中药治疗强直性脊柱炎组方规律分析

Analysis of formulation principles of traditional Chinese medicine in treating ankylosing spondylitis

关键词:  强直性脊柱炎  专利  中药复方  数据挖掘  用药规律

Key words:  ankylosing spondylitis  patent  traditional Chinese medicine compound prescription  data mining  medication rule

摘要:

[目的] 基于多元化数据挖掘技术探究国家专利数据库自建库以来、与中药复方干预强直性脊柱炎相关的组方用药规律。[方法] 以国家知识产权局中的专利数据库为基础，检索其中干预强直性脊柱炎的中药复方，创建中药处方数据库，使用IBM SPSS Statistics 26.0、SPSS Modeler 18.0、Cytoscape 3.10软件进行频数统计、关联规则分析、聚类分析，并构建核心中药网络图。[结果] 纳入治疗强直性脊柱炎的中药复方专利共270首，涉及中药736味。使用频数位列前10名的中药依次为：牛膝、当归、甘草、威灵仙、杜仲、独活、狗脊、鸡血藤、川芎及桂枝。对使用频数≥30次的高频药物进行功效类别分析，排名前2位的类别为补虚药、祛风湿药。四气主要以温、平为主；五味主要以苦、甘、辛味为主；归经多以肝、肾、脾经常见。关联规则分析结果显示，按照支持度从高到低排序，获得对药组合16条，以当归-黄芪（支持度21.11%，置信度70.18%）为代表，角药组合10条，以牛膝-威灵仙+当归（支持度12.22%，置信度66.67%）为代表。聚类分析共得到7组中药组合。[结论] 强直性脊柱炎的中医基本病机为肾虚督亏，兼有风、寒、湿、热等邪气侵犯，病性总属本虚标实，处方多由牛膝、威灵仙、独活、狗脊、桑寄生等祛风湿、强筋骨药物构成以扶正祛邪，再配伍当归、甘草、杜仲、白芍、黄芪等补益药补其正虚，具体应结合实际情况辨证论治以遣方用药，通过多元数据挖掘，为临床治疗强直性脊柱炎的药物选择与配伍以及新药研发提供参考和思路。

Abstract:

[Objective] To explore the formulation principles of traditional Chinese medicine（TCM） compound prescriptions for ankylosing spondylitis（AS） recorded in the national patent database since its establishment，using diversified data mining techniques. [Methods] Based on the patent database of the China National Intellectual Property Administration，TCM compound prescriptions for AS were retrieved to create a prescription database. IBM SPSS Statistics 26.0，SPSS Modeler 18.0，and Cytoscape 3.10 software were used for frequency analysis，association rule analysis，cluster analysis，and to construct a core herb network diagram. [Results] A total of 270 patented TCM compound prescriptions for AS were included，involving 736 distinct herbs. The top 10 herbs by frequency of use were：Achyranthis Bidentatae Radix（Niuxi），Angelicae Sinensis Radix（Danggui），Glycyrrhizae Radix et Rhizoma（Gancao），Clematidis Radix et Rhizoma（Weilingxian），Eucommiae Cortex（Duzhong），Angelicae Pubescentis Radix（Duhuo），Cibotii Rhizoma（Gouji），Spatholobi Caulis（Jixueteng），Chuanxiong Rhizoma（Chuanxiong），and Cinnamomi Ramulus（Guizhi）. Analysis of high-frequency herbs（used ≥30 times） by efficacy category ranked Tonifying and Dispelling Wind-Dampness as the top two categories. The primary herb properties were warm and neutral；the main flavors were bitter，sweet，and pungent；and the most common meridian affinities were the Liver，Kidney，and Spleen meridians. Association rule analysis yielded 16 herb-pair combinations，represented by Angelicae Sinensis Radix-Astragali Radix（support 21.11%，confidence 70.18%），and 10 three-herb combinations，represented by Achyranthis Bidentatae Radix-Clematidis Radix et Rhizoma+Angelicae Sinensis Radix（support 12.22%，confidence 66.67%）. Cluster analysis produced 7 distinct herb groups. [Conclusion] The fundamental TCM pathogenesis of AS involves kidney deficiency and insufficiency of the Du（Governing） Meridian，accompanied by the invasion of pathogenic factors such as wind，cold，dampness，and heat，representing a condition of root deficiency with branch excess. Prescriptions are often composed of herbs that dispel wind-dampness and strengthen bones and tendons，such as Achyranthis Bidentatae Radix，Clematidis Radix et Rhizoma，Angelicae Pubescentis Radix，Cibotii Rhizoma，and Taxilli Herba（Sangjisheng），to support the healthy qi and expel pathogens. These are combined with tonifying herbs like Angelicae Sinensis Radix，Glycyrrhizae Radix et Rhizoma，Eucommiae Cortex，Paeoniae Radix Alba（Baishao），and Astragali Radix to address the underlying deficiency. The specific formulation should be based on pattern differentiation tailored to the actual clinical presentation. This multivariate data mining provides references and insights for clinical drug selection，compatibility in treating AS，and new drug development.