基于关联规则挖掘中医内外合治类风湿关节炎对免疫炎症的影响  

Study on the Influence of Internal and External Treatment of Rheumatoid Arthritis on Immune Inflammation based on Association Rules

作　　者：端淑杰 刘健[2] 张帆[1] 忻凌[1] 

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2期10-14,21,共6页Rheumatism and Arthritis

基　　金：国家临床重点专科中医风湿病科建设项目(财社〔2013〕239号);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);安徽省重点实验室建设项目(1306c083035);国家科技支撑计划课题(2012BA126B02)

摘　　要：目的:采用关联规则数据挖掘技术和统计学方法分析刘健采用中医健脾单元疗法中医内外合治类风湿关节炎对患者炎症及免疫指标的影响,为临床治疗提供依据。方法:使用计算机数据挖掘技术提取并整理安徽中医药大学第一附属医院风湿科住院类风湿关节炎患者的资料。采用SPSS 17.0软件中t检验和SPSS Clementine 12.0软件Aprior模块分析中药、外用药与实验室指标变化的关系。结果:临床最常用4类中药为健脾化湿药、活血通络药、清热利湿药、祛风除湿药,以归脾、胃、肝、肾经为主,外敷药为芙蓉膏和消瘀接骨散;单纯中药组和内外合治组中红细胞沉降率(ESR)、超敏C-反应蛋白(hsCRP)、类风湿因子(RF)、抗CCP抗体、α1-酸性糖蛋白(α1-AGP)、Ig G、Ig A、C3、C4、血小板计数(PLT)治疗后比治疗前均下降;2组治疗后指标比较,内外合治组ESR、hs-CRP、RF、PLT下降明显,差异有统计学意义(P<0.05)。与ESR、hs-CRP、RF、抗CCP抗体支持度和置信度相对较高的中药是蒲公英、黄芩、白花蛇舌草、威灵仙、豨莶草;与α1-AGP、Ig G、Ig A、C3、C4支持度和置信度相对较高的中药是薏苡仁、山药、茯苓、陈皮、白花蛇舌草、鸡血藤,与PLT支持度和置信度高的中药是丹参和山药。芙蓉膏联合消瘀接骨散与ESR、hs-CRP、RF下降有明显关联。结论:清热利湿药和祛风除湿药与炎症指标有关联,健脾化湿药和清热利湿药、活血通络药与免疫指标有关联,活血通络药与凝血有关联,外敷药与炎症指标下降关联密切,中医内外合治采用多途径、多靶点治疗类风湿关节炎,取得良好的疗效。Objective：To study the influence of LIU Jian＇s TCM unit therapy to treat rheumatoid arthritis internally and externally on immune inflammation using data mining and statistical analysis to provide the basis for clinical treatment.Methods：The data of patients with rheumatoid arthritis in the Department of Rheumatism of the First Affiliated Hospital of Anhui University of Traditional Chinese Medicine were extracted and analyzed by computer data mining.The t test of software SPSS 17.0 and the Aprior module of software SPSS Clementine 12.0 were used to analyze the relationship between Chinese medicine,external medicine and laboratory indicators.Results：Four kinds of commonly and clinically used Chinese medicine were functioned as invigoratingspleen to eliminate dampness,promoting blood circulation,cleating heat and removing dampness,and dispelling wind and dampness and they reach the spleen meridian,the stomach meridian,the liver meridian and the kidney meridian.The external medicine wereFurong ointment （ 芙蓉膏） and Xiaoyu Jiegu san （ 消瘀接骨散 ） .The ESR,hs-CRP, RF, anti CCP antibody, α1- AGP, IgG,IgA,C3,C4 and PLT of the group treated with Chinese medicine internally and the group treated internally and externally decreased compared with those before treatment.Compared with the other group,the ESR,hs-CRP, RF and PLT count of the group treated externally and internally significantly decreased and the difference was statistically significant （P 〈 0.05 ） .Chinese drugs with relatively high support degree and confidence degree to ESR,hs-CRP, RF and anti CCP antibody were Pugongying （ Herba Taraxaci Mongolici ）,Huangqin（ Radix Scutellariae Baicalensis ）,Baihuasheshecao（ Herba Hedyotidis ）,Weilingxian（ Radix et Rhizoma Clematidis Chinensis ） and Xixiancao （ Herba Siegesbeckiae ） .Those with relatively high support degree and confidence degree to α1-AGP, IgG,IgA,C3 and C4 were Yiyiren （ Semen Coicis ） ,Shanyao （ Rhizoma Dioscoreae Oppositae ） ,Fuling （ poria

关 键 词：关节炎 类风湿 关联规则 中医内外合治 

分 类 号：R259[医药卫生—中西医结合]