基于数据挖掘技术的RA方证构效规律及与脏腑相关性研究

Rheumatoid arthritis is a symmetrical polyarthritis as the main clinical manifestations of heterogeneity, systemic, autoimmune diseases, the disease is chronic, progressive, aggressive disease, mainly violations of peripheral joints, synovial pathology Membranous hyperplasia, inflammatory cell infiltration, pannus formation, erosive cartilage and bone tissue damage, leading to structural damage, deformity and loss of function. Other systems such as heart, lungs, blood, nerves, eyes and other organs and tissues can also be involved in the development of the disease during the active and remission of alternating occurrences, and worse, with the further development of the disease and complications will also endanger life , Due to the etiology and pathogenesis of this disease has not yet fully clear, the current clinical lack of radical treatment and prevention of this disease is an effective measure. The traditional Chinese medicine treatment of the disease is better, accumulated a wealth of theory and experience, but the literature is not the same place, the lack of a unified understanding of many effective method of prescription, because scattered in the massive literature, difficult Cause enough attention, failed to achieve effective guidance of the role of clinical practice. This study is based on data mining, using frequency analysis, association rule analysis, factor analysis and other methods, to explore the traditional Chinese medicine treatment of the disease syndromes syndromes, the law of structural efficiency, and the relationship between RA and organs to treat the disease The benefit.

类风湿关节炎是以对称性多关节炎为主要临床表现的异质性、系统性、自身免疫性疾病，本病是慢性、进行性、侵蚀性疾病，主要侵犯外周关节，滑膜病理为滑膜增生、炎性细胞浸润、血管翳形成、侵蚀性软骨及骨组织损伤，导致关节结构破坏、畸形和功能丧失。其他系统如心、肺、血液、神经、眼等器官和组织亦可受累，疾病发展过程中活动期和缓解期交替出现，更有甚者，随着病情进一步发展与并发症加重还会危及生命，由于本病的病因和发病机制尚未完全明确，目前临床上尚缺乏根治及预防本病的有效措施。而中医药治疗该病疗效较好，积累了丰富的理论与经验，然而文献说法不一之处较多，缺乏统一认识，诸多行之有效的理法方药，因散在于海量的文献之中，难以引起足够的重视，未能达到有效指导临证实践之作用。本研究基于数据挖掘，利用频数分析，关联规则分析，因子分析等方法，拟探究中医药治疗该病的方证规律，构效规律，以及RA与脏腑的相关性，以对治疗该病有所裨益。

类风湿关节炎的病因和发病机制尚未完全明确，目前临床上尚缺乏根治及预防本病的有效措施。而中医药治疗该病疗效较好，积累了丰富的理论与经验，然而文献说法不一之处较多，缺乏统一认识，诸多行之有效的理法方药，因散在于海量的文献之中，难以引起足够的重视，未能达到有效指导临床实践的作用。本研究基于数据挖掘，探究中医药治疗该病的处方用药规律，以期对治疗该病有所裨益。研究对象为1984年1月至2020年12月，中国知网(CNKI)、万方数据(WANFANG DATA)、维普中文科技期刊数据库(VIP)中治疗类风湿关节炎与痹证的相关文献中的中药处方。按照文献纳入排除标准，整理共获得治疗类风湿关节炎的中药处方1088首（其中含有完整剂量治疗类风湿关节炎的中药处方648首），治疗痹证的中药处方1748首（其中含有完整剂量治疗痹证的中药处方1242首）。对收集整理的类风湿关节炎与痹证方药进行统计分析，主要包含药物频次统计、四气统计、五味统计、归经统计、关联分析、聚类分析、高频基础方统计、剂量统计，并对类风湿关节炎与痹证的数据进行比较，结果发现类风湿关节炎与痹证处方用药思路高度一致，临床辨证论治遵循《素问•痹论》的论述，在《素问•痹论》基础上结合取象比类，现代药理研究用药。本项目进一步证实了类风湿关节炎中医病名为痹证的正确性，临床可按照痹证的论述指导诊治类风湿关节炎，不少具体的研究结果对中医药临床辨治类风湿关节炎有一定的实用价值。