| Background:Osteoporosis(OP)is a systemic bone disease characterized by low bone mass and damage to bone tissue microstructure,resulting in increased bone fragility and prone to fractures.It is also known as "silent killer".Osteoporosis is a bone disease that is obviously related to age.With the increasing aging of our population,osteoporosis has become one of the chronic diseases that seriously affect the health of middle-aged and elderly people.Yuehua Li Professor has been devoted to clinical research and treatment of osteoporosis,emphasizing that osteoporosis is not only a physiological disease of aging and degeneration in old age,but also a metabolic disease,a comorbidity of various kidney diseases,etc.A variety of reasons can accelerate osteoporosis,many pathogenic factors,and long treatment cycles are characteristics.Therefore,in the course of treatment,Professor Li has developed a variety of Chinese medicine types for patients to choose and use.Commonly used are Jingujian No.1-3 Decoction,Jingujian No.1-3 Granules and Jingujian 1-3 Paste.Osteoporosis requires a long period of medication treatment,so the ointment formulation is the best dosage form that patients like very much and can continue to take medication for a long time.Therefore,the purpose of sequential treatment consolidation is achieved,and a wealth of clinical experience has been accumulated.Objective:Using data mining technology,explore the drug law of Professor Li Yuehua’s application of ointment in the treatment of middle-aged and elderly osteoporosis,so as to fully study the experience of Professor Li Yuehua’s application of ointment in the treatment of osteoporosis,and inherit and spread the academic ideas of experts.To provide a new way of thinking for the treatment of osteoporosis with a new Chinese medicine,that is,ointment.Method:Through retrospective research methods,the clinical prescriptions of osteoporosis treated with ointment from Professor Li Yuehua’s outpatient clinic from 2016 to 2019 were collected.After standardizing the data,the basic patient information and traditional Chinese medicine database were established,and SPSS Statistic 24.0 was used for descriptive statistics.,And use SPSS Modeler18.0 for association rule analysis and cluster analysis,and use the traditional Chinese medicine inheritance assistance platform system(V2.5)to analyze the prescription medicine’s four qi,five flavors and normalization.Result:1.According to the statistics of the gender and age of the patients prescribed by the ointment,among the 522 patients,141 were male and 381 were female.The ratio of men to women was 1:2.70;at the same time,patients of different ages were stratified,≤44 Age is young,≥45&≤59 is middle-aged,≥60&≤74 is young,≥75&≤89 is old,≥90 is long-lived,there are 6 out of 522 patients,There are 1 male and 5 females;95 middle-aged,15 males and 80 females;252 young and old,65 males and 187 females;164 elderly There are 57 males and 107 females;there are 5 long-lived elderly people,including 3 males and 2 females.It can be seen that the majority of patients who will apply ointment in the clinical treatment of osteoporosis are women and fewer men,and they are mostly young elderly(≥60&≤74),followed by elderly(≥75&≤89 years)of it.2.According to the statistics of prescription time and seasonal distribution,it is found that the most prescriptions are issued in November,December and January,and the least prescriptions are issued in June,July and August,so the winter distribution is the most in the distribution of prescriptions in each season,Followed by autumn,with the least number of prescriptions in summer.3.From the diagnosis type of the cases collected this time,it can be seen that the patients with low bone mass,osteoporosis and osteoporosis with pathological fractures are the most,among which the patients with osteoporosis with pathological fractures are the most.389 people,accounting for 74.5%;129 patients with osteoporosis,accounting for 24.7%;the least people with low bone mass,4 people,accounting for 0.8%.It can be seen from the distribution