中药治疗神经根型颈椎病的应用与配伍规律  

Application and compatibility rules of traditional Chinese medicine in the treatment of cervical radiculopathy

作　　者：朱立国[1] 唐彬 魏戌[3] 高云 谢琪[5] 张兴平[1] 银河[1] 王浩[1] ZHU Liguo;TANG Bin;WEI Xu;GAO Yun;XIE Qi;ZHANG Xingping;YIN He;WANG Hao(The Second Department of Spine,Wangjing Hospital,China Academy of Chinese Medical Sciences,Beijing100102,China;Graduate School,Beijing University of Chinese Medicine,Beijing100029,China;Office of Academic Research,Wangjing Hospital,China Academy of Chinese Medical Sciences,Beijing100102,China;Eye Hospital,China Academy of Chinese Medical Sciences,Beijing100040,China;China Academy of Chinese Medical Sciences,Beijing100700,China)

机构地区：[1]中国中医科学院望京医院脊柱二科,北京100102 [2]北京中医药大学研究生院,北京100029 [3]中国中医科学院望京医院科研处,北京100102 [4]中国中医科学院眼科医院,北京100040 [5]中国中医科学院,北京100700

出　　处：《中国医药导报》2019年第24期127-130,153,共5页China Medical Herald

基　　金：国家“十二五”科技支撑计划课题(2014BAI08B00);国家中医药管理局中医药行业科研专项(201207001-04);中国中医科学院科技创新优势团队资助项目(YS1304)

摘　　要：目的分析临床实践中中药治疗神经根型颈椎病(CR)的应用规律。方法利用中医医疗与临床科研信息共享系统,采集2012年12月~2014年7月中国中医科学院望京医院住院与门诊治疗的CR患者信息,以其中274例服用中药的CR患者为研究对象,通过PLSQL和Excel进行标准化分类和统计分析,应用Liquorice软件计算中药使用配伍规律的关联频度和互信息值,并绘制复杂网络图。结果总共收集430张处方,从药物使用频次方面分析,川芎、甘草、白芍、当归、元胡、桂枝、威灵仙、黄芪等中药使用最多。从药性、药味与归经方面分析,温性药物最常使用(48.65%),苦味(49.24%)与甘味(46.63%)药物使用相对较多,入肝经药物使用最多(51.80%)。中药配伍分析发现,川芎与白芍、甘草、当归、元胡的关联度相对较高,互信息值分别为22.31、16.52、18.55、21.88。复杂网络图结果显示,经典名方黄芪桂枝五物汤或桂枝加葛根汤可能是治疗CR的基本方剂。结论根据临床实践分析,对于CR,中药的使用以活血化瘀为主要治则,再配合益气养血、祛风除湿散寒等功效的中药进行治疗,临床中可基于黄芪桂枝五物汤或桂枝加葛根汤随证加减。Objective To analyze the application rules of traditional Chinese medicine in treating cervical radiculopathy(CR)in clinical practice.Methods The information sharing system of traditional Chinese medical treatment and clinical scientific research was used to collect CR patient information of inpatient and outpatient treatment in Wangjing Hospital,China Academy of Chinese Medical Sciences from December 2012 to July 2014.A total of 274 cases of CR patients taking traditional Chinese medicine were studied.The PLSQL and excel were used for standardized classification and statistical analysis,and Liquorice software was used to calculate the correlation frequency and mutual information value of compatibility rules of traditional Chinese medicine,and to draw a complex network diagram.Results A total of 430 prescriptions were collected.According to the frequency analysis of drug use,Rhizoma Ligustici Chuanxiong,Radix Glycyrrhizae,Radix Paeoniae Alba,Radix Angelicae Sinensis,Rhizoma Corydalis,Ramulus Cinnamomi,Radix Clematidis,Radix Astragali seu Hedysari and other traditional Chinese medicine were most used.According to the analysis of aspects of drug nature,drug taste and channel tropism,warm drugs were most commonly used(48.65%),bitter taste drugs(49.24%)and sweet taste drugs(46.63%)were more relatively used,and liver channel drugs were most commonly used(51.80%).The compatibility analysis of traditional Chinese medicine showed that Rhizoma Ligustici Chuanxiong had a relatively high correlation with Radix Paeoniae Alba,Radix Glycyrrhizae,Radix Angelicae Sinensis and Rhizoma Corydalis,with mutual information values of 22.31,16.52,18.55 and 21.88 respectively.The results of complex network diagram showed that the classical prescription Huangqi Guizhi Wuwu Decoction or Guizhi plus Gegen Decoction might be the basic prescription for treating CR.Conclusion According to the analysis of clinical practice,for the CR,the use of traditional Chinese medicine takes promoting blood circulation for removing blood stasis as the princ

关 键 词：神经根型颈椎病 中药 配伍规律 真实世界 复杂网络分析 

分 类 号：R681.5[医药卫生—骨科学]