1.上海中医药大学附属龙华医院(上海 200032)
2.上海中医药大学脊柱病研究所(上海 200032)
3.上海市施杞名中医工作室(上海 200032)
张成波,男,硕士研究生,主要从事中医骨伤科的临床研究工作;
许金海,副主任医师;E-mail:jinhaixu@126.com。
叶洁,主任医师,硕士研究生导师;E-mail:yejie1977@126.com
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张成波, 童正一, 许金海, 等. 基于数据挖掘的中医治疗脊髓型颈椎病证治方药规律研究[J]. 上海中医药杂志, 2021,55(4):15-20.
Chengbo ZHANG, Zhengyi TONG, Jinhai XU, et al. Data mining based research on rules of syndrome-treatment-prescription-medicine for traditional Chinese medicine treatment of cervical spondylotic myelopathy[J]. Shanghai Journal of Traditional Chinese Medicine, 2021,55(4):15-20.
张成波, 童正一, 许金海, 等. 基于数据挖掘的中医治疗脊髓型颈椎病证治方药规律研究[J]. 上海中医药杂志, 2021,55(4):15-20. DOI: 10.16305/j.1007-1334.2021.2005046.
Chengbo ZHANG, Zhengyi TONG, Jinhai XU, et al. Data mining based research on rules of syndrome-treatment-prescription-medicine for traditional Chinese medicine treatment of cervical spondylotic myelopathy[J]. Shanghai Journal of Traditional Chinese Medicine, 2021,55(4):15-20. DOI: 10.16305/j.1007-1334.2021.2005046.
目的,2,总结分析中医治疗脊髓型颈椎病的证治方药规律,为临床实践提供参考。,方法,2,通过检索中国知网数据库、万方医学网数据库、维普中文科技期刊数据库,收集并整理1990年1月1日至2019年12月31日期间有关中药内服治疗脊髓型颈椎病的文献,运用Excel 2010软件计算证型、证候要素与方药的频数、频率,运用SPSS 21.0软件对数据库中的高频药物进行聚类分析,运用SPSS Modeler 18.0软件对高频药物进行关联规则分析。,结果,2,①最终筛选出符合条件的文献59篇,归类后得出本病的中医证型有34个,其中肝肾亏虚证、气滞血瘀证、经络瘀阻证、气血不足证为常见证型,占58.82%。②实性病性要素为6个,主要为血瘀、气滞、湿阻;虚性病性要素为4个,主要为气虚、血虚、督脉亏虚。脏腑病位主要涉及肾、肝。③治疗本病的中药方剂共有84首,其中成方46首,成方运用较多的是补阳还五汤、地黄饮子、圣愈汤等;对常用成方功能进行归类,发现补益剂与理血剂的使用频率最高,占78.26%。④治疗本病的中药共165味,高频中药依次为当归、黄芪、川芎、红花等;补虚药、活血化瘀药是治疗脊髓型颈椎病的常用药物类别,其中补虚药最多、占34.60%。⑤聚类分析可知本病高频使用的中药可分三类,对于肝肾亏虚兼风寒湿阻型可选药物组合为牛膝、党参、山茱萸等;对于气虚血瘀型可选的药物组合为当归、黄芪与川芎;对于经络瘀阻型可选的药物组合为白芍、地龙、赤芍等。⑥关联规则分析得到7味核心中药、14条核心药物组合,其中得到一组角药(黄芪、当归、川芎),并发现核心药物组合主要为补虚药(黄芪、当归、白芍)、活血化瘀药(川芎、桃仁、红花)以及平肝熄风药(地龙)。,结论,2,采用数据挖掘分析中医治疗脊髓型颈椎病证治方药规律的方法可行,其结果可为临床实践提供一定有价值的参考。
Objective,2,This paper analyzed and summarized the rules of syndrome-treatment-prescription-medicine for traditional Chinese medicine (TCM) treatment of cervical spondylotic myelopathy (CSM) to provide reference for clinical practice.,Methods,2,Literatures about the treatment of cervical spondylotic myelopathy with oral administration of traditional Chinese medicine were collected and sorted out by searching China National Knowledge Infrastructure (CNKI) database, Wanfang Medical Network database and Chinese Sci & Tech Journals (VIP) database from January 1, 1990 to December 31, 2019. Excel 2010 software was used to calculate the frequency of syndromes, syndrome elements, prescriptions and traditional Chinese herbal medicines (TCHMs), SPSS21.0 software was used to cluster the high-frequency herbal medicines in the database, and SPSS Modeler 18.0 software was used to analyze the association rules of high-frequency TCHMs.,Results,2,①Fifty-nine qualified literatures were finally screened out, and 34 TCM syndromes of CSM were obtained after classification, of which liver and kidney deficiency syndrome, qi stagnation and blood stasis syndrome, channel-collateral stasis and obstruction syndrome and qi and blood