邹昆 郭万首 张启栋 刘沛 黄诚 王卫国

摘要 目的：基于中医传承辅助平台V2.5（TCMISS V2.5）研究膝骨关节炎中药熏洗处方的用药规律。方法：通过收集中国期刊全文数据库（CJFD）、中国学术期刊数据库（CSPD）、中文科技期刊数据库（CCD）、PubMed数据库建库至2019年11月中药熏洗治疗膝骨关节炎的处方，输入中医传承辅助平台V2.5，分析处方中各种中药的应用频次、性味归经、关联规则和新方分析。结果：对筛选出的372首中药处方进行分析，应用最多的前3位依次为透骨草、红花、伸筋草，归经以肝、心、脾、肾经为主，药性以温为主，药味以辛、苦、甘为主，新方组合11条。结论：中药熏洗治疗膝骨关节炎以海桐皮汤为主方，治法主要是祛湿散寒、化瘀通络，治肝是关键，兼顾心脾肾。

关键词 膝骨关节炎;中药熏洗;用药规律;数据挖掘;中医传承辅助系统;关联规则;归经

Abstract Objective：To analyze the medication rule in herbal fumigation for knee osteoarthritis（KOA）by using Traditional Chinese Medicine Inheritance Support System v2.5（TCMISS v2.5）.Methods：Herbal fumigation prescriptions for KOA from CNKI，VIP，Wanfang and PubMed database from the establishment of the databases to 2019 was collected，then the data entered into TCMISS v2.5.Analyze the frequency of application of various traditional Chinese medicinal in prescriptions，the characteristics and flavors of meridians，association rules and new prescription were analyzed.Results：Based on the analysis of 372 herbal fumigation prescriptions，it was found the top 3 most commonly used were Phryma leptostachya Linn.，Flos Carthami，Herba Lycopodii.The meridian tropism were mainly of liver，heart and spleen.The medicinal properties were mainly warm，and flavor were mainly pungent，bitter and sweet，and 11 prescriptions were found.Conclusion：Herbal fumigation for the KOA is mainly used by classic prescription Haitongpi Decoction.The method of treatment is to eliminate cold and dampness，activate blood and resolve stasis and remove obstructions in the meridians.Treating the liver is the first.The second is to take care of the heart，spleen and kidney.

Keywords Knee Osteoarthritis; Chinese medicinal fumigation; Medication rule; Data mining; Traditional Chinese Medicine Inheritance Support System; Association Rules; Meridian Tropism

中圖分类号：R274.9;R255.6;R684.3文献标识码：Adoi：10.3969/j.issn.1673-7202.2021.10.009

膝骨关节炎（Knee Osteoarthritis，KOA）是膝关节的退行性疾病，其主要症状是疼痛、活动受限、关节畸形[1]。国内症状性膝骨关节炎的发病率是8.1%，女性（10.3%）高于男性（5.7%），且与年龄正相关，与经济水平、文化程度负相关[2]。此外，存在地域性差异，西南地区患病率最高（13.7%），其次西北部（10.8%），中南部（7.8%），东北部（7.0%），最低的是东部（5.5%）和北部（5.4%）。中医药治疗KOA的方法包括：针灸、推拿、中药内服和熏洗[3]。中药熏洗疗法历史悠久，最早见于《五十二病方》，在治疗KOA上发挥着重要作用，能有效缓解疼痛、改善关节功能[4-5]。由于中医文献数据的快速积累，治疗KOA的中药熏洗处方众多，有必要对这些中药处方进行用药规律总结[6]，本研究通过收集整理公开发表的治疗KOA的中药熏洗处方，应用中医传承辅助平台进行数据挖掘，旨在总结中药熏洗治疗KOA用药规律，为临床治疗提供参考。……