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[1]包偉東,胡靜,李煥香,等.基于數(shù)據(jù)挖掘技術(shù)分析初次全膝關(guān)節(jié)置換術(shù)后下肢腫脹的中醫(yī)證型和用藥規(guī)律[J].中醫(yī)正骨,2024,36(11):21-25,61.
　BAO Weidong,HU Jing,LI Huanxiang,et al.TCM syndrome types and clinical medication rules for lower limb swelling after primary total knee arthroplasty:a data mining-based analysis[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2024,36(11):21-25,61.
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基于數(shù)據(jù)挖掘技術(shù)分析初次全膝關(guān)節(jié)置換術(shù)后下肢腫脹的中醫(yī)證型和用藥規(guī)律()
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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第36卷
期數(shù):
2024年11期
頁碼:
21-25,61
欄目:
文獻(xiàn)研究
出版日期:
2024-11-20

文章信息/Info

Title:
TCM syndrome types and clinical medication rules for lower limb swelling after primary total knee arthroplasty:a data mining-based analysis
作者:
包偉東1; 胡靜2; 李煥香3; 王涵玉4; 邢鵬飛4; 王帥亞3; 孫永強(qiáng)1; 曹向陽1; 童培建5
1.河南省洛陽正骨醫(yī)院/河南省骨科醫(yī)院,河南 鄭州 450016; 2.鄭州衛(wèi)生健康職業(yè)學(xué)院,河南 鄭州 450122; 3.禹州市中醫(yī)院,河南 禹州 461670; 4.河南中醫(yī)藥大學(xué),河南 鄭州 450046; 5.浙江中醫(yī)藥大學(xué),浙江 杭州 310053
Author(s):
BAO Weidong1; HU Jing2; LI Huanxiang3; WANG Hanyu4; XING Pengfei4; WANG Shuaiya3; SUN Yongqiang1; CAO Xiang-yang1; TONG Peijian5
1.Luoyang Orthopedic-Traumatological Hospital,Zhengzhou 450016,Henan,China 2.Zhengzhou Health Vocational College,Zhengzhou 450122,Henan,China 3.Yuzhou Hospital of Traditional Chinese Medicine,Yuzhou 461670,Henan,China 4.Henan University of Chinese Medicine,Zhengzhou 450046,Henan,China 5.Zhejiang Chinese Medical University,Hangzhou 310053,Zhejiang,China
關(guān)鍵詞:
關(guān)節(jié)成形術(shù); 置換; 膝;  腫脹;  下肢;  證候;  方劑分析; 計(jì)算機(jī)輔助;  數(shù)據(jù)挖掘
Keywords:
arthroplasty; replacement; knee;  swelling;  lower extremity;  syndrome complex;  formula analysis; computer assisted;  data mining
摘要:
目的:分析初次全膝關(guān)節(jié)置換術(shù)(total knee arthroplasty,TKA)后下肢腫脹的中醫(yī)證型和用藥規(guī)律。方法:應(yīng)用計(jì)算機(jī)檢索中國知網(wǎng)、維普網(wǎng)、萬方數(shù)據(jù)庫,搜集有關(guān)中醫(yī)藥治療TKA后下肢腫脹的文獻(xiàn),檢索時限均為建庫至2024年2月。從符合要求的文獻(xiàn)中提取數(shù)據(jù),以Microsoft Office Excel2019軟件建立數(shù)據(jù)庫,對涉及的中醫(yī)證型名稱、方劑名稱、方劑功能分類、中藥名稱及中藥功能分類規(guī)范化處理后進(jìn)行頻次統(tǒng)計(jì),對篩選出的高頻藥物進(jìn)行聚類分析和關(guān)聯(lián)規(guī)則分析。結(jié)果:①文獻(xiàn)檢索及篩選結(jié)果。共檢索到2131篇文獻(xiàn),經(jīng)過篩選最終納入57篇文獻(xiàn)。②中醫(yī)證型分析結(jié)果。納入的57篇文獻(xiàn)共涉及7種中醫(yī)證型,出現(xiàn)頻次較高的中醫(yī)證型為氣滯血瘀、瘀水互結(jié)、氣虛血瘀。③方劑分析結(jié)果。納入的57篇文獻(xiàn)共涉及57首方劑。按照功能分類,理血劑43首、補(bǔ)血劑8首、祛濕劑5首、溫里劑1首。出現(xiàn)頻次較高的方劑為桃紅四物湯、身痛逐瘀湯和復(fù)元活血湯。④藥物分析結(jié)果。57首方劑共涉及115味中藥,其中出現(xiàn)頻次≥5的中藥(高頻藥物)共32味,出現(xiàn)頻次較高的中藥為當(dāng)歸、川芎、紅花、甘草; 按照中藥功能分類,活血化瘀藥和補(bǔ)虛藥出現(xiàn)頻次較高。32味高頻藥物可聚為3類,第1類5味中藥,功效以活血化瘀為主,適用于氣滯血瘀證; 第2類6味中藥,功效以補(bǔ)氣養(yǎng)血健脾為主,適用于氣虛血瘀證; 第3類21味中藥,功效以利水滲濕祛痰、滋補(bǔ)肝腎為主,適用于肝腎虧虛、痰瘀互結(jié)證。對32味高頻藥物進(jìn)行關(guān)聯(lián)規(guī)則分析,設(shè)置支持度為30%、置信度為90%,得到6味核心藥物(紅花、桃仁、當(dāng)歸、川芎、甘草、赤芍),共涉及19條關(guān)聯(lián)規(guī)則,其中當(dāng)歸-桃仁-紅花為核心藥物組合。結(jié)論:初次TKA后下肢腫脹的常見證型為氣滯血瘀、瘀水互結(jié)、氣虛血瘀,臨床用藥以活血化瘀藥和補(bǔ)虛藥為主,核心藥物為紅花、桃仁、當(dāng)歸、川芎、甘草、赤芍,核心藥物組合為當(dāng)歸-桃仁-紅花。
Abstract:
