来源：风湿病与关节炎,2019,8（3）:11-15,21.

基于HIS 4615份病历探讨复方芪薏胶囊对类风湿关节炎

患者免疫炎症指标的影响（临床研究）

侯阿美¹，刘　健²，郭锦晨¹

　　【摘　要】目的：研究复方芪薏胶囊对类风湿关节炎免疫炎症指标的影响。方法：收集安徽中医药大学第一附属医院信息系统（HIS）风湿病科2012年5月至2017年12月RA住院患者的病历资料，采用SPSS 22.0软件分析类风湿关节炎患者一般情况、免疫炎症指标的变化，SPSS Clementine 14.2和ORACLE 10 g工具进行关联规则分析与随机行走模型评价。结果：①共有4615例类风湿关节炎患者符合本次研究要求，其中试验组1324例，对照组3291例。2组患者在性别、年龄及住院时间等方面比较，差异无统计学意义（P > 0.05）。②2组患者免疫球蛋白M（IgM）、类风湿因子（RF）、抗环瓜氨酸肽（抗CCP）抗体治疗前后差值均降低，且试验组在降低IgM、RF、抗CCP抗体方面优于对照组，差异有统计学意义（P < 0.01）。③关联规则分析：复方芪薏胶囊与免疫炎症指标的改善有明显关联，且复方芪薏胶囊与IgA、IgG、IgM、RF、抗CCP抗体、超敏C-反应蛋白（hs-CRP）、红细胞沉降率（ESR）等指标改善的关联置信度明显高于对照组。复方芪薏胶囊联合蒲公英、杜仲、猪苓、山药、车前草、黄芩等中药与IgA、IgG、IgM、RF、抗CCP抗体、hs-CRP、ESR等指标改善的关联置信度明显高于对照组。④随机行走模型分析：试验组抗CCP抗体、IgM综合评价指标的正向递增率分别为0.523 7、0.116 5，每正向行走1步综合改善率分别为18.75%、3.45%。对照组抗CCP抗体、IgM综合评价指标的正向递增率分别为0.512 5、0.073 8，每正向行走1步综合改善率分别为20.12%、24.70%。结论：复方芪薏胶囊能够有效改善类风湿关节炎患者免疫炎症指标，且其联合中药内服与指标的改善存在明显关联。

　　【关键词】　关节炎，类风湿；复方芪薏胶囊；免疫炎症；关联规则；随机行走模型

Effect of Fufang Qiyi Jiaonang（复方芪薏胶囊）on Immune Inflammation Indicators in Patients with Rheumatoid Arthritis Based on HIS 4615 Medical Records

HOU A-mei,LIU Jian,GUO Jin-chen

　　【ABSTRACT】Objective:To study the effect of Fufang Qiyi Jiaonang（复方芪薏胶囊）on immune inflammation index of rheumatoid arthritis.Methods:The data of RA inpatients from May 2012 to December 2017 in the Hospital Information System（HIS）of the Rheumatology Department of the First Affiliated Hospital of Anhui University of Chinese Medicine were collected.SPSS 22.0 was used to analyze the general situation of patients with rheumatoid arthritis and the changes of their immune inflammation index.SPSS Clementine 14.2 and ORACLE 10 were used to analyze the association rules and evaluate the random walk model.Results:①A total of 4615 patients with rheumatoid arthritis met the requirements of this study,including 1324 in the experiment group and 3291 in the control group.There was no significant difference in gender,age and length of stay between the two groups（P > 0.05）.② The differences of IgM,RF and anti-CCP antibody between the two groups before and after treatment were decreased,and the experiment group was better than the control group on lowering IgM,RF and anti-CCP antibody,with statistical significance（P < 0.01）.③Association rule analysis showed that Fufang Qiyi Jiaonang was significantly correlated with the improvement of immune inflammation index,and the correlation confidence of Fufang Qiyi Jiaonang with the improvement of IgA,IgG,IgM,RF,anti-CCP antibody,hs-CRP,ESR was significantly higher in the treatment group than that in control group.The correlation confidence between Fufang Qiyi Jiaonang combined with Pugongying（Taraxacum mongolicum Hand.-Mazz.）,Duzhong（Eucommia ulmoides Oliver）,Zhuling（Polyporus）,Shanyao（Dioscorea opposita Thunb.）,Cheqiancao（Plantaginaceae）and Huangqin（Scutellaria baicalensis Georgi）and the improvement of IgA,IgG,IgM,RF,anti-CCP antibody,hs-CRP,ESR and other indicators was significantly higher than that of the control group.④The random walk model analysis showed that the positive increment rates of anti-CCP antibody and IgM comprehensive evaluation indexes in the experiment group were 0.523 7 and 0.116 5 respectively,and the comprehensive improvement rates were 18.75% and 3.45% for each positive walk step.The positive increment rates of CCP antibody and IgM comprehensive evaluation indexes in the control group were 0.512 5 and 0.073 8 respectively,and the comprehensive improvement rates were 20.12% and 24.70% for each positive step.Conclusion:Fufang Qiyi Jiaonang can effectively improve the immune inflammation index of patients with rheumatoid arthritis,and its combination with Chinese medicine has a significant correlation with the improvement of the index.

　　【Keywords】 arthritis,rheumatoid;Fufang Qiyi Jiaonang（复方芪薏胶囊）;immune inflammation;association rules;random walk model