不同剂型中药治疗类风湿关节炎的用药规律及改善免疫炎症指标的数据挖掘研究

Dan HUANG; Jian LIU; Ling XIN; Jin-gui XIE; Qiang ZHU; Pei-sheng CHEN; Zhi-bin SHEN; Qing-he MENG; Hai-yan WANG

doi:10.1007/s11655-020-3480-1

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不同剂型中药治疗类风湿关节炎的用药规律及改善免疫炎症指标的数据挖掘研究

Original Article | Updated：2022-03-18

- 不同剂型中药治疗类风湿关节炎的用药规律及改善免疫炎症指标的数据挖掘研究
- Data Mining Study on Prescription Patterns of Different Dosage Forms of Chinese Herbal Medicines for Treating and Improving Immune-Inflammatory Indices in Patients with Rheumatoid Arthritis
- Chinese Journal of Integrative Medicine 2022年28卷第3期页码：215-222
- Affiliations：
  
  1.Department of Rheumatology, First Affiliated Hospital of Anhui University of Chinese Medicine, Hefei (230031), China
  2.The School of Management, University of Science and Technology of China, Hefei (230026), China
  3.Anhui Jiren Pharmaceutical Co., Ltd., Bozhou, Anhui Province (236800),China
  4.Department of Acupuncture, Huangshan Hospital of Chinese Medicine, Huangshan, Anhui Province (245000), China
  5.Department of Internal Medicine, Bozhou Hospital of Chinese Medicine, Bozhou, Anhui Province (236800), China
- Author bio：
  
  Prof. LIU Jian, E-mail: liujianahzy@126.com
- Funds：
  
  the National Key Research and Development Program of the Ministry of Science and Technology(2018YFC1705204);the Major Science and Technology Project of Anhui Province(17030801009);the Key Research and Development Projects of Foreign Scientific and Technological Cooperation planned in Anhui Province(201904b11020011);the Anhui Provincial Laboratory of Internal Medicine Application and Development of Modern Chinese Medicine(2016080503B041);the Construction Project of LIU Jian Studio of Traditional Chinese Medicine in Anhui Province(Secretary of Development of Traditional Chinese Medicine [2018] No.11);the 12th Batch of the "115" Innovation Team in Anhui Province(1 [2019] of the Anhui Talent Office)
- DOI：10.1007/s11655-020-3480-1
  中图分类号：
- 纸质出版日期：2022-03-01，
  
  网络出版日期：2020-08-22，
  
  录用日期：2020-05-18
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Dan HUANG, Jian LIU, Ling XIN, 等. 不同剂型中药治疗类风湿关节炎的用药规律及改善免疫炎症指标的数据挖掘研究[J]. Chinese Journal of Integrative Medicine, 2022,28(3):215-222.

Dan HUANG, Jian LIU, Ling XIN, et al. Data Mining Study on Prescription Patterns of Different Dosage Forms of Chinese Herbal Medicines for Treating and Improving Immune-Inflammatory Indices in Patients with Rheumatoid Arthritis[J]. Chinese Journal of Integrative Medicine, 2022,28(3):215-222.
Dan HUANG, Jian LIU, Ling XIN, 等. 不同剂型中药治疗类风湿关节炎的用药规律及改善免疫炎症指标的数据挖掘研究[J]. Chinese Journal of Integrative Medicine, 2022,28(3):215-222. DOI： 10.1007/s11655-020-3480-1.

Dan HUANG, Jian LIU, Ling XIN, et al. Data Mining Study on Prescription Patterns of Different Dosage Forms of Chinese Herbal Medicines for Treating and Improving Immune-Inflammatory Indices in Patients with Rheumatoid Arthritis[J]. Chinese Journal of Integrative Medicine, 2022,28(3):215-222. DOI： 10.1007/s11655-020-3480-1.

摘要

目的:

探讨不同剂型中药治疗类风湿关节炎 (RA) 的用药规律及对免疫炎症指标的影响.

