方坚治疗腰椎间盘突出症用药规律探讨  

Discussion on the Medication Rules of FANG Jian in the Treatment of Lumbar Disc Herniation

作　　者：林宏衡 李玉鹏 黄幸儒 方坚(指导) LIN Hong-Heng;LI Yu-Peng;HUANG Xing-Ru;FANG Jian(The Third Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangzhou 510378 Guangdong,China;The Second Affiliated Hospital of Guangzhou University of Chinese Medicine/Guangdong Provincial Hospital of Traditional Chinese Medicine,Guangzhou 510120 Guangdong,China)

机构地区：[1]广州中医药大学第三附属医院,广东广州510378 [2]广州中医药大学第二附属医院/广东省中医院,广东广州1510120

出　　处：《广州中医药大学学报》2023年第10期2639-2644,共6页Journal of Guangzhou University of Traditional Chinese Medicine

基　　金：广东省中医药局科研项目(编号:20211204)。

摘　　要：【目的】采用数据挖掘方法探讨方坚教授治疗腰椎间盘突出症的组方用药规律。【方法】收集整理方坚教授于2014年3月至2021年1月门诊收治且有效的腰椎间盘突出症患者的病案资料,基于中医传承辅助平台(V3.0)的统计分析功能模块对中医证型分布及处方药物的四气五味、归经、功效分类等进行统计;基于平台的方剂分析功能模块进行药物的关联规则分析与聚类分析,以探讨其用药模式及提取核心药物组合。【结果】共得到方坚教授治疗腰椎间盘突出症的处方981首,涉及中药191味。处方药物使用频次≥100次的药物有24味,居前10位的中药为当归、熟地黄、淫羊藿、桂枝、牛膝、炙甘草、茯苓、鸡血藤、木瓜、白术;所用药物性味多甘温,主要归肝、脾、肾经;药物按其功效主要可归为补虚类、活血化瘀类、祛风湿类、解表类、利水渗湿类等。关联规则分析与聚类分析结果显示,常用药物组合有14个,药物组合关联规则有22条,核心方药组合7个。【结论】方坚教授治疗腰椎间盘突出症具有从肝脾肾论治、重视养血补虚、兼顾活血祛湿的用药特点,其用药规律可为中药治疗腰椎间盘突出症的临床用药提供参考。Objective To explore the medication rules of Professor FANG Jian in the treatment of lumbar disc herniation based on the data mining method.Methods The clinical data of the effective cases of outpatients with lumbar disc herniation treated by Professor FANG Jian from March 2014 to January 2021 were collected and collated.The statistical analysis of the distribution of tradition Chinese medicine(TCM)syndrome patterns,and the properties and flavors,meridian tropism and therapeutic-action classification of the prescription drugs was conducted based on the statistical analysis function module of the Traditional Chinese Medicine Inheritance Support System(V3.0)platform.The platform's prescription analysis function module was used to perform association rule analysis and cluster analysis for the exploration of the drug use patterns and the extraction of the core drug combinations.Results A total of 981 prescriptions for lumbar disc herniation treated by Professor FANG Jian were obtained,involving 191 Chinese medicines.There were 24 herbs with the frequency≥100 times,and the top10 herbs were Angelicae Sinensis Radix,Rehmanniae Radix Praeparata,Epimedii Folium,Cinnamomi Ramulus,Achyranthis Bidentate Radix,Glycyrrhizae Radix et Rhizoma Praeparata cum Melle,Poria,Spatholobi Caulis,Chaenomelis Fructus,and Atractylodis Macrocephalae Rhizoma.The drugs used were mostly sweet in flavor and warm in nature and mainly had the meridian tropism of the liver,spleen and kidney meridians.According to their efficacy,the drugs can be classified as herbs for supplementing the deficiency,herbs for activating blood and resolving blood stasis,herbs for dispelling wind-damp,herbs for releasing the exterior,herbs for promoting urination and draining dampness.The association rule analysis and cluster analysis yield14 commonly-used drug combinations,22 drug combination association rules and 7 core prescription combinations.Conclusion The medication rules of Professor FANG Jian in treating lumbar intervertebral disc herniation are characterized

关 键 词：腰椎间盘突出症 养血补虚 活血祛湿 数据挖掘 用药规律 方坚 

分 类 号：R681.53[医药卫生—骨科学]