characteristics of the medical syndrome types that there are 25 patients with liver and kidney deficiency syndrome,accounting for 4.8%;212 patients with spleen and kidney deficiency syndrome,accounting for 40.6%;285 patients with kidney deficiency and blood stasis syndrome,accounting for 54.6%;Among them,kidney deficiency and blood stasis syndrome are the most.4.According to the analysis of the total number of ointments,prescription weight and prescription price,the average mean of the 522 prescriptions is 32.43±2.83(flavors),of which the least prescription has 25 flavors and the most 39 flavors;prescriptions The average weight is 4869.33± 154.41(g),the lightest weight is 4180g,and the weight is finally 5000g;5.The average prescription drug amount is 1196.43 ± 118.14(yuan),of which the cheapest is 1017.82 yuan,and the most expensive is 1489.88 yuan.6.From the analysis of high-frequency drugs,it can be found that the top 30 drugs commonly used by Professor Li are Chuanxiong,Roasted Astragalus,Gusuibu,Salt Eucommia,Black Sesame,Rehmannia glutinosa,Rehmannia glutinosa,Mulberry,Chuan Achyranthes,Duhuo,Sanhu Seven powders,Gentiana macrophylla,Turmeric,Choerospondias axillaris,Mulberry parasite,Rhodiola rosea,Chuan Wu,Salvia miltiorrhiza,Herbal black,Achyranthes bidentata,Hot dog ridge,Red ginseng,Hawthorn,Wolfberry,Asarum,Tortoise shell,Orange peel,Stretchgrass,Codonopsis,Clematis.The medicines used mainly include Gushen Bu,Yan Du Zhong,Radix Rehmanniae,Radix Astragalus,Codonopsis,etc.,phlegm and blood stasis medicines Angelica,Salvia miltiorrhiza,Panax notoginseng powder,etc.,Shujin Tongluo medicine Chuanhuai Achyranthes bidentata.,Duhuo,mulberry parasite,etc.;medicines to adjust the taste and color of the cream,such as black sesame,mulberry,wolfberry,etc.;gum medicines such as tortoise shell gum,staghorn gum,donkey-hide gelatin,etc.,and sugar accessories such as honey,rock sugar,etc.Features of clinical selection of brown sugar,xylitol,etc.7.According to the statistics of association rules,Professor Li commonly used two medicine combinations of Salvia miltiorrhiza and Chuanxiong combination,red ginseng,wolfberry,Duhuo,mulberry parasite,Gushenbu,salt eucommia and so on;and three commonly used drugs The combination consists of Panax notoginseng powder,salt eucommia ulmoides and Gushenbu,Salvia miltiorrhiza,Zhihuangqi and Chuanxiong,Salvia miltiorrhiza,Gusuibu and Chuanxiong,Sour jujube,black sesame and Chuanxiong,Danshen,Yan Duzhong and Chuanxiong etc.;The commonly used combination of Siwei medicine mainly consists of Panax notoginseng powder,salt eucommia ulmoides,Chuanxiong and Gushenbu,Panax notoginseng powder,salt eucommia ulmoides,Zhihuangqi and Gusuibu,Sanqi powder,black sesame,salt eucommia and salt Gushenbu combination,Danshen,Gushenbu,Zhihuangqi and Chuanxiong combination,Panax notoginseng powder,Rehmannia glutinosa,salt eucommia and Gushenbu etc.8.Through cluster analysis and clinical practice,it is proved that the basic prescriptions of Professor Li ’s clinical application of ointment for the treatment of osteoporosis are:Chuanxiong,Zhihuangqi,Codonopsis,Osteopsis,Eucommia salt,Rehmannia glutinosa,Rehmannia glutinosa,Black sesame,mulberry,Achyranthes bidentata,Achyranthes bidentata,Salvia miltiorrhiza,Panax notoginseng powder,jujube kernel,Duhuo,mulberry parasite,hot dog ridge,Gentiana macrophylla,turmeric,clematis,tortoise shell gum,wolfberry,hawthorn,orange peel,plus Psoralen,Fried Atractylodes.Conclusion:1.At present,the patients who choose to apply ointment in the treatment of osteoporosis are mainly young women who are between 60 and 74 years old.The largest prescription of ointment is in winter,and the ointment has the characteristics of "seasonal tonic",which is generally seasonal.However,considering the comprehensive analysis of various factors,the reason for the correlation between the amount of ointment and the season in this study is The cold weather in winter and poor circulation of blood and blood lead to the symptoms of various diseases in the elderly more prominent in this season.Because Professor Li’s clinical