| Objective:By applying the TCM inheritance computing platform(V3.0)software,we analyzed the factors influencing the onset of gouty arthritis and the characteristics of episodes,and also conducted statistical analysis on the prescription medication used by the mentor in treating gouty arthritis,so as to summarize the identification ideas and medication rules of the mentor in treating gouty arthritis.Methods:The data of gouty arthritis cases that met the criteria of admission and exclusion in the outpatient and inpatient departments of the First Hospital of Heilongjiang University of Traditional Chinese Medicine during December 2021-January 2023 were collected,and after standardization,the data were entered into the TCM inheritance computing platform V3.0 and Excel for frequency statistics,association rule analysis and entropy cluster analysis to explore the influencing factors of gouty arthritis onset and The data were entered into the TCM heritage computing platform V3.0 and Excel for frequency statistics,association rule analysis and entropy cluster analysis,to explore the influencing factors and seizure characteristics of gouty arthritis,and to summarize the identification ideas and medication rules of the tutor in treating gouty arthritis.Results:1.Among the 166 patients in this study,160 were male and 6 were female;the oldest patient was 75 years old,the youngest patient was 13 years old,and the most patients were in the 30-39 age group,accounting for 27.71%;138 patients were overweight and obese,accounting for 83.14%.2.Among the 166 patients,there were 32 cases with family history,accounting for 19.28%;the most frequent site of first onset was the first metatarsophalangeal joint,appearing 75 times,accounting for 45.18%;the most frequent disease duration was 1-5 years,appearing 58 times,accounting for 34.94%;the most frequent predisposing factor was high purine diet,appearing 86 times,accounting for 39.76%;the total number of concomitant diseases was 213.The frequency of concomitant diseases was 213 times,among which the most patients with hypertension was 63 cases,accounting for 37.95%,and 145 patients with "three highs" was 145 cases,accounting for68.08%;the highest frequency of red tongue was 51 times,accounting for30.72%,and the highest frequency of yellow,thick and greasy tongue was 44 times,accounting for 26.51%.The highest frequency of tongue coating was yellow thick and greasy coating,which appeared 44 times,accounting for26.51%;the highest frequency of pulse was slippery pulse,which appeared 33 times,accounting for 19.88%.3.In this study,a total of 196 drugs were used,and the total frequency of drugs used was 2857 times,and those with a frequency of 80 times or more were yam rhizome,pinellia tuber,coix seed,poria cocos,glabrous greenbrier rhizome,dried tangerine peel,plantain seed,achyranthis bidentatae,radix paeoniae alba,sichuan lovage rhizome,rehmannia,Chinese angelica,immature bitter orange,christina loosestrife,and clematis root;The frequency of the four natures of drugs,from high to low,was warm,cold,calm,cool,and hot;The frequency of the five flavors of drugs,from high to low,was sweet,bitter,spicy,sour,and salty;The frequency of drug channel tropism from high to low was as follows: spleen meridian,stomach meridian,lung meridian,liver meridian,kidney meridian,heart meridian,gallbladder meridian,bladder meridian,small intestine meridian,large intestine meridian,triple jiao meridian,and pericardial meridian;The top five drugs ranked in terms of efficacy were diuretic and dampness reducing drugs,heat clearing drugs,tonifying drugs,promoting blood circulation and resolving blood stasis drugs,and expelling wind and dampness drugs.4.In this study,by applying the association rule in prescription analysis,with a set support of 81 and a confidence level of 0.9,the commonly used drug combinations were glabrous greenbrier rhizome and yam rhizome;coix seed and plantain seed;pinellia tuber,dried tangerine peel and poria cocos;yam rhizome,coix seed,achyranthis bidentatae and plantain seed.5.Four core drug combinations were obtained by cluster analysis,which were: combination 1 yam rhizome,coix seed,pinellia tuber,plantain seed,poria cocos,immature bitter orange;combination 2 coix seed,yam rhizome,pinellia tuber,poria cocos,glabrous greenbrier rhizome,radix paeoniae alba;combination 3 pinellia tuber,dried tangerine peel,poria cocos,yam rhizome,sichuan lovage rhizome,radix paeoniae alba;combination 4 yam rhizome,coix seed,pinellia tuber,atractylodes rhizome,glabrous greenbrier rhizome,amur corktree bark.6.The distribution of the types of GA: 42 cases with dampness heat accumulation syndrome,40 cases with phlegm stasis obstruction syndrome,38 cases with spleen deficiency dampness excess syndrome,37 cases with liver and kidney deficiency syndrome,5 cases with cold dampness obstruction syndrome,and 4 cases with yang deficiency cold coagulation syndrome.The commonly used drugs for dampness heat accumulation syndrome included amur corktree bark,atractylodes rhizome,coix seed,achyranthis bidentatae,glabrous greenbrier rhizome,yam rhizome,clematis root,indian iphigenia bulb,giant knotweed rhizome,and plantain seed;The commonly used drugs for phlegm stasis obstruction syndrome included pinellia tuber,dried tangerine peel,poria cocos,mustard,peach kernel,safflower,sichuan lovage rhizome,Chinese angelica,and radix paeoniae alba.The commonly used drugs for spleen deficiency dampness obstruction syndrome included ginseng,largehead atractylodes rhizome,poria cocos,pinellia tuber,dried tangerine peel,coix seed,achyranthis bidentatae,glabrous greenbrier rhizome,and giant knotweed rhizome;The commonly used drugs for liver and kidney deficiency syndrome included rehmannia,eucommia bark,achyranthis bidentatae,Chinese taxillus twig,yam rhizome,largeleaf gentian root,plantain seed,pubescent angelica root,coix seed,and christina loosestrife.Conclusion:1.Patients with GA are mainly middle-aged and elderly men,with a tendency to be younger;most patients are overweight and obese;the first onset site is mainly the first metatarsophalangeal joint;there is a genetic susceptibility;factors such as high purine diet,alcohol consumption and exertion are likely to trigger the onset of GA;it is likely to be accompanied by "three highs" and other diseases at the same time;patients with a disease duration of more than 10 years are likely to be accompanied by gout stones.2.The syndrome types of this disease are distributed as dampness heat accumulation syndrome,phlegm stasis obstruction syndrome,spleen deficiency dampness excess syndrome,liver and kidney deficiency syndrome,cold dampness obstruction syndrome,and yang deficiency cold coagulation syndrome.The first four syndrome types account for the vast majority of this disease.The commonly used traditional Chinese medicines for treating this disease include yam rhizome,pinellia tuber,coix seed,poria cocos,glabrous greenbrier rhizome,dried tangerine peel,plantain seed,achyranthis bidentatae,radix paeoniae alba,sichuan lovage rhizome,rehmannia,Chinese angelica,immature bitter orange,christina loosestrife,and clematis root;The main types of medication efficacy are diuretic and dampness enhancing drugs,heat clearing drugs,deficiency tonifying drugs,blood activating and stasis resolving drugs,and wind dispelling and dampness removing drugs.The four natures types are mostly warm,cold,and calm,while the five flavors are mostly sweet,bitter,and spicy.The meridians are mainly attributed to the spleen,stomach,liver,and kidney meridians.3.In this study,the commonly used drugs for the dampness heat accumulation syndrome of GA are Simiao Wan,Shuanghe Tang with modified phlegm stasis obstruction syndrome,Erchen Tang and Liujunzi Tang with modified spleen deficiency dampness excess syndrome,and Duhuo Parasitic Tang with modified liver and kidney deficiency syndrome. |
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