Analysis on Traditional Chinese Medicine Prescription Patterns in 3609 Patients with Osteoarthritis Based on The Real World / 世界科学技术-中医药现代化

ABSTRACT

Traditional Chinese medicine (TCM) is widely used as a complementary approach for osteoarthritis treatment.This article is based on the real world.The implicit prescription patterns behind TCM formulae were examined by association rules mining and cluster analysis,so as to explore the Chinese medicinal compatibility patterns or rules in osteoarthritis treatment.This study was based on real-world data from the hospital information system (HIS).Chinese medicinal prescriptions of hospitalized patients with osteoarthritis from June 2012 to June 2016 were collected from the Department of Rheumatism and Immunology,the First Affiliated Hospital of Anhui University of Chinese Medicine.TCM was listed according to the selected medicinal formulae and the added information was organized to establish a database.The frequency and association rules of prescription patterns were analyzed using the SPSS Modeler 14.2 Data Mining System.Cluster analysis of prescription patterns was also analyzed.An initial statistical analysis was carried out to categorize herbs according to their natures,flavors,channel tropisms and functions.Based on categorization,frequencies of occurrence were computed.At the same time,the relationship between TCM and immune and inflammatory markers was analyzed.The results showed that the main prescriptive features from the selected formulae of the mining data were that,(1) warm or cold herbs,sweet or bitter herbs,and with the channel tropism of spleen channel are the most frequently prescribed herbs in 3609 medicinal formulae;(2) herbs with blood-activating and stasis-resolving,restoring vital energy,water-eliminating and damp-removing,heat-clearing and or expelling wind-damp functions are frequently prescribed;(3) association rule analysis extracted three frequently used pairs of herbs,which are Hong Hua & Tao Ren (98.90％),Pu Gong Ying & Bai Hua She She Cao (97.88％),Fu Ling & Ze Xie (92.63％);(4) association rule between TCM and immune-inflammation index showed that the pair of Du Huo and Chen Pi was associated with increased superoxide dismutase (SOD) enzyme.The pair of Mai Ya and Dan Shen was associated with decreased high-sensitivity C-reactive protein (hs-CRP),erythrocyte sedimentation rate (ESR),complement component 3 (C3),complement component 4 (C4),immunoglobulin A (IgA) and immunoglobulin G (IgG).The pair of Mai Ya and Fu Ling was associated with decreased immunoglobulin M (IgM).It was concluded that osteoarthritis was closely related to spleen deficiency.These prescriptions focus on herbs for qi-nourishing and spleen-invigorating,blood-activating and stasis-resolving,spleen-invigorating and dampness-eliminating,heat-clearing and detoxicating which seems to be the key element in the treatment process.Meanwhile,the use of restoring vital energy herbs and spleen-strengthening herbs also forms the basis of prescription patterns.