来源：风湿病与关节炎,2024,13（1）:14-18,39.

高明利教授治疗痛风性关节炎急性期的用药规律（临床研究）

汪　敏¹，高明利²，齐　庆²，孙蓬远²，关　蕊¹，张晓雨³

　　【摘　要】目的：应用数据挖掘的科研方法分析高明利教授辨治痛风性关节炎急性期的药物组方原则及用药规律，为临床用药提供科学的依据。方法：收集2017年1月15日至2021年12月15日在辽宁中医药大学附属医院风湿科高明利教授门诊就诊的206例痛风性关节炎急性期患者的病例数据及首诊处方，对性别、年龄、四气五味、归经、药物功效、药物的频次进行分析；采用软件IBM SPSS Modeler 18.0、SPSS 26.0对数据进行复杂网络分析、关联规则分析及聚类分析。结果：对206例病例数据进行整理，男女比为40∶1，涉及药物135味，频次最高的药物为萆薢、泽泻、知母、薏苡仁；四气多为寒、平、温；五味多为苦、甘、辛，归经多为肾、胃、肝三经。药物类别清热药、利水渗湿药、祛风湿药应用居多。关联规则分析得出常用药对及药物组，高频药物聚类分析共聚5大类。结论：高明利教授治疗痛风性关节炎急性期以清热药、利水渗湿药及祛风湿药为基准，重用清热药与利水渗湿药，用以清热利湿、通络止痛，在性味归经上重用苦寒之品，多选择从肾经上加以干预，治疗多以清热利湿为中心，佐用健脾、活血、引经、补益、解表、散结、止痛等药物。

　　【关键词】　痛风性关节炎；急性期；数据挖掘；中药；用药规律；高明利

Professor GAO Ming-li's Medication Patterns in the Treatment of Acute Gouty Arthritis

WANG Min,GAO Ming-li,QI Qing,SUN Peng-yuan,GUAN Rui,ZHANG Xiao-yu

　　【ABSTRACT】Objective:To apply the data mining method to analyze Professor GAO Ming-li's medication principles and patterns in the diagnosis and treatment of acute gouty arthritis,and provide scientific basis for clinical medication.Methods:Collect case data and initial diagnosis prescriptions of 206 patients with acute gouty arthritis treated by professor Gao Ming-li at the Rheumatology Department of Liaoning University of Traditional Chinese Medicine Affiliated Hospital from January 15,2017 to December 15,2021.Gender,age,the four qi and five flavors,channel entry,medicine efficacy,and medicine frequency were analyzed.Software IBM SPSS Modeler 18.0 and SPSS 26.0 were used to perform complex network analysis,association rule analysis,and cluster analysis on the data.Results:Two hundred and six cases were sorted out,with a male to female ratio of 40∶1,involving 135 medicines.The most frequent medicines were Bixie（Rhizoma Dioscoreae Hypoglaucae）,Zexie（Rhizoma Alismatis）,Zhimu（Rhizoma Anemarrhenae）,and Yiyiren（Semen Coicis）.The four qi were mostly cold,neutral,and warm;the five flavors were mostly bitter,sweet,and acrid,and the channel entry were mainly the kidney,stomach,and liver channels.From the perspective of medicine categories,the majority of them were used for clearing heat,promoting urination and percolating dampness,and dispelling wind and dampness.Association rule analysis identified commonly used medicine pairs and groups,and high-frequency drug clustering analysis aggregates 5 major categories.Conclusion:Professor GAO Ming-li's treatment of acute gouty arthritis is based on medicines of clearing heat,promoting urination and percolating dampness,and dispelling wind and dampness,among which he puts emphasis on medicines of clearing heat,promoting urination and percolating dampness to clear heat and drain dampness,unblock the collaterals and relieve pain,and focuses on medicines with natures of bitter and cold to clear heat and drain dampness and intervene from the kidney channel.He also uses medicines of invigorating the spleen,promoting blood circulation,guiding channels,supplementing and boosting,releasing exterior,dispersing nodules,and relieving pain.

　　【Keywords】 gouty arthritis;acute phase;data mining;Chinese medicine;medication rule;GAO Ming-li