杨静　梁江　唐东昕　余谦　卢云　陈守能　刘青红　杨柱

【摘 要】目的：基于古今醫案云平台V2.3.4软件，探讨国医大师刘尚义教授治疗类风湿关节炎的临床用药规律及特点。方法：筛选2019年1月1日至2020年6月1日就诊于贵州省中医院国医堂刘尚义教授门诊的类风湿关节炎患者的信息，采用数据挖掘分析模块，分析刘尚义教授治疗类风湿关节炎的临床用药规律及特点。结果：共录入医案262例，处方262首，涉及中药158味，使用频次前5位中药为胆南星、白芥子、威灵仙、附子、川芎;药物属性多以温平、辛甘为主，归肝肾二经;功效多以祛风湿、散寒止痛为主;常用组合包括附子-胆南星-川芎，白芥子-威灵仙-豨莶草，黄精-山萸肉-龟甲-干石斛-玉竹，羌活-炙甘草-淫羊藿-当归-巴戟天-补骨脂。结论：刘尚义教授治疗类风湿关节炎常用祛风湿、散寒止痛配合强筋骨之品，达到标本兼治的目的。

【关键词】 类风湿关节炎;数据挖掘;用药规律;国医大师;刘尚义

Analysis of TCM Master LIU Shang-yi's Medication Rule in Treating Rheumatoid Arthritis

YANG Jing，LIANG Jiang，TANG Dong-xin，YU Qian，LU Yun，CHEN Shou-neng，LIU Qing-hong，YANG Zhu

【ABSTRACT】Objective：Based on the V2.3.4 software of Ancient and Modern Medical Record Cloud Platform，to explore the clinical medication rules and characteristics of Professor LIU Shang-yi，a master of traditional Chinese medicine（TCM），in the treatment of rheumatoid arthritis.Methods：Information of patients with rheumatoid arthritis treated（from January 1，2019 to June 1，2020）in the outpatient department of Professor LIU Shang-yi in Guizhou Hospital of Chinese Medicine was screened from the information entry system，and the data mining analysis module was used to analyze his clinical medication rules and characteristics in the treatment of rheumatoid arthritis.Results：A total of 262 medical records and 262 prescriptions were recorded，involving

158 kinds of drugs.The top 5 drugs used frequently were Dannanxing（Arisaema cum Bile），Baijiezi（Semen Sinapis），Weilingxian（Radix et Rhizoma Clematidis），Fuzi（Radix Aconiti Lateralis Praeparata），Chuanxiong（Rhizoma Chuanxiong）.The main drug properties were warm，neutral，acrid and sweet.There are mainly liver and kidney channels.The main efficacy is to dispel rheumatism，disperse cold and relieve pain;Common combinations include Fuzi-Dannanxing-Chuanxiong，Baijiezi-Weilingxian-Xixiancao（Herba Siegesbeckiae），Huangjing（Rhizoma Polygonati）-Shanyurou（Fructus Corni）-Guijia（Carapax et Plastrum Testudinis）-Ganshihu（Caulis Dendrobii）-Yuzhu（Rhizoma Polygonati Odorati），Qianghuo（Rhizoma et Radix Notopterygii）-Zhigancao（Radix et Rhizoma Glycyrrhizae Praeparata cum Melle）-Yinyanghuo（Herba Epimedii）-Danggui（Radix Angelicae Sinensis）-Bajitian（Radix Morindae Officinalis）-Buguzhi（Fructus Psoraleae）.Conclusion：Professor LIU Shang-yi often uses drugs of dispelling rheumatism，dispersing cold and relieving pain to treat rheumatoid arthritis.

【Keywords】 rheumatoid arthritis;data mining;medication rule;master of Chinese medicine;LIU Shang-yi

类风湿关节炎（rheumatoid arthritis，RA）是以侵蚀性、对称性多关节炎为主要临床表现的慢性全身性自身免疫性疾病。据2018年统计，我国大陆地区RA发病率为0.42%，总患病人数约500万，其中病程≥15年的致残率为61.3%，是造成活动功能受限的主要原因之一[1]。对于基础治疗效果不佳的患者，建议使用生物制剂，但会加重患者的家庭经济负担[2-3]。中医学将RA归属于“痹证”范畴，是指由于经络痹阻，气血运行不畅，引起肢体关节发生疼痛、酸楚、麻木、重着，以及活动障碍为主要表现的一类病症。中医药治疗RA历史悠久，积累了丰富的临床经验，且疗效显著[4]。……