Objective:To analyze the TCM syndrome types and medication rules for lower limb swelling following primary total knee arthroplasty(TKA).Methods:The articles concerning TCM treatment of lower limb swelling after TKA included from database's inception to February 2024 were retrieved from China National Knowledge Infrastructure,Vip Database,and Wanfang Database through computer.The eligible articles were screened according to the predefined inclusion and exclusion criteria,and the data were extracted from the included articles and then input into the Microsoft Office Excel 2019 software to build a database,based on which,the involved TCM syndrome types,prescriptions,prescription function classifications,Chinese herbs(CHs)and CHs function classifications were normalized and standardized,followed by frequency statistics.The selected high-frequency CHs were then subjected to cluster analysis and association rule analysis.Results:①Article retrieval and screening results.Two thousand one hundred and thirty-one articles were searched out.After screening,57 ones were included in the final analysis.②The TCM syndrome type.Seven TCM syndrome types were involved in the 57 included articles,among which the qi-stagnation and blood-stasis syndrome,blood-stasis and water-retention syndrome,as well as qi-deficiency and blood-stasis syndrome appeared most frequently.③The prescription.Fifty-seven prescriptions were involved in the 57 included articles,including 43 blood-regulating formulas,8 blood-supplementing formulas(TCD),5 desiccating formulas,and 1 interior-warming formulas,among which the Taohong Siwu Tang(桃紅四物湯),Shentong Zhuyu Tang(身痛逐瘀湯),and Fuyuan Huoxue Tang(復(fù)元活血湯)appeared most frequently.④The CHs.One hundred and fifteen CHs were involved in the 57 prescriptions,among which 32 ones(high-frequency CHs)displayed a occurrence frequency≥5,and the top 4 ones with high occurrence frequency were Angelicae Sinensis Radix(TCD),Chuanxiong Rhizoma,Carthami Flos(TCD),and Glycyrrhizae Radix et Rhizoma(TCD).Furthermore,sorted by efficacy,the blood-activating and stasis-resolving CHs,as well as deficiency-reinforcing CHs appeared most frequently.As revealed by the cluster analysis,the 32 high-frequency CHs were clustered into three categories,with 5 CHs into Category I,mainly the ones for activating blood and removing stasis,which were suitable for qi-stagnation and blood-stasis syndrome; 6 CHs into CategoryⅡ,mainly the ones for reinforcing qi,nourishing blood and strengthening spleen,which were suitable for qi-deficiency and blood-stasis syndrome; and 21 CHs into CategoryⅢ,mainly the ones for diuresis,removing Dampness,expelling Phlegm,and reinforcing liver-kidney,which were suitable for liver-kidney deficiency syndrome,as well as intermingled phlegm and blood stasis syndrome.In addition,with a support of 30% and a confidence of 90%,the associ-ation rule analysis on the 32 high-frequency CHs yielded 6 core CHs(Carthami Flos(TCD),Persicae Semen,Angelicae Sinensis Radix(TCD),Chuanxiong Rhizoma,Glycyrrhizae Radix et Rhizoma(TCD),Paeoniae Radix Rubra),involving 19 association rules,with Angelicae Sinensis Radix(TCD)-Persicae Semen-Carthami Flos(TCD)as the core herb combination.Conclusion:The common TCM syndromes are qi-stagnation and blood-stasis syndrome,blood-stasis and water-retention syndrome,as well as qi-deficiency and blood-stasis syndrome for lower limb swelling in patients who underwent primary TKA.The clinical medication are centred on the blood-activating and stasis-re-solving CHs,as well as the deficiency-reinforcing CHs.The Carthami Flos(TCD),Persicae Semen,Angelicae Sinensis Radix(TCD),Chuanxiong Rhizoma,Glycyrrhizae Radix et Rhizoma(TCD)and Paeoniae Radix Rubra are usually used as the core CHs,and Angelicae Sinensis Radix(TCD)-Persicae Semen-Carthami Flos(TCD)as the core herb combination in treating lower limb swelling after primary TKA.

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備注/Memo

備注/Memo:
基金項(xiàng)目:河南省中醫(yī)藥科學(xué)研究專項(xiàng)課題(2023ZY1019,2024ZY2119)
通訊作者:孫永強(qiáng) E-mail:[email protected]
更新日期/Last Update: 1900-01-01