Study On Prescription Law Of Traditional Chinese Medicine For Postmenopausal Osteoporosis Based On CiteSpace And Consensus Conference Method

Objective:The visual software CiteSpace is used to analyze the prescription rules of traditional Chinese medicine(TCM)in the therapy of postmenopausal osteoporosis(PMOP),and the consensus conference method is used to demonstrate the results of the formula law,and determine the formula law of TCM in the therapy of PMOP.It provides a reference for the methodology of formula law analysis and clinical therapy of PMOP.Methods:The CNKI and Web of Science detabases were searched to screen and download the RCT bibliography and original text of the PMOP.Extract the required data,including dispatch area,types of literature,PMOP syndromes of Chinese medicine treating PMOP parting,dosage form,basic side,Chinese medicine therapy of PMOP liver and kidney Yin deficiency,kidney Yang deficiency,Deficiency of kidney Yin and Yang,kidney deficiency and blood stasis of drug therapy and composition,drug therapy based on disease differentiation and composition,compatibility of drugs based on symptoms and clip composition,based on a similar therapy(including tonic liver and kidney Yin,warming and nourishing kidney Yang,improve blood circulation and disperse stasis,strengthening tendons and bones,etc.)The general situation analysis of PMOP and the correlation analysis of prescription rules of PMOP were conducted.In the general situation analysis,annual publications,journal publications,regional publications and literature types were descriptive statistical analysis conducted using Excel,and authors,research institutions and keywords were visual analysis conducted by CiteSpace.Formula law related analysis,syndrome,dosage form,basic party by Excel descriptive statistical analysis,such as TCM therapy of PMOP liver and kidney Yin deficiency,kidney Yang deficiency,deficiency of kidney Yin and Yang,kidney deficiency and blood stasis of drug therapy and composition,drug therapy based on disease differentiation and composition,compatibility of drugs based on symptoms and clip of composition,and compatibility of drugs based on similar therapy,etc.Analysis documents should be prepared first,and then CiteSpace should conduct frequency analysis,association analysis and cluster analysis.After sorting the above analysis results,the items are formed,the consensus conference method is adopted to demonstrate,and the final formation rule is obtained.Results:General situation of PMOP literature analysis results:Annual number increase volatility,journal of osteoporosis in China the largest published literature,most of the published literature area of guangdong province,has formed a number of the team,the team internal contact closely,but less contact between teams,research institutions,such as orthopedics hospital affiliated to guangzhou university of Chinese medicine is the main research institutions,The main focus of the clinical study on PMOP is clinical efficacy,The research hotspot of TCM in the treatment of PMOP:in the clinical efficacy,the main concern index is bone mineral density.Among the prescriptions,the Qing’e pill has the greatest concern.Results of correlation analysis of prescription rules of TCM in PMOP therapy:1 Prescription rules of TCM in PMOP therapy based on syndrome differentiation:The common therapy methods of TCM in PMOP therapy of liver-kidney Yin deficiency are tonic the liver and kidney,combining with warming and tonifying kidney Yang,activating blood circulation and removing stasis,strengthening spleen,replenishing qi,etc.Common medicines for nourishing the liver and kidney include ripe rehmannia,cornus officinalis,wolfberry,Chinese yam,achyranthes bidentata,and antler gum.Warming and tonifying the kidney Yang is the most commonly uesd therapy,and the most commonly used drugs are Epimedium,Guisebu,Eucommia ulmoides,and psoraleae.Commonly used medicines for invigorating the spleen and benefiting qi include Chinese yam,ginseng,Tuckahoe,Atractylodes atractylodes and Astragalus membranaceus.Commonly used drugs to promote blood circulation and remove blood stasis include caulis spatholobi,peach kernel and safflower.The commonly used TCM therapy for PMOP kidney Yang deficiency syndrome is warming and tonifying kidney Yang,nourishing the liver and kidney,strengthening the spleen,invigorating qi,promoting blood circulation and removing stasis.Commonly used drugs for warming and tonifying kidney Yang include Epimedium,Psoraleae,Eucommia ulmoides,and Radix Morbidiae officinalis.Nourishing the liver and kidney is the most commonly compatible therapy,and commonly used drugs include rehmannia glutinosa,cornus officinalis,Chinese yam,wolfberry fruit,and tortoise shell gum.The commonly used medicines for invigorating spleen and benefiting qi are astragalus membranaceus,Chinese yam,tuckahoe,atractylodes atractylodes,codonopsis pilosula,etc.The often used medicines for improvig blood circulation and dispersing stasis contain angelica,salvia miltiorrhiza,peach kernel.The often used TCM therapy of PMOP deficiency of Yin and Yang of kidney is warming and tonicing kidney Yang,tonicing liver and kidney,and strengthening tendons and bones,and tonicing blood.The commonly used drugs for nourishing liver and kidney include cooked rehmannia glutinosa,cornus officinalis,Chinese yam,achyranthes bidentata,lotus flower,wolfberry fruit,polygonum multiflorum,tortoise shell gum,dog spine,ligustrum lucidum,etc.The commonly used drugs for warming and tonifying kidney Yang include eucommia ulmoides,epimedium,fructus