treatment of osteoporosis often flexibly chooses different dosage forms according to the specific situation and patient’s wishes,and it is clear that osteoporosis is a chronic debilitating disease,and the ointment should be a treatment method,not a simple nourishment In addition to the clear therapeutic effect,it has the advantages of good taste and high patient acceptance,so it has the advantages of orderly consolidation of curative effects.Professor Li believes that osteoporosis cream can be taken for a long time all year round,but in The compatibility of medicines should be based on the principle of "three measures",and should not be restricted to the general view of supplementation in winter.2.Analyze the economic characteristics of the ointment from the amount of ointment,the weight of the prescription,and the amount of the prescription.From this,it can be seen that Professor Li’s ointment has a larger number of ointments than the soup,and the weight of the prescription is below 5000g.Professor Li’s single prescription medication lasts for one and a half months,and the average price of the prescription is basically below 1,500 yuan.In comparison,clinical observations show that the prescription price of ointment is actually more economical than ordinary soup.3.Professor Li divided the syndromes of osteoporosis into three types:liver and kidney deficiency,spleen and kidney deficiency,spleen and kidney deficiency,and blood stasis according to the progress of the disease.In this study,osteoporosis with pathological fractures And the syndrome type is the highest in both spleen and kidney deficiency and blood stasis type.It shows that with the progress of the disease,even when there is an obvious fracture,the patient is more willing to choose the long-term dosage form of ointment.From the side,it shows that the current population’s cognition and attention to osteoporosis are generally insufficient.4.According to the association,cluster analysis and Professor Li Yuehua ’ s clinical confirmation of osteoporosis,the ointment of osteoporosis is basically based on his experience Fang Jin Gu Jian,which is specifically:Chuanxiong,Sunburn Astragalus,Codonopsis,Psoralen,Fried Atractylodes,Kusuibu,Salt Eucommia ulmoides,Rehmannia glutinosa,Rehmannia glutinosa,black sesame,mulberry,Achyranthes bidentata,Achyranthes bidentata,Salvia miltiorrhizae,Panax notoginseng powder,Sour jujube kernel,Duhuo,Mulberry parasite,Hot dog ridge,Gentiana macrophylla,Turmeric,Turtle shell gum,Goji berries,hawthorn and orange peel are used as the basic prescription of osteoporosis cream.Among them,Gushenbu,Eucommia,Psoralen can nourish kidney yang;raw/rehmannia glutinosa,tortoise shell gum,etc.nourish kidney yin;sunburned astragalus,codonopsis,fried atractylodes,etc.,tonic spleen,orange peel,hawthorn digestion and stomach to prevent ointment Recipes are so greasy that they hinder the stomach;Chuanxiong,Salvia miltiorrhiza,Panax notoginseng powder,turmeric,Chuanhuai Achyranthes bidentata,Rhodiola rosea,etc.;Tendon network.In addition,in order to ensure the quality of the cream side in terms of quality,color and taste,the color and flavor of the cream side are reconciled with mulberries and black sesame.5.Using data mining to explore the characteristics of famous doctors’ prescription medications and summarizing the experience of famous doctors is one of the important means of inheriting the experience of traditional Chinese medicine in recent years and cultivating talents of traditional Chinese medicine.Its use of modern information technology not only avoids the subjectivity of the human brain Limitations,while also helping to promote the process of internationalization and modernization of Chinese medicine,but it also has certain drawbacks,data mining experience can not completely replace the experience summary,in other words,it is fundamentally incomplete Reflecting the academic thoughts of famous masters,only part of the link problems can be completed.In the case of small details,expert interpretation and analysis are needed again. |
PDF Full Text Request