关键词:

类风湿关节炎, 辨病论治, 病证结合

Abstract:

Objective　To analyzed the medication rules of differentiation and treatment of rheumatoid arthritis (RA) by Zhang Minghe and Fan Yongsheng. Methods　The data mining method was used. One hundred and fifty-two patients with RA treated at Zhang Minghe Clinic and 125 patients at Fan Yongzhen Clinic from April 2018 to December 2019 were selected; each patient's information was collected more than 3 times; among which, the 1-3 treatment times with good efficacy were selected, and 217 effective treatment times were obtained from Zhang, and 201 from Fan. With the help of "Ancient and Modern Medical Records Cloud Platform (V2.1)", the data of the two professors' cases were sorted out, the similarities and differences of the cases were compared and analyzed, and the rules and characteristics of the differentiation and treatment of RA were summarized. Results　Among the 217 treatment times by Zhang, the top 2 Zhengsu were phlegm dampness [56.68% (123/217)] and cold[50.69% (110/217)], and the tope 2 syndrome types were cold-dampness obstruction [43.78% (95/217)] and damp-heat obstruction [21.20% (46/217)]. The categories of commonly used Chinese medicine were wind-dampness drugs, heat-clearing drugs, blood-activating drugs for removing blood stasis, etc. According to association rule analysis, there was no correlation between the efficacy of commonly used Chinese medicine and its highly correlated Zhengsu and syndrome types. The core prescriptions were obtained through complex network analysis. The common treatment methods in the 201 treatment times by Fan were Tongluo, dispelling wind, dispelling dampness, Yiyin, and so on. The categories of commonly used Chinese medicine were deficiency tonifying drugs, wind-dampness dispelling drugs, surface relieving drugs, etc. Through the analysis of association rules, it found that the treatment method was consistent with the efficacy of traditional Chinese medicine with high correlation. Through complex network analysis, it found that the Tongluo method was highly correlated with other treatment methods. Conclusion　Zhang pays attention to disease differentiation and drug use, and takes the "clearing heat and detoxifying method" as the basic treatment; Fan pays attention to syndrome differentiation and treatment, and often makes flexible differentiation and treatment according to the syndrome types. The common rules of the two for RA are dispelling wind and removing dampness, Tongluo, clearing heat and detoxifying, activating blood circulation and removing blood stasis, and Fuzheng and protecting the stomach.

Key words:

Rheumatoid arthritis, Disease differentiation and treatment, Combination of disease and syndrome