来源：风湿病与关节炎,2023,12（3）:13-19,28.

基于数据挖掘的补肾法治疗类风湿关节炎用药规律研究（临床研究）

郑慧兰^1,2，陶庆文^2,3，汪志伟¹，屈祥科¹，韩雨欣¹，王建明^2,3

　　【摘　要】目的：探索补肾法治疗类风湿关节炎的用药规律，从“理-法-方-药”角度阐释补肾法治疗类风湿关节炎的内涵，为临床治疗提供依据。方法：计算机检索中国知网、万方、维普、PubMed、Science Direct、Cochrane Library、Web of science数据库，筛选补肾法治疗类风湿关节炎的文献，构建补肾方剂数据库，根据《中国药典》及《中华本草》对中药名称进行规范处理。运用Microsoft Excel进行频数统计和功效分类统计，IBM SPSS Modeler实现Apriori建模进行关联规则分析，Cytoscape计算拓扑学特征并形成复杂网络，IBM SPSS Statistics对高频中药进行系统聚类分析以及因子分析。结果：最终纳入144篇文献，包含111首方剂，涉及156味中药。频次统计结果显示，使用频次 ﹥20次的中药有25味，前5味为熟地黄、淫羊藿、白芍、续断、补骨脂，功效分类以补益药、祛风湿药、活血化瘀药和清热药为主。经设置后Apriori算法最终产生560条规则，常见组合有熟地黄-骨碎补-威灵仙、熟地黄-补骨脂-淫羊藿、桂枝-白芍-续断。聚类分析得到具有同质性的5组中药药组，因子分析最终得到公因子8个，补肾祛寒治尪汤加减是多个补肾中药复方的共同因子。结论：补肾法治疗类风湿关节炎的核心要点是扶正祛邪、标本同治，扶正以补肾壮骨、温阳散寒为主，重视调和营卫，祛邪包括祛风除湿、活血化瘀、清解郁热，并灵活配伍藤类药和虫类药通经活络。

　　【关键词】　类风湿关节炎；补肾法；数据挖掘；用药规律；中药药组

Study on the Medication Rule of Kidney-tonifying Therapy for Rheumatoid Arthritis Based on Data Mining

ZHENG Hui-lan,TAO Qing-wen,WANG Zhi-wei,QU Xiang-ke,HAN Yu-xin,WANG Jian-ming

　　【ABSTRACT】Objective:To explore the medication rules of kidney-tonifying therapy in the treatment of rheumatoid arthritis,and explain the connotation of kidney-tonifying therapy in the treatment of rheumatoid arthritis from the perspective of "theory,method,prescription and medicine",so as to provide basis for clinical treatment.Methods:The database of tonifying kidney prescription was constructed by searching the databases such as CNKI,VIP,Wanfang,PubMed,Science Direct,Cochrane Library,Web of science to screen the literature of kidney-tonifying therapy for rheumatoid arthritis,and the names of Chinese medicine were standardized according to The Pharmacopoeia of the People's Republic of China and The Chinese Materia Medica.Microsoft Excel was used for frequency statistics and efficacy classification statistics.IBM SPSS Modeler implemented Apriori modeling for association rule analysis.Cytoscape calculated topological characteristics and forms complex networks,and IBM SPSS Statistics performed systematic cluster analysis and factor analysis on high-frequency Chinese medicine.Results:One hundred and forty-four articles,including 111 prescriptions and 156 Chinese medicines,were finally included.The results of frequency statistics showed that there were 25 Chinese medicines with a frequency of more than 20 times.The first five are Shudihuang（Radix Rehmanniae Praeparata）,Yinyanghuo（Herba Epimedii）,Baishao（Radix Paeoniae Alba）,Xuduan（Radix Dipsaci）and Buguzhi（Fructus Psoraleae）,whose efficacy classification was mainly based on tonifying medicines,wind-damp-dispelling medicines,blood-activating and blood-stasis removing medicines,and heat-clearing medicines.After setting,the Apriori algorithm finally generated 560 rules,and the common combinations included Shudihuang-Gusuibu（Rhizoma Drynariae）-Weilingxian（Radix et Rhizoma Clematidis）,Shudihuang-Buguzhi-Yinyanghuo,and Guizhi（Ramulus Cinnamomi）-Baishuo-Xuduan.Five groups of Chinese medicine with homogeneity were obtained by cluster analysis,and 8 common factors were finally obtained by factor analysis.The modified Bushen Quhan Zhiwang Tang（补肾祛寒治尪汤）was the common factor of multiple Chinese medicinal compounds of tonifying kidney.Conclusion:The key point of the treatment of rheumatoid arthritis with the method of tonifying the kidney is to strengthen the body resistance to eliminate pathogenic factors and to treat the root and tip simultaneously.Strengthening the body resistance mainly depends on strengthening the kidney and the bone,warming the yang and dissipating the cold,and pays attention to the coordination of the ying and wei.Eliminating pathogenic factors includes removing wind and dampness,activating blood circulation and removing stasis,clearing away heat,and flexibly combining the rattan and insect medicines to activate the meridians and collaterals.

　　【Keywords】 rheumatoid arthritis;kidney-tonifying therapy;data mining;medication rule;Chinese medicine group