来源：风湿病与关节炎,2019,8（10）:9-13.

痛风性关节炎患者免疫指标的变化及中医药干预的

数据挖掘研究（临床研究）

贺明玉¹，刘　健²，韩馨悦¹，张国磊¹

　　【摘　要】目的：研究痛风性关节炎患者免疫指标［免疫球蛋白A（IgA）、免疫球蛋白M（IgM）、免疫球蛋白G（IgG）、补体C3（C3）、补体C4（C4）］的变化，及其与白细胞计数（WBC）、C-反应蛋白（CRP）、红细胞沉降率（ESR）等炎症指标，尿酸（UA）、D-二聚体（DD）等指标的相关性，并探讨运用中医药疗法干预痛风性关节炎的用药规律。方法：收集安徽中医药大学第一附属医院风湿免疫科2012年5月至2018年12月痛风性关节炎住院患者的病历资料，采用SPSS 22.0统计软件对实验室指标、实验室指标相关性分析等进行数据挖掘。采用SPSS Clementine 17.0软件Aprior模块分析痛风性关节炎患者免疫指标（IgA、IgG、C3、C4）与中药的关联程度。结果：①实验室指标显示，中医药干预后，IgA、IgM、IgG、C3、C4、UA、DD指标均有所降低，IgM有所上升。②相关性分析结果显示，IgA、C3、C4与UA呈正相关，C3、C4与ESR呈正相关，IgA、C3与WBC呈正相关，C3与CRP呈负相关，与其他指标无相关性（P > 0.05）。③中药使用频次分析，使用频次最高的前4类药物为健脾化湿药、清热解毒药、活血化瘀药、祛风湿药。④关联结果分析显示，与免疫指标下降关联较高的中药组合为陈皮-泽泻、蒲公英-泽泻、泽兰-蒲公英，其提升度均 > 1。结论：痛风性关节炎患者免疫指标的变化，主要表现为C3、C4上升，与UA、炎症指标具有一定相关性。中医药干预疗法主以清热解毒、健脾利湿。可有效降低机体免疫指标水平，减少UA生成，促进UA排泄，缓解患者临床症状。

　　【关键词】　痛风性关节炎；中医药；免疫指标；关联规则；数据挖掘

Changes of Immune Indicators in Patients with Acute Gouty Arthritis and Data Mining of Chinese Medicine Intervention

HE Ming-yu,LIU Jian,HAN Xin-yue,ZHANG Guo-lei

　　【ABSTRACT】Objective:To study the changes of immune indexes（IgA,IgM,IgG,C3 and C4）in patients with gouty arthritis,and their correlation with Laboratory indexes such as WBC,CRP,ESR,and uric acid（UA）,D-dimer（DD）inflammation,and to explore the medication of Chinese medicine for gouty arthritis.Methods:Data of gouty arthritis of inpatients（from May 2012 to December 2018）in the Department of Rheumatology,First Affiliated Hospital of Anhui University of Chinese Medicine were collected.Data mining was carried out using statistical software SPSS 22.0 to analyze the correlation of laboratory indicators and the index correlation analysis of laboratory indicators.Aprior module in the software SPSS Clementine 17.0 was used to analyze the correlation between immune indexes（IgA,IgM,IgG,C3,C4）and Chinese medicine.Results:①Laboratory indicators showed that after Chinese medicine intervention,IgA,IgG,C3,C4,UA and DD indicators were all reduced,and IgM was increased.②The results of correlation analysis showed that IgA,C3,C4 were positively correlated with UA;C3,C4 were positively correlated with ESR;IgA,C3 were positively correlated with WBC;C3 was negatively correlated with CRP and was not correlated with other indicators（P > 0.05）.③Frequency analysis of Chinese medicine showed that the top 4 types of medicinals used most frequently are spleen-strengthening and dampness-removing medicinals,heat-clearing and detoxifying medicinals,blood-activating and stasis-removing medicinals and rheumatism-removing medicinals.④The results of correlation analysis showed that the combination of Chinese medicine with higher correlation with the decrease of immune index were Chenpi-Zexie,Pugongying-Zexie,Zelan-Pugongying and their promotion degree was above one.Conclusion:The changes of immune indexes in patients with gouty arthritis are mainly manifested in the elevation of C3 and C4,which are correlated with UA and inflammation.Chinese medicine intervention therapy mainly includes clearing away heat and detoxification,invigorating spleen and eliminating dampness.It can effectively reduce the level of immune indicators,reduce the generation of UA,promote UA excretion,and alleviate the clinical symptoms of patients.

　　【Keywords】 gouty arthritis;traditional Chinese medicine;immune indicators;association rules;data mining