Data Mining-based Approach On The Rules Of Medication And Systemic Evaluation For Osteoarthritis

Object: 1.To make holistic approach to osteoarthritis based on the retrieval and collation of ancient and modern literatures.According to different routes of medication,this paper investigated the clinical medication rulse,formula design and compatibility features of internal and external prescription of osteoarthritis,so as to make a beneficial exploration for its clinical application and provide some references for the prevention and treatment of this disease.2.To systematically evaluate the clinical efficacy and safety of Huoxue Huayu recipes(prescriptions that activating blood and removing blood stasis)in the treatment of osteoarthritis,and provide evidence-based medicinal basis for clinical medication of osteoarthritis.Methods: 1.Study on medication rules: a full retrieval of the ancient and modern literatures on the treatment of osteoarthritis with traditional Chinese medicine was conducted.Mathematical statistics,association rule analysis,clustering analysis and data mining were used to make a detailed study on the clinical medication rules and compatibility characteristics of osteoarthritis.2.Systematic evaluation: comprehensive retrieval of literatures on the treatment of osteoarthritis with Huoxue Huayu recipe were carried out,randomized controlled trials(RCT)were strictly screened according to the inclusion criteria,and systematic evaluation was conducted with Review Manager.Results: 1.Medication rules: 1 Ancient and modern oral-taking prescriptions are mainly based on tonic herbs,followed by wind-dampness-expelling herbs,blood-activating and stasis-transforming herbs,exterior-releasing herbs,etc.Most of the herbs are warm in nature,sweet and acrid in flavors,usually entering into Liver,Kidney and Spleen Channel.The herbal combinations are tonic herbs,wind-cold-dispersing herbs,wind-dampness-expelling herbs,blood-activating and stasis-transforming herbs,interior-warming herbs,etc;the most common drug compatibilities are Qianghuo,Fangfeng,Xixin,Niuxi,Danggui,Baishao,Duzhong,Buguzhi,Gancao,Duhuo,Wujiapi,Sangzhi,Qinjiao,Chuanxiong,Fuzi and Rougui.The clustering combinations showed the efficacies of replenishing qi and blood,tonifying liver and kidney,expelling wind-cold-dampness,activating blood and removing stasis,thus providing the references for clinical medication.2 Ancient and modern external-application prescriptions are mainly based on wind-dampness-expelling herbs,blood-activating and stasis-transforming herbs,followed by exterior-releasing herbs,interior-warming herbs,etc.Most of the herbs are warm and hot in nature,acrid and bitter in flavors,usually entering into Liver and Spleen Channel.The herbal combinations are wind-dampness-expelling herbs,blood-activating and stasis-transforming herbs,and wind-cold-dispersing herbs.Dampness-drying and phlegm-transforming herbs,purgatives and stasis-removing herbs are also combined which were recorded in ancient prescriptions.The most common drug compatibilities are Chuanwu,Caowu,Duhuo,Shenjincao,Tougu,Chuanxiong,Honghua,Ruxiang,Moyao,etc.Baizhi,Fangfeng,Qianghuo,Danggui,Cangzhu,Tiannanxing,Dahuang were also commonly used in ancient prescriptions.The clustering combinations showed the efficacies of removing wind-cold-dampness,warming and unblocking the channels,activing blood and removing stasis,dispersing cold and stoping pain,drying dampness and trasforming phlegm.It can be tailored according to clinical practice.2.Systematic evaluation: A total of 24 articles were included,involving 2134 cases.The results of meta-analysis confirmed the positive effect of Huoxue Huayu recipe in the treatment of osteoarthritis.Funnel plot analysis of indexes with the number of references greater than 10 showed poor symmetry,suggesting the possibility of publication bias.Conclusion: 1.The pathogenesis of osteoarthritis belongs to deficiency in nature and excess in superficiality,or deficiency accompanied with excess syndrome.The treatment of osteoarthritis usually focus on “tonifying,expelling pathgen,warming and unblocking” by the practitioners in all times.Based on the holistic view,the oral-taking prescriptions emphasize on the syndrome differentiation and treatment of the whole body;Searching for the root cause of the disease,focusing on supplementing the the deficiency of qi and blood in zang-fu organs,regulating the function of the body,the treatment is mainly based on tonification,assisted by the way of dispersing wind-cold,resolving wind-dampness,activating blood and trasforming stasis,warming the interior.While the external application prescriptions attach improtance to the local treatment and syndrome differentiation.the theraputic methods forcus on eliminating pathogenic factors,such as dispersing cold,resolving dampness,warming channels,unblocking vessels,subsiding swollen and relieving pain to alleviate the clinical symptoms.2.Basically,the systematic evaluation of literatures confirmed the effectiveness and safety of Huoxue Huayu Recipe in the treatment of osteoarthritis.However,due to the existence of publication bias,poor methodological quality of the included literatures and obvious heterogeneity of some indicators,etc.Multi-center,high-quality,large-sample randomized controlled trials are needed to further confirm its clinical efficacy and safety.