persicae,psoraleae peregris,herba officinalis,cistanche deserticola,cinnamon,etc.Drugs for strengthening tendons and strengthening bones are often used to warm and tonify kidney Yang,such as eucommia ulmoides,bone broken bubu,achyranthes bidentata and euphorbia officinalis.Blood tonic drugs are often used to nourish the liver and kidney drugs,there are cooked rehmannia,wolfberry,lotus,angelica,etc.The commonly used TCM therapys for PMOP kidney deficiency and blood stasis are warming and tonic kidney Yang and improve blood circulation and disperse stasis.The two therapys should be paid equal attention to each other,and combined with such therapys as tonifying blood.The commonly used drugs for warming and tonifying kidney Yang include epimedium,eucommia ulmoides and bone shushibu.Commonly used drugs for improving blood circulation and dispersing stasis include cortex moutan,safflower,salvia miltiorrhiza,turtle worm,myrrh,peony root,frankincense,peach kernel,caulis spatholobus,panax notoginseng,etc.Blood tonic is the most common compatible therapy,commonly used blood tonic drugs are angelica,paeony,ripe rehmannia glutinosa and so on.2 Prescription composition rule of PMOP based on disease differentiation and therapy:The therapy of disease differentiation and therapy is mainly targeted at disease therapy,and the therapy is characterized by both reinforcing and reducing the deficiency and the actual condition.Therapy of the disease,tonifying liver and kidney,spleen and qi to treat the root cause,dispel wind and dehumidify,huoxue tongluo to treat the symptoms.Commonly used drug combinations include epimedium,psoraleae psoraleae,fructus guisetum,agaric fungus,cucumber seed,astragalus membranaceus,keel,oyster,safflower,frankincense,myrrh,turtle worm,panax notoginseng,natural copper,salvia miltiorrhiza,etc.3 Drug compatibility rule based on concurrent symptoms:For the symptoms of chills and warmth,commonly used drugs include aconite,dried ginger,cinnamon isothermal drugs;In view of the symptoms of hot flashes and night sweats,the commonly used drugs are anemu,phellodendri and other drugs for clearing empty heat;For the pain of the limb joints,the commonly used drugs are gentiana,mulberry branch and other good at dispelling rheumatism and stopping arthralgia drugs;For the body heavy,commonly used drugs have anti-self,coix seed and other drugs to dispel wind dampness;For constipation,commonly used hemp seed and other moisten bowel laxative drugs;For insomnia,commonly used night rattan and other collaterals,tranquilizing drugs.4 Drug compatibility rule based on the same therapy method:Among the traditional Chinese medicines for the therapy of PMOP,the commonly used drugs for nourishing liver and kidney are rehmannia glutinosa,cornus officinalis,wolfberry fruit,tortoise shell,antler gum,mulberry parasite,ligustrum lucidum,rehmannia glutinosa,etc.The commonly used drugs for warming and tonifying kidney Yang are epimedium,eucommia ulmoides,guisebu,psoralea,euphorbia officinalis,cistanche deserticola,antler gum,dog’s ridge,xanthate,etc.The commonly used spleenstrengthening and qi replenishingdrugs include poria cocos,Chinese yam,astragalus membranaceus,atractylodes atractylodes,dangshen,jujube,ginseng,etc.Commonly used blood tonic drugs are angelica,rehmannia glutinosa,paeonia lactiflora,polygonum multiflorum,zihe che,jujube,donkey-ejiao,longan meat,etc.Commonly used drugs for strengthening tendons and bones are eucommia ulmoides,achyranthes bidentata,bone fragment,tortoiseshella,dog spine,rhizome,artificial tiger bone,natural copper,etc.The commonly used drugs for improving blood circulation and dispersing stasis are angelica,achyranthes bidentata,ligusticum chuanxiong,safflower,panax notoginseng,radix paeoniae,caulis spatholobi,peach seed,myrrh,salvia miltiorrhiza,and turtle worm.The commonly used drugs for tonifying kidney and reinforcing essence are cornus officinalis,dodder seed,oyster,keel,cherry blossom,schizandra fruit,lotus seed,raspberry,milkvetch seed,etc.Common medicines for clearing deficiency and heat are rehmannia glutinosa,anemone anemone,phellodendron,peony root and cortex moutan.5 Consensus conference method:27 items were drawn up for the above results and voted,and the result was that the affirmative vote for each item was≥70%.Therefore,the above results were agreed and a consensus was reached.Some suggestions were put forward,such as "attention should be paid to the role of invigorating spleen and supplementing qi in the therapy of PMOP","female characteristics should be taken into consideration and PMOP should be treated from chong ren".Conclusion:The basic treatment of PMOP treatment is kidney supplementation,which is mainly manifested as kidney essence,kidney Yin and kidney Yang.For the treatment of liver and kidney Yin deficiency,the commonly used classic formulas are Liuwei Dihuang Pills,Zuo Gui Pills,Erzhi Pills,etc;for the treatment of kidney Yang deficiency,the commonly used classic formula is Yougui Pills,etc;the treatment of kidney Yin and Yang deficiency,commonly used classic formulas are Erxian Tang,Guilu Erxian Gum,etc.The drugs that can be used to nourish the liver and kidneys include cooked ground yellow,dogwood,goji berries,etc;the optional drugs for warm tonic kidney Yang include epimedium,eucommia,drynaria rhizome,psoralea etc.Clinical should be based on the patient’s specific situation,with nourishing the liver,blood,liver and qi,spleen and qi,blood circulation and stasis,can be supplemented with dispelling wind cold and dampness,strengthening tendons and bones,clearing deficiency heat,etc.