骨科气滞血瘀证患者中药用药规律分析  

Analysis of medication rules of traditional Chinese medicine in patients with qi stagnation and blood stasis type in orthopedics department

作　　者：李志远 靳梦亚 LI Zhiyuan;JIN Mengya(TCM Pharmacy,Beijing Jishuitan Hospital Affiliated to Capital Medical University,Beijing,100035;Section of Pharmacy,Dongfang Hospital of Beijing University of Chinese Medicine,Beijing,100078)

机构地区：[1]首都医科大学附属北京积水潭医院中药房,北京100035 [2]北京中医药大学东方医院药学部,北京100078

出　　处：《实用临床医药杂志》2024年第11期84-89,共6页Journal of Clinical Medicine in Practice

基　　金：北京市中医管理局北京市第三批中药骨干人才培养项目(京中医科字〔2022〕59号);北京积水潭医院院级科研基金项目(YGQ-2202119);北京中医药大学青年教师项目(2019-JYB-JS-103)。

摘　　要：目的分析北京中医药大学东方医院骨科气滞血瘀证患者中药用药规律。方法采用Excel软件对2019—2022年东方医院骨科气滞血瘀证患者的中药内服处方进行数据分析,统计患者处方用药的使用频次、频率、用量,以及排名前30味中药的药性归经、功效分类。采用结构化查询语言SQL server 2008 R2软件中的关联规则进行数据挖掘,分析骨科气滞血瘀证患者内服中药处方的配伍规律及核心用药。结果骨科中药处方中,用量频次排名前5位的是茯苓、当归、白芍、泽泻、川芎;使用频次排名前30位的中药的四气五味主要为甘、温、苦、辛,归经以肝经、脾经、肾经为主,功效主要是活血祛瘀、补虚及利水渗湿。中药药性、功效及方剂核心用药均符合气滞血瘀证骨病标本兼治的理念。制白附子、半夏(不同炮制品)、水蛭存在严重超剂量使用问题。结论通过数据挖掘分析方法可明确骨科中药用药规律特点,发现临床超剂量使用问题,为临床合理安全用药提供依据。Objective To analyze the medication rules of traditional Chinese medicine(TCM)for patients with qi stagnation and blood stasis syndrome in the orthopedic department of Dongfang Hospital of Beijing University of Chinese Medicine.Methods The data of TCM internal prescriptions for patients with qi stagnation and blood stasis syndrome in the orthopedic department of Dongfang Hospital from 2019 to 2022 were analyzed using Excel software.The times of usage,frequency,and dosage of prescribed drugs,along with the medicinal properties,meridian tropism,and functional classification of the top 30 herbs were calculated.The association rules in SQL server 2008 R2 software were used for data mining to analyze the compatibility patterns and core medications in TCM prescriptions for orthopedic patients with qi stagnation and blood stasis syndrome.Results Among the orthopedic TCM prescriptions,the top five herbs with the highest usage frequency were Fuling,Danggui,Baishao,Zexie,Chuanxiong;the top 30 frequently used herbs were mainly sweet,warm,bitter,and pungent flavors;their meridian tropism was primarily the liver,spleen,and kidney meridians;and their primary functions were to activate blood circulation and dispel blood stasis,tonify deficiency,and promote diuresis and eliminate dampness.The medicinal properties,functions,and core medications of TCM prescriptions were in line with the principle of treating both the symptoms and the root causes of orthopedic diseases with qi stagnation and blood stasis syndrome.There were serious issues of overdosage in uthe se of prepared Baifuzi,Banxia(different processed products),and Shuizhi.Conclusion The analysis of medication patterns of TCM for orthopedic diseases through data mining methods can clarify the characteristics of medication use and identify issues of clinical overdosage,providing a basis for rational and safe clinical medication.

关 键 词：中药 骨科 气滞血瘀证 数据挖掘 配伍规律 

分 类 号：R816.8[医药卫生—放射医学] R286[医药卫生—临床医学] R319