deficiency syndrome were common syndromes, accounting for 58.82%. ②There were 6 elements manifesting excess disease nature, mainly blood stasis, qi stagnation and dampness obstruction and 4 elements manifesting deficiency disease nature, mainly qi deficiency, blood deficiency and governor channel deficiency. Zang-fu organs involved were mainly kidney and liver. ③There were 84 TCM prescriptions for the treatment of CSM, of which 46 were set prescriptions. The mostly used ones were Buyang Huanwu Decoction, Dihuang Yinzi Decoction, and Shengyu Decoction, etc. According to the classification based on the effects of commonly used prescriptions, it is found that tonifying prescriptions and blood-regulating prescriptions were the most frequently used, accounting for 78.26%. ④There were 165 kinds of TCHMs for the treatment of CSM. The high-frequency TCHMs in turn were Danggui (,Radix Angelicae Sinensis,), Huangqi (,Radix Astragali seu Hedysari,), Chuanxiong (,Rhizoma Ligustici Chuanxiong,), and Honghua (,Flos Carthami,), etc. Deficiency-tonifying TCHMs and blood circulation-promoting and blood stasis-removing TCHMs were commonly used for the treatment of CSM, of which deficiency-tonifying TCHMs were the most in kinds, accounting for 34.60%. ⑤Cluster analysis showed that TCHMs of high-frequency used in CSM treatment can be divided into three categories: For liver and kidney deficiency syndrome, the optional TCHMs were Niuxi (,Radix Achyranthis Bidentatae,), Dangshen (,Radix Codonopsis,), and Shanzhuyu (,Fructus Corni,), etc.; For qi deficency and blood stasis syndrome, the optional TCHMs were Danggui (,Radix Angelicae Sinensis,), Huangqi (,Radix Astragali seu Hedysari,), and Chuanxiong (,Rhizoma Ligustici Chuanxiong,); For channel-collateral stasis and obstruction syndrome, the optional TCHMs were Baishao (,Radix Paeoniae Alba,), Dilong (,Lumbricus,), and Chishao (,Radix Paeoniae Rubra,), etc. ⑥According to the association rules, 7 core TCHMs and 14 core TCHM combinations were obtained, of which a triangular TCHM group including Huangqi (,Radix Astragali seu Hedysari,), Danggui (,Radix Angelicae Sinensis,) and Chuanxiong (,Rhizoma Ligustici Chuanxiong,) was obtained. It was also found that the core TCHM combinations were mainly deficiency-tonifying TCHMs including Huangqi (,Radix Astragali seu Hedysari,), Danggui (,Radix Angelicae Sinensis,) and Baishao (,Radix Paeoniae Alba,), blood circulation-promoting and blood stasis-removing TCHMs including Chuanxiong (,Rhizoma Ligustici Chuanxiong,), Taoren (,Semen Persicae,) and Honghua (,Flos Carthami,), and liver-calming and wind-stopping TCHM including Dilong(,Lumbricus,).,Conclusion,2,It is feasible to analyze the rules of TCM treatment of cervical spondylotic myelopathy based on data mining, and the data mining results can provide valuable reference for clinical practice.
脊髓型颈椎病中药内服中医证候中医治法数据挖掘
cervical spondylotic myelopathyTCM oral administrationTCM syndromeTCM treatmentdata mining
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