摘要
目的:分析腰椎椎管狭窄症中药外用方的用药规律。方法:利用计算机检索中国知网、万方医学网、维普网中关于中药外用治疗腰椎椎管狭窄症的文献,检索时限均为1990年1月1日至2020年12月31日。提取入选文献中的外用方剂,统计方剂的组成药物(包括加减药物)及药物的功效、性、味、归经,并对提取的信息进行规范化处理。将提取的药物信息录入MicrosoftExcel 2016软件,建立数据库,统计各种药物出现的频次及药物的功效、性、味、归经分布情况;采用SPSS25.0软件对筛选出的高频药物以Q型聚类方法进行聚类分析;采用SPSSModeler18.0软件对筛选出的高频药物进行关联规则分析。结果:共检索到217篇文献,通过筛选最终纳入40篇。40篇文献包含40首外用方剂,涉及119味中药。119味中药累计出现517次,其中出现频率>1.00%的中药共32味。119味中药按照功效分为12类,其中理血药占比居第1位、祛风湿药居第2位、补益药居第3位;温性药出现的频次最多(264次),其次为平性药(105次)和寒性药(104次);药味出现频次前3位的依次为辛味(315次)、甘味(113次)、苦味(69次);119味中药涵盖了11种不同的归经,排在前3位的分别是肝经(371次)、脾经(200次)和肾经(135次)。聚类分析结果显示,32味高频中药可聚为3类,第1类包括莪术、三棱、艾叶、伸筋草、透骨草、苏木,第2类包括延胡索、白芷、姜黄、木香、羌活、花椒、五加皮,第3类包括川芎、当归、木瓜、秦艽、赤芍、杜仲、独活、防风、大黄、草乌、川乌、桂枝、红花、没药、乳香、威灵仙、细辛、海桐皮、大血藤。通过对32味高频中药进行关联规则分析,共获得9个关联规则,涉及7个核心药物组合,分别为伸筋草-透骨草、威灵仙-没药、乳香-没药、草乌-川乌、草乌-红花、威灵仙-没药-乳香、没药-红花-乳香。结论:腰椎椎管狭窄症中药外用方多以理血药为核心,辅以祛风湿药和补益药,多用性温,味辛、甘,入肝、脾、肾经的中药;多以伸筋草、透骨草、乳香、没药、威灵仙、川乌、草乌、红花为核心进行加减组方。
Objective:To analyze the medication rules of external-applied Chinese herbal medicine(CHM)prescriptions in treatment of lumbar spinal stenosis(LSS).Methods:The articles concerning external application of CHM for treatment of LSS included from January 1,1990 to December 31,2020 were retrieved from China National Knowledge Internet(CNKI),Wanfang Med Online and VIP Database through computer.The external-applied CHM prescriptions were extracted from the included articles and were normalized, followed by statistics on the specific Chinese herbs(including those in modified prescriptions)as well as their efficacy, property, flavor and meridian tropism.The extracted and normalized Chinese herb information was input into the Microsoft Excel 2016 software for building a database, based on which their occurrence frequency as well as efficacy, property, flavor and meridian tropism were statistically analyzed.The high-frequency Chinese herbs were then subjected to Q-mode cluster analysis and association rule analysis by using SPSS25.0 software and SPSS Modeler18.0 software respectively.Results:Two hundred and seventeen articles were searched out.After screening, 40 articles were included in the final analysis, involving 40 external-applied CHM prescriptions and 119 Chinese herbs(appeared 517 times),among which 32 ones displayed a occurrence frequency of >1.00%.The 119 Chinese herbs were classified into 12 categories according to their efficacy, and the top 3 herbs with high proportion included blood-regulating herbs, wind-dampness-dispelling herbs and tonifying herbs in turn.Sorted by property, the most frequently appeared Chinese herbs were those with a warm property(264 times),followed by the ones with a neutral property(105 times)and a cold property(104 times).The Chinese herbs with pungent, sweet and bitter flavors were more preferred, with their usage frequency of being 315,113 and 69 times respectively. The 119 Chinese herbs were categorized into 11 types by meridian tropism,and they mainly acted on the liver meridians( 371 times),spleen meridians( 200 times) and kidney meridians( 135 times). As revealed by the cluster analysis,the 32 high-frequency Chinese herbs were clustered into three classes,with Rhizoma Curcumae,Sparganii Rhizoma,Folium Artemisiae Argyi,Herba Lycopodii,Herba Speranskiae Tuberculatae and Lignum Sappan into Class I;Rhizoma Corydalis,Radix Angelicae Dahuricae,Rhizoma Curcumae Longae,Radix Aucklandiae,Rhizoma et Radix Notopterygii,Pericarpium Zanthoxyli and Cortex Acanthopanacis into ClassⅡ;and Rhizoma Ligustici Chuanxiong,Radix Angelicae Sinensis,Fructus Chaenomelis,Radix Gentianae Macrophyllae,Radix Paeoniae Rubra,Cortex Eucommiae,Radix Angelicae Pubescentis,Radix Saposhnikoviae,Radix et Rhizoma Rhei,Radix Aconiti Kusnezoffii,Radix Aconiti,Ramulus Cinnamomi,Flos Carthami,Myrrha,Olibanum,Radix Clematidis,Herba Asari,Cortex Erythrinae and Caulis Sargentodoxae into ClassⅢ. The association rule analysis of the 32 high-frequency Chinese herbs yielded 9 association rules,involving 7 core herb combinations,namely Herba Lycopodii-Herba Speranskiae Tuberculatae,Radix Clematidis-Myrrha,Olibanum-Myrrha,Radix Aconiti Kusnezoffii-Radix Aconiti,Radix Aconiti Kusnezoffii-Flos Carthami,Radix Clematidis-Myrrha-Olibanum and Myrrha-Flos Carthami-Olibanum. Conclusion: The external-applied Chinese herbal prescriptions for LSS are centred on blood-regulating herbs,supplemented by wind-dampness-dispelling herbs and tonifying herbs,which are often warm in property and pungent and sweet in flavor and acts on the liver meridians,spleen meridians and kidney meridians. Herba Lycopodii,Herba Speranskiae Tuberculatae,Olibanum,Myrrha,Radix Clematidis,Radix Aconiti,Radix Aconiti Kusnezoffii and Flos Carthami are usually used as the core of the Chinese herbal prescriptions.
作者
张亚运
许金海
莫文
ZHANG Yayun;XU Jinhai;MO Wen Longhua(Hospital Shanghai University of Traditional Chinese Medicine,Shanghai 200032,China)
出处
《中医正骨》
2021年第8期28-32,共5页
The Journal of Traditional Chinese Orthopedics and Traumatology
关键词
外治法
椎管狭窄
腰椎
方剂分析
计算机辅助
数据挖掘
external therapies
spinal stenosis
lumbar vertebrae
formula anal comput assist
data mining