方法:

通过数据挖掘收集2012年8月至2018年6月安徽省4家医院(3家三甲医院和1家二甲医院)RA患者的临床资料. 将病历资料分为颗粒剂组和饮片组. 提取处方信息后

根据知识库对各处方药物进行量化和标准化

建立RA治疗方剂数据库. 首先

利用Liquorice软件(一种复杂的网络分析工具)从两组病例资料中获得核心处方及其组合模式. 其次

用SPSS 23.0软件比较两组免疫炎症指标和肝肾功能指标的变化. 然后

应用SPSS Clementine 11.1软件的Aprior模块

分析中药与各项指标改善的相关性. 最后用ORACLE 10g工具对两组间免疫炎症指标进行随机行走模型评价.

结果:

1) 共6829例RA患者符合本研究要求

其中颗粒剂组3816例

饮片组3013例; 2) 安徽省4家医院治疗类风湿关节炎的中药颗粒剂和中药饮片的处方模式一致. 核心处方为健脾化湿药、清热解毒药、活血通络药、祛风除湿药. 3) 两种剂型中药均可改善RA患者免疫炎症指标

疗效相似

且均对肝肾功能无影响; 4) 豨莶草和白花蛇舌草与免疫炎症指标的改善关联度较高; 5) 中药颗粒剂和中药饮片干预治疗后免疫炎症指标均有明显改善

免疫炎症指标与干预措施之间存在长程关联.

结论:

安徽省四家代表性医院从脾论治类风湿关节炎

中药颗粒剂与饮片用药基本规律一致

均以健脾化湿药、清热解毒药、活血通络药、祛风除湿药为主

中药颗粒剂与中药饮片可明显改善RA患者的免疫炎症指标

且疗效相当

均可作为治疗类风湿关节炎的选择.

Abstract

Objective:

To explore the prescription patterns of different dosage forms of Chinese herbal medicines (CHMs) for the treatment of rheumatoid arthritis (RA) and their effects on immune-inflammatory indices.

Methods:

Clinical data were collected from patients with RA in 4 hospitals (3 Class A comprehensive hospitals and 1 Class B comprehensive hospital) in Anhui Province

China

from August 2012 to June 2018 via the electronic medical record gathering system. Following extraction of prescription information

each prescribed herb was quantified and standardized according to the knowledge base to establish a database of RA treatment formulae. The medical records were divided into the granules group and decoction pieces group. Core herbs and their combination patterns were obtained from the two groups of cases using Liquorice software. Changes in immune-inflammatory and hepatic and renal function indices were compared between the two groups using SPSS 23.0 software. The Aprior module of SPSS Clementine 11.1 software was applied to analyse the correlation between CHMs and improvement in indices. Finally

the ORACLE 10 g tool was used to evaluate the random walk model of the immune-inflammatory indices between the two groups.

Results:

(1) We retrospectively analysed 35

898 prescriptions for 6

829 patients with RA who received CHM treatment. There were 3

816 patients in the granules group and 3

013 in the decoction pieces group. (2) The core herbs were Pi (Spleen)-strengthening and dampness-resolving drugs

blood-activating and stasis-resolving drugs

wind/dampness-dispelling drugs and heatclearing and detoxifying drugs. (3) Both dosage forms could improve immune-inflammatory indices in RA patients

with similar efficacy and no influence on hepatic or renal function. (4)

Herba Siegesbeckiae

and

Oldenlandia

had a stronger association with immune-inflammatory indices in the two groups. (5) The immune-inflammatory indices showed obvious improvement after treatment with granules and decoction pieces of CHMs

and there were long range correlations between the comprehensive evaluation indices and interventions.

Conclusions:

The principal CHM treatment methods for RA in four hospitals in Anhui Province are strengthening Pi and resolving dampness

activating blood and resolving stasis

dispelling wind/dampness and clearing heat. Granules and decoction pieces of CHMs have similar efficacy in improving immune-inflammatory indices in RA patients and could be used as treatment options for RA.

关键词

类风湿关节炎中药颗粒剂饮片数据挖掘

Keywords

rheumatoid arthritisChinese heral medicinegranulesdecoction piecesdata mining

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