.28%). The main meridians were liver meridian (1441 times), spleen meridian (1197 times) and heart meridian (1157 times). There were 17 groups of drug combinations with frequency higher than 200, involving 12 groups of core drug combinations and 2 new prescriptions. Conclusion: Professor Wang Ping treats LDH with deficiency of origin and excess of superficiality as the core pathogenesis of this disease, and believes that deficiency of qi and blood is the basis, and wind-cold obstruction and blood stasis block are the criteria. Taking unifying qi and blood, invigorating spleen and nourishing liver, removing blood stasis and promoting qi as the main treatment methods, Chuanxiong was used as the first drug, and Gan Wen and Xin San were often used. At the same time, pay attention to regulating the liver and spleen, moistening the tendons. The prescriptions were mostly modified by Huangqi Guizhi Wuwu Decoction and Siwu Decoction as the core prescriptions of the disease.
文章引用：于大伟, 杨宇航, 霍路遥, 冯天笑, 张久国, 吴思, 王平. 基于数据挖掘王平教授治疗腰椎间盘突出症的临床用药规律研究[J]. 药物资讯, 2023, 12(2): 61-69. https://doi.org/10.12677/PI.2023.122008

参考文献

[1] Kerr, D., Zhao, W.Y. and Lurie, J.D. (2015) What Are Long-Term Predictors of Outcomes for Lumbar Disc Herniation? A Randomized and Observational Study. Clinical Orthopaedics and Related Research, 473, 1920-1930.
https://doi.org/10.1007/s11999-014-3803-7
[2] 杨威, 唐福宇, 梁冬波, 田凯. 中药熏洗治疗腰椎间盘突出症的用药规律[J]. 广西医学, 2018, 40(8): 968-970.
[3] Hoy, D., March, L., Brooks, P., et al. (2010) Measuring the Global Burden of Low Back Pain. Best Practice & Research in Clinical Rheumatology, 24, 155-165.
https://doi.org/10.1016/j.berh.2009.11.002
[4] Hahne, A.J., Ford, J.J. and McMeeken, J.M. (2010) Conservative Management of Lumbar Disc Herniation with Associated Radiculopathy: A Systematic Review. Spine, 35, E488-E504.
https://doi.org/10.1097/BRS.0b013e3181cc3f56
[5] 封燕琴, 王翠娟, 吴丹, 等. 中医药辨证施治对腰椎间盘突出症患者临床疗效、疼痛及中医症状评分的影响[J]. 中国现代医生, 2021, 59(20): 127-130.
[6] 中华医学会骨科学分会脊柱外科学组, 中华医学会骨科学分会骨科康复学组. 腰椎间盘突出症诊疗指南[J]. 中华骨科杂志, 2020, 40(8): 477-487.
[7] 国家药典委员会. 中华人民共和国药典[M]. 一部. 北京: 中国医药科技出版社, 2015.
[8] 敖威. 浅谈中医对腰椎间盘突出症的认识[J]. 临床医药实践, 2009, 18(36): 940-941.
[9] 牛兵占, 等. 黄帝内经[M]. 石家庄: 河北科学技术出版社, 1996.
[10] 巢元方. 诸病源候论[M]. 沈阳: 辽宁科学技术出版社, 1997: 25.
[11] 张自强. 腰椎间盘突出症的中医药治疗进展[J]. 光明中医, 2021, 36(18): 3197-3199.
[12] 王月, 刘露丝, 刘娟, 等. 川芎油对氯化钴损伤PC12细胞保护作用及其活性成分研究[J]. 天然产物研究与开发, 2017, 29(11): 1940-1945.
[13] 李芊, 吴效科. 川芎化学成分及药理作用研究新进展[J]. 化学工程师, 2020, 34(1): 62-64+44.
[14] 马宁宁, 范姗姗, 李欣, 等. 川芎的抗炎物质筛选及其作用机制分析[J]. 中国实验方剂学杂志, 2018, 2(18): 140-146.
[15] 孙存霞, 吴国林. 川芎中的化学成分的抗炎活性及其质量控制的研究[J]. 医药论坛杂志, 2015, 36(7): 58-60
[16] 王丽燕, 王敏, 李科旦. 中药熏蒸联合西医常规治疗寒湿型腰椎间盘突出症急性期患者36例[J]. 中国中医药科技, 2022, 29(4): 623-625.
[17] 张卫, 张瑞贤. 中药“五味”理论溯源——味的起源[J]. 国际中医中药杂志, 2012, 34(1): 60-62.
[18] 郭建生, 盛展能, 李钟文. 中药辛味的药性理论研讨[J]. 湖南中医学院学报, 1982(3): 69-81.
[19] 林志刚, 蒋诗超, 程艳彬, 等. 探讨《黄帝内经》“筋骨”理论对中医推拿的指导意义[J]. 中华中医药杂志, 2016, 31(7): 2491.
[20] 李鸿, 徐无忌. 黄芪桂枝五物汤联合针灸治疗血瘀型腰椎间盘突出症[J]. 中医药临床杂志, 2020, 32(4): 688-691.
https://doi.org/10.16448/j.cjtcm.2020.0425
[21] 崔庆同. 黄芪桂枝五物汤联合射频热凝术对气虚血瘀型腰椎间盘突出症的神经病理性疼痛控制及突出间盘CT值的相关性研究[D]: [硕士学位论文]. 天津: 天津中医药大学, 2021.
https://doi.org/10.27368/d.cnki.gtzyy.2021.000324
[22] 要少飞. 羌活胜湿汤加减治疗腰椎间盘突出症(寒湿型)的临床观察[D]: [硕士学位论文]. 哈尔滨: 黑龙江中医药大学, 2019.
https://doi.org/10.27127/d.cnki.ghlzu.2019.000187
[23] 杨玉赫, 徐雪娇, 李陈雪, 白宇, 车志远. 赤芍化学成分及药理作用研究新进展[J]. 化学工程师, 2021, 35(9): 42-44+31.
https://doi.org/10.16247/j.cnki.23-1171/tq.20210942
[24] 周岚. 补阳还五汤促进周围神经损伤修复的药理研究[J]. 河南中医, 2016, 36(4): 735-738.

Baidu
map