中药治疗腰椎间盘突出症临床用药规律的聚类分析

目的：探讨临床中药治疗腰椎间盘突出症的用药规律和治疗思想。方法：调查湖南省5家中医院2008～2010年期间以腰椎间盘突出症为第1诊断的住院病历，按照所制定的调查表收集相关资料，将所收集的资料建立SPSS数据库。以频数分析、聚类分析、R×C列表X2检验等方法分析腰椎间盘突出症的临床用药特点和规律．结果：共调查分析1045例，其中443例采用了中药汤剂内服治疗，使用中药共89味、3891味次，按功效分活血化瘀药21味、补虚药18味、祛风湿药14味、解表药7味、平肝息风药7味；药味苦、辛、甘者出现频率达49．26％；药性温、平者出现频率达40．14％；药物归经肝、肾、脾者出现频率达60．12％；聚类分析结果：89味中药药物功效类型聚为第1类的为补虚类、活血化瘀类；聚为第2类的为祛风湿类，其他类药物归为第3类。结论：活血化瘀药、补虚药、祛风湿药的遣用，是中医治疗LDH的基本配伍，同时根据辨证情况辅以清热药、解表药、息风平肝药、利水渗湿药。。常用中药的性味分别为辛、苦、甘和温、平；常用中药归经为肝、脾、肾。

Clinical medication rules in traditional Chinese medicine treatment of lumbar intervertebral disc herniation：a cluster analysis

Objective：To investigate the medication rules and therapeutic thoughts in the traditional Chinese medicine （TCM） treatment of lumbar intervertebral disc herniation （LDH）. Methods：An investigation was conduc- ted on the medical records of patients with a first diagnosis of LDH hospitalized in 5 TCM hospitals in Hunan Prov- ince from 2008 to 2010;data were collected using the designed questionnaire,and an SPSS database was established accordingly. Frequency analysis,cluster analysis,and contingency table chi - square test were used to analyze the characteristics and rules of clinical medication for LDH. Results ： A total of 1045 cases were investigated, and 443 of them were orally given TCM decoction. A total of 89 herbal medicines （389l medicine -times） were used,inclu- ding 21 blood- activating and stasis -resolving medicines, 18 deficiency -tonifying medicines, 14 wind -damp - dispelling medicines,8 exterior syndrome - relieving medicines, and 7 liver - pacifying and wind - extinguishing medicines. The frequency of medicines with bitter, pungent, and sweet tastes was 49. 26% ;the frequency of medi- cines which were warm and neutral in nature was 40. 14% ;the frequency of medicines for the liver, kidney, and spleen meridians was 60. 12%. The cluster analysis of the 89 herbal medicines showed that the first category was deficiency -tonifying medicines and blood - activating and stasis - resolving medicines;the second category was wind -damp -dispelling medMnes;other medicines were classified into the third category. Conclusion：Combined use of blood - activating and stasis - resolving medicines, deficiency - tonifying medicines, and wind - damp - dis- pelling medicines are the basic composition for the TCM treatment of LDH,and syndrome differentiation - based ad- juvant therapy can be applied using heat - clearing medicines, exterior syndrome - relieving medicines,liver - pacff-ying and wind - extinguishing medicines, or diuresis - inducing and dampness - draining al medicines can he classified into those with pungent, hitter, and sweet tastes, those with or those for liver,spleen,and kidney meridians. medicines. Common herb- warm and neutral natures,