基于关联规则挖掘痛风性关节炎中医内外合治对患者免疫、炎症等指标的影响  

On the Influence of Internal and External Treatment of Gouty Arthritis with Chinese Medicine on Patients' Immune and Inflammatory Indexes based on Association Rules

作　　者：宋倩[1] 刘健[2] 忻凌[2] 周巧[1] 黄旦[1] 郭锦晨 SONG Qian LIU Jian XIN Ling ZHOU Qiao HUANG Dan GUO Jin-chen

机构地区：[1]安徽中医药大学,安徽合肥230038 [2]安徽中医药大学第一附属医院,安徽合肥230031

出　　处：《风湿病与关节炎》2017年第1期9-13,35,共6页Rheumatism and Arthritis

基　　金：国家中医药重点学科中医痹病学建设项目(国中医药发〔2009〕30号);国家临床重点专科中医风湿病科建设项目(财社〔2013〕239号);安徽省重点实验室建设项目(1306c083035;1606c08238);国家科技支撑计划课题(2012BA126B02)

摘　　要：目的:应用关联规则和统计学方法分析刘健采用中医健脾单元疗法治疗痛风性关节炎对患者免疫、炎症及氧化指标的影响,为优化治疗提供依据。方法:搜集并整理安徽中医药大学第一附属医院电子病例系统所录入的痛风性关节炎患者的资料。采用SPSS 17.0、SPSS Clementine 12.0软件和Aprior模块分析中药、外用药与实验室指标变化的关系。结果:1治疗后,单纯内治组患者的免疫指标补体C3,炎症指标红细胞沉降率(ESR)、超敏C-反应蛋白(hs-CRP)、α1-酸性糖蛋白(α1-AGP),尿酸(UA)均有所降低(P<0.05);内外合治组患者红细胞计数、血红蛋白浓度、血小板计数均有所上升(P<0.05或P<0.01);免疫指标C3、C4,炎症指标ESR、hs-CRP、α1-AGP,UA均有所降低(P<0.05或P<0.01);内外合治组患者ESR、hs-CRP、α1-AGP较单纯内治组患者改善更为明显(P<0.05或P<0.01);2所用中药多集中在健脾利湿、清热解毒、活血化瘀、祛风除湿4类,提取每类使用频次前5位的中药共20味;3在关联规则置信度设为70%,支持度设为20%条件下提取值与指标关联较高的前2味中药,即茯苓、薏苡仁、白术、猪苓、车前草、蒲公英、山慈菇、大黄、丹参、桃仁、红花、威灵仙12味中药。结论:刘健在治疗痛风性关节炎时所采取的健脾单元综合疗法配伍明确,组方精炼,疗效确切。Objective：To analyze the influence ofLiu Jian＇s method of treating gouty arthritis with Unit Therapy of Invigorating Spleen on patients＇ immune,inflammatory and oxidative indexes using association rules and statistical methods in order to optimize treatment.Methods：Data of patients with gouty arthritis were collected from the First Affiliated Hospital of Anhui University of Chinese Medicine and sorted.Softwares SPSS 17.0 and SPSS Clementine 12.0 and Aprior module were used to analyze the relationship between Chinese medicine,externally applied medicine and laboratory indexes.Results： ①After treatment,C3,ESR,hs-CRP, ctl-AGP and UA of patients with internal treatment decreased （ P 〈 0.05 ） .Red blood cell count,hemoglobin concentration and platelet count in patients with combined internal and external treatment increased （ P 〈 0.05 or P 〈 0.01 ） . Immune indexes C3,C4 and inflammatory indexes ESR,hs-CRP, α1-AGP and UA decreased （P 〈 0.05 or P 〈 0.01 ） .ESR,hs-CRP and cO-AGP in patients with combined treatment were improved compared with those with only internal treatment （P 〈 0.05 or P 〈 0.01 ） . ② Chinese drugs used in the treatment belong to four categories according to their functions such as strengthening spleen,clearing away the heat and expelling superficial evils,activating blood circulation to dissipate blood stasis,and dispelling wind and eliminating dampness.Twenty drugs were chosen from the five top frequently used drugs in each category. ③ When association rule confidence was 70% and support was 20%, twelve drugs were chosen according to the higher association between extraction value and index,i.e. Fuling （ Poria ） ,Yiyiren （ Semen Coicis ） ,Baizhu （ Rhizoma Atractylodis Macrocephalae ） ,Zhuling （ Polyporus ） ,Cheqiancao （ Herba Plantaginis ） ,Pugongying （ Herba Taraxaci Mongolici ） ,Shancigu （ Pseudobulbus Cremastrae seu Pleiones ）,Dahuang（ Radix et Rhizoma Rhei Palmati ）,Danshen（ Danshen ）,Taoren （ Semen Persicae �

关 键 词：痛风性关节炎 关联规则 中药 健脾单元疗法 

分 类 号：R259[医药卫生—中西医结合]