基于关联规则挖掘中药内外合治骨关节炎对免疫炎症指标的影响  

Effect of Internal and External Treatment of Traditional Chinese Medicine in Treating Osteoarthritis on Immune Inflammation Index Using Association Rules

作　　者：周巧[1] 刘健[2] 忻凌[1] 宋倩[1] 郭锦晨 黄旦[1] 

机构地区：[1]安徽中医药大学研究生院,安徽合肥230038 [2]安徽中医药大学第一附属医院风湿科,安徽合肥230031

出　　处：《中华中医药学刊》2017年第8期2070-2073,共4页Chinese Archives of Traditional Chinese Medicine

基　　金：国家自然科学基金青年科学基金项目(81403388);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内科应用]30号);安徽省自然科学基金项目(1508085QH159);安徽省重点实验室建设项目(1306c083035);安徽省科技攻关项目(1301042211);安徽省重点实验室:现代中医基础与开发研究项目(1606c08238);安徽中医学院科技创新团队项目(2010TD005);安徽中医药大学校级基金项目(2014qn025)

摘　　要：目的:应用关联规则和统计学方法分析导师刘健教授治疗骨关节炎所用中药及外用药对免疫炎症指标的影响,为优化治疗方案提供依据。方法:整理安徽中医药大学第一附属医院风湿免疫科2012年6月—2015年10月骨关节炎住院患者的病历资料,根据是否采用中医外治法进行分成单纯内治和内外合治组,采用SPSS22.0对两组的相关实验组指标进行统计分析。并通过SPSS Clementine 12.0软件Aprior模块分析中药及外用药与指标的关系。结果:共有1414例骨关节炎患者。单纯内治组为670例(占47.3%),内外合治组744例(占52.6%)。中药处方中以清热解毒、健脾化湿、祛风除湿、活血通络4类药为主,外治法以中药外敷为主,常用有芙蓉膏和消瘀接骨散。与治疗前相比,单纯内治和内外合治组均能降低补体C4、IgA、血沉(ESR)、超敏C反应蛋白(hs-CRP)水平(P<0.05或P<0.01);且内外合治组能降低IgG的水平,上调超氧化物歧化酶(SOD)的水平;与单纯内治组相比,内外合治组在降低IgA、ESR、hs-CRP水平,以及上调超氧化物歧化酶(SOD)水平方面优于单纯内治组(P<0.05或P<0.01)。在关联规则置信度设为75%,支持度设为20%条件下,以中药薏苡仁、茯苓、豨莶草、鸡血藤、蒲公英、川牛膝、独活与指标关联度较高。外用药以芙蓉膏和消瘀接骨散与指标关联度较高。结论:骨关节炎的内服药物以清热解毒、健脾化湿、祛风除湿、活血通络4类药为主,外用药以芙蓉膏和消瘀接骨散为主。内外合治组在改善体内炎症免疫反应,以及上调自由基清除剂SOD方面明显优于单纯内治组。其作用机制则有待于进一步研究。Objective：To analyze the effect of Chinese herbs and external drugs by Professor LIU jian on immune inflammation index in osteoarthritis by using association rules and statistical methods,thereby providing the evidence for optimizing prescriptions.Methods：The data of osteoarthritis was recorded by hospitalized in the department of rheumatism of the First Affiliated Hospital of Anhui Traditional Chinese Medicine University from June 2012 to October 2015.Depending on whether use external drugs or not,we divided them into simple internal treatment group and combined internal and external treatment group.Use SPSS 22.0 statistical analysis to study the two groups’ immune inflammation index.The relationship between Chinese herbs,external used medicine and immune inflammation index were analyzed by using SPSS22.0 and Aprior module in SPSS Clementine 12.0.Results：There were 1414 cases of patients with osteoarthritis,including 670 patients（47.3%） of pure internal treatment group,744 cases（52.6%） of internal and external treatment group.Chinese herbs in prescriptions can be divided into four groups respectively,clearing away heat and toxic materials,invigorating spleen to eliminate dampness,dispelling wind and eliminating dampness,promoting blood circulation to re-move meridian obstruction.External therapy was given priority to external application,such as Furong ointment and Xiaoyu bone powder.Compared with before treatment,simple internal governance and external governance groups could decrease complement C4,IgA,erythrocyte sedimentation rate（ESR）,high-sensitivity C-reactive protein（hs-CRP）levels（P〈0.05 or P〈0.01）.The internal and external combined group can reduce the levels of IgG and increase superoxide dismutase（SOD） levels.Comparing with the simple internal treatment,external governance group in reducing IgA,ESR,hs-CRP levels and increasing superoxide dismutase enzyme（SOD） levels was better than the untreated group（P〈0.05 or P〈0.01）.Under the condition of confidence le

关 键 词：骨关节炎 关联规则 免疫炎症 氧化应激 

分 类 号：R684.3[医药卫生—骨科学]