Abstract:

Objective　To analyze the medication rules of traditional Chinese medicine (TCM) in the treatment of steroid-induced osteonecrosis of the femoral head (SONFH), in order to provide theoretical support and reference for the clinical medication of SONFH. Methods　The relevant literatures on the treatment of SONFH with TCM were searched in the National Knowledge Infrastructure Database (CNKI) and WanFang Data Knowledge Service Platform (WanFang) from July 2005 to July 2024, and the TCM included in the prescriptions was processed and standardized. WPS table, SPSS Statistics 25.0, SPSS Modeler18.0, and other software were used to analyze the drug frequency, property-flavor-meridians, association rules, and cluster analysis of TCM in the treatment of SONFH. Results　A total of 410 relevant literatures were searched and 31 were included. A total of 36 prescriptions were selected, involving 101 kinds of TCM, mainly involving 4 flavors, 3 properties, 12 meridians, and 17 drug categories. High frequency drugs included angelica sinensis, Astragalus membranaceus, Salvitis miltiorrhiza, Chuanxiong, Rehmannia Rehmannia, Achyranthes ulcommia, bone crushing supplement, Tuckaia poria, teasel root and so on. The medicinal properties were mainly warm, flat, and mild, and the flavors were mainly sweet, xin, bitter, and salty. The main meridians were liver meridian, kidney meridian, spleen meridian, heart meridian, and lung meridian. Efficacy categories of tonifying vacuity drugs, promoting blood circulation and removing blood stasis drugs, wind-dampness drugs were more common. Association rules obtained "Chuanxiong - Angelica", "Achyranthus - Angelica", "drynaria rhizome - Angelica", "Eucommia - Angelica", and other core drug pairs. The cluster analysis classified the drugs into 6 categories. Conclusions　The main pathogenesis of SONFH is kidney deficiency, phlegm dampness, and blood stasis. The treatment principle is "warming meridians and clearing collaterals, activating blood and relieving pain, tonifying liver and kidney, invigorating spleen and removing dampness". The main drugs used are warm, flat, and mild warm. The main meridian involved is liver meridian, followed by kidney meridian, spleen meridian, heart meridian, and lung meridian. The main therapeutic drugs are tonifying deficiency, promoting blood circulation and removing blood stasis, dispelling wind-dampness and rehydrating dampness.

Key words:

Steroid-induced osteonecrosis of the femoral head, Traditional Chinese medicine, Data mining, Medication rules

摘要：

目的　分析中医药治疗激素性股骨头坏死（SONFH）的用药规律，以期为SONFH临床用药提供理论支持与参考。方法　检索2005年7月至2024年7月国家知识基础设施数据库（CNKI）、万方数据知识服务平台（WanFang）收录的中医药治疗SONFH相关文献，对纳入处方的中药进行数据处理与规范。采用WPS表格、SPSS Statistics 25.0、SPSS Modeler 18.0等对相关中药进行用药频次、性味归经、关联规则、聚类分析。结果　检索相关文献共410篇，纳入文献31篇。共出现处方36首，共出现中药101种，主要涉及药味4种、药性3种、归经12条、药物类别17种。高频中药有当归、黄芪、丹参、川芎、地黄、牛膝、杜仲、骨碎补、茯苓、续断等。药味有甘、辛、苦、咸。药性有温、平、微温。归经有肝经、肾经、脾经、心经、肺经等。中药类别有补虚药、活血化瘀药、祛风湿药、利水渗湿药等。关联规则获得多个药对，如川芎-当归、牛膝-当归、骨碎补-当归、杜仲-当归等。聚类分析将中药分为6类。结论　SONFH主要病机为肾虚、痰湿、血瘀，治疗原则为温经通络、活血止痛、补益肝肾、健脾祛湿；以温、平、微温类中药为主；涉及归经以肝经为主，其次是肾经、脾经、心经、肺经；以补虚药、活血化瘀药、祛风湿药、利水渗湿药为主。

关键词:

激素性股骨头坏死, 中医药, 数据挖掘, 用药规律