基于关联规则挖掘健脾化湿清热通络中药对骨关节炎患者血小板参数影响.docVIP

基于关联规则挖掘健脾化湿清热通络中药对骨关节炎患者血小板参数影响 　　【摘 要】目的：采用关联规则技术挖掘分析刘健教授运用健脾化湿、清热通络中药治疗骨关节炎的用药规律，为临床辨证论治骨关节炎提供依据。方法：整理安徽中医药大学第一附属医院风湿免疫科2012年6月至2016年12月电子病历录入的诊断为骨关节炎患者的资料，采用SPSS 21.0、SPSS Clementine 　　11.1软件Aprior模块和统计学方法分析中药、中成药及外用药对患者??验室指标的影响。结果：①共纳入骨关节炎患者1970例，经健脾化湿、清热通络中药治疗后，患者血小板参数、炎症指标及免疫指标等均有所改善。②本院风湿免疫科治疗骨关节炎常用药物有5大类：健脾化湿药、祛风除湿药、活血化瘀药、清热解毒药和补益肝肾药。根据每类药物使用频次前5位提取，健脾化湿药为茯苓、陈皮、泽泻、薏苡仁、山药，祛风除湿药为威灵仙、烫狗脊、?g莶草、伸筋草、独活，活血化瘀药为丹参、桃仁、红花、鸡血藤、牛膝，清热解毒药为蒲公英、白花蛇舌草、黄芩、黄柏、知母，补益肝肾药为杜仲、桑寄生、熟地黄、枸杞子、千年健。③设关联规则支持度为20%，置信度为70%，口服中药及中成药分别与实验室指标关联，关联度最高的前5位，蒲公英、丹参、薏苡仁关联于血小板计数（PLT）指标下降，薏苡仁、泽泻、独活关联于免疫球蛋白IgG指标下降，丹参、鸡血藤、黄芩关联于超敏C-反应蛋白指标下降，蒲公英、威灵仙关联于α1-酸性蛋白指标下降，黄芩、丹参、鸡血藤关联于三酰甘油指标下降，新风胶囊关联于PLT指标下降，新风胶囊、芙蓉膏关联于红细胞沉降率、IgG、补体C3、补体C4指标下降。④由聚类分析得出，聚1类丹参、狗脊、桃仁、红花，聚2类茯苓、陈皮、山药、薏苡仁，聚3类蒲公英、白花蛇舌草、?g莶草、威灵仙、泽泻，聚4类知母、黄柏、熟地黄、枸杞子，聚5类桑寄生、牛膝、伸筋草、黄芩，聚6类杜仲、独活，聚7类鸡血藤。结论：骨关节炎活动期患者实验室指标及血小板参数处于异常活跃状态，中药治疗可以改善患者实验室指标，减轻免疫炎症反应，其中尤以健脾化湿、清热通络中药为主。 　　【关键词】 骨关节炎；血小板参数；健脾化湿；清热通络；关联规则；聚类分析 　　【ABSTRACT】Objective：To mine the medication rules of professor LIU Jians using Chinese medicinal of invigorating spleen and removing dampness and clearing away heat and dredging collateral to treat osteoarthritis，in order to provide the basis for clinical syndrome differentiation and treatment of osteoarthritis.Methods：Data（from June 2012 to December 2016）of patients with osteoarthritis in the electronic medical records of Rheumatology Department of the First Affiliated Hospital of Anhui University of Chinese Medicine were collected.Aprior modules in soft wares of SPSS 21.0 and SPSS Clementine 11.1 and statistical methods were used to analyze the effects of Chinese medicine，Chinese patent medicine and external medicine on laboratory indicators of patients.Results：① There were a total of 1970 patients in the study.After treatment of invigorating spleen and removing dampness and clearing away heat and dredging collateral with Chinese medicine，platelet parameters，inflammatory index and immune index of them were improved.②There are five categories