| Objective:1.Through the use of data mining method,this paper summarizes the medication rules of external treatment of traditional Chinese medicine in the treatment of knee osteoarthritis(KOA)in recent 10 years,so as to provide a theoretical basis for the follow-up clinical research of external treatment of traditional Chinese medicine.2.On the basis of previous studies,this study treated KOA patients with traditional Chinese medicine smearing,ironing and sticking therapy,observed the visual analogue scale(VAS)score,osteoarthritis index(WOMAC)score of knee joint before and after treatment,and fully elaborated the combination of external treatment of traditional Chinese medicine by detecting the serum 5-hydroxytryptamine(5-HT),prostaglandin E2(PGE2)and substance P(SP)The pain mechanism of KOA treated by traditional Chinese medicine.Methods:1.Data mining:using the method of combining subject words and free words,relevant literatures were searched in CNKI,CBM,VIP full text database,Wanfang and other databases,the literatures were screened according to the inclusion criteria and exclusion criteria,and the external prescriptions of traditional Chinese medicine were summarized In 2007,we established the database of KOA treated by external treatment of traditional Chinese medicine,and obtained the results of prescription composition and frequency of nature,taste and meridian tropism.At the same time,we used IBM SPSS statistics 26 and IBM SPSS modeler 14.1 for cluster analysis and association rule analysis,and compared the research results with traditional Chinese medicine smearing,ironing and sticking therapy drugs,to explore the relationship between them.2.Clinical research: according to the diagnostic criteria,inclusion criteria,exclusion criteria and exclusion criteria of KOA,60 patients with KOA admitted to the trauma department of orthopedics of the First Affiliated Hospital of Guangxi University of traditional Chinese medicine from April2020 to December 2020 were randomly divided into 2 groups,namely,the experimental group: Traditional Chinese medicine erasure,ironing plus sticking therapy group,and control group: flurbiprofen gel plaster group.30 patients in each group signed informed consent.The VAS score,WOMAC score and related pain factors(5-HT,PGE2,SP)were observed before and 2weeks after treatment.The experimental data were statistically processed by SPSS 26.0 statistical software.The measurement data were expressed by mean ± standard deviation(`X±S).The counting data were analyzed by chi square test.The comparison of the mean between the two groups before and after treatment was performed by independent samples T-test and paired sample t-test,rank sum test were used for grade data,P < 0.05 showed that the difference was statistically significant.Results:1.Data mining results: a total of 193 prescriptions of traditional Chinese medicine were included in this study,including 189 kinds of traditional Chinese medicine.The cumulative occurrence times were 2377,and the top10 were safflower,Shenjincao,clematis,Tougucao,Duhuo,Ruxiang,Chuanwu,chuanxiong,Caowu and Danggui.At the same time,it was found that the main channel tropism of four Qi and five flavors were warm(84 times,44.7%),bitter(107 times,35.9%)and zujueyin liver channel(119 times,25.4%).In addition,five cluster combinations were found by cluster analysis:cluster I(frankincense,myrrh,Radix Saposhnikoviae,Radix Clematis);cluster II(Radix Aconiti,Radix Aconiti kusnezoffii,Ramulus Cinnamomi,Folium Artemisiae argyi);cluster III(Rhizoma Polygoni Multiflori,cortex Pittosporum,Carthamus tinctorius,angelica);cluster IV(Radix Angelicae Pubescentis,Radix Notopterygii,Radix Achyranthes Bidentatae,papaya,Radix Gentianae);cluster V(Rhizoma Chuanxiong,asarum).The association rules analysis showed that the top five drug pairs with the highest confidence were "frankincense → myrrh,Radix Aconiti kusnezoffii(100%)," frankincense → myrrh,Clematis(95.3%)At the same time,through the comparison with traditional Chinese medicine smearing,ironing and sticking therapy drugs,it was found that there were 20 drugs with the same flavor,and the main characteristics of the two drugs were warm,bitter and foot Jueyin liver meridian.2.Clinical research results:(1)a total of 60 patients with koa were included in this study,all of them showed good compliance,and there was no case shedding from the beginning to the end of the trial.(2)Before treatment,the age,gender,course of disease,knee X-ray K-L grade,VAS score,WOMAC score and 5-HT,PGE2,SP content of the two groups were compared.The study found that there was no significant difference between the two groups(P > 0.05),so it was comparable.(3)Comparison between groups: after 2 weeks of treatment,the scores of VAS,WOMAC,5-HT,PGE2 and SP in the experimental group and the control group were all lower than those before treatment,and the difference was statistically significant(P< 0.05),indicating that Chinese herbal ointment,ironing and sticking therapy and flurbiprofen gel paste can effectively relieve pain symptoms and improve the activity function of patients with knee osteoarthritis.(4)Comparison between groups: after 2 weeks of treatment,the VAS score,WOMAC score,5-HT and PGE2 efficacy of the experimental group were lower than those of the control group(P < 0.05).However,there was no significant difference in the efficacy of SP(P > 0.05),indicating that Chinese medicine rubbing,ironing and sticking therapy were better than flurbiprofen gel in improving the patient’s function and relieving pain symptoms.Paste has more advantages,but there is no significant difference in the efficacy of SP.(5)Comparison of clinical effects: after treatment,the total effective rate of the experimental group was 96.7%,while that of the control group was 90%.The curative effect of the experimental group was more significant than that of the control group(P < 0.05),indicating that after 2 weeks of treatment,Chinese medicine erasure,ironing and sticking therapy were more effective than flurbiprofen gel paste.Conclusions:1.The main components of traditional Chinese medicine for external treatment of knee osteoarthritis are safflower,Shenjincao,clematis,Tougucao and Duhuo.The main components of nature and taste are warm,bitter and liver meridian of foot Jueyin.2.Traditional Chinese medicine rubbing,ironing and sticking therapy is in line with the law of external use of traditional Chinese medicine in the treatment of knee osteoarthritis,which provides a solid theoretical basis for the follow-up clinical research.3.Traditional Chinese medicine smearing,ironing and sticking therapy in the treatment of knee osteoarthritis can effectively relieve pain symptoms and improve joint activity.4.Traditional Chinese medicine rubbing,ironing and sticking therapy can reduce the content of 5-HT,PGE2 and SP,which may be one of the pain mechanisms in the treatment of early and mid-term knee osteoarthritis. |
