Exploration On The Medication Rule Of Clearing Heat And Removing Dampness In The Treatment Of Acute Gouty Arthritis With Damp-heat Accumulation Syndrome

Purpose: To collect and sort out the literature on the treatment of acute gouty arthritis(AGA)with damp-heat accumulation syndrome by removing heat and dispersing dampness,and explore the medication rule of the treatment of AGA with damp-heat accumulation syndrome by removing heat and dispersing dampness through statistically analyzing the literature using statistical software,so as to provide more reference for clinical treatment.Material and method: Based on the China National Knowledge Infrastructure(CNKI),Wanfang Data Knowledge Service Platform and China Science and Technology Journal Database(VIP),all the published literature on the treatment of AGA with damp-heat accumulation syndrome by removing heat and dispersing dampness was searched from January 1,2001 to December 31,2020.The literature meeting the inclusion criteria was collected to establish a prescription database.Additionally,the frequency and types of drugs in the database was statistically analyzed using Microsoft Excel,the association rules of the drugs were analyzed using IBM SPSS Modeler 18.0,and the drugs with high frequency were clustered using SPSS 22.0.Results:1.Frequency analysis of drugs: According to the statistics,a total of 180 prescriptions meeting the inclusion criteria were screened in this study,involving 197 traditional Chinese medicines(TCMs),with a total frequency of medication of 2,195.The TCMs with frequency? 15(n = 41)were defined as the high-frequency medicines for the treatment of AGA with damp-heat accumulation syndrome.The top ten TCMs with the highest frequency of medication were Phellodendron amurense,coix seed,Smilax glabra,Atractylodes lancea,Achyranthes bidentata,Glycyrrhiza uralensis,Rhizoma dioscoreae hypoglaucae,Clematis chinensis Osbeck,Plantaginis Semen and Caulis Lonicerae Japonicae from high to low.2.Category analysis of drugs: The high-frequency medicines with frequency ? 15 were classified according to drug properties,including heat-clearing drugs,diuretic and hygroscopic drugs,blood-activating and stasis-resolving drugs,wind-dispelling and dampness-removing drugs,deficiency-nourishing drugs,liver-pacifying and wind-extinguishing drugs,purgating drugs and exterior syndrome-relieving drugs from high to low.3.Analysis of association rule: Based on the 197 TCMs involved in this study,the analysis of association rules showed 266 association rules.According to the network chart of association rules,Atractylodes lancea,Phellodendron amurense,coix seed,Achyranthes bidentata,Smilax glabra and Rhizoma dioscoreae hypoglaucae were commonly used in clinical compatibility.Among them,the second-order association rule with the highest support was Achyranthes bidentata combined with Phellodendron amurense,with support of 67.222%.The third-order association rule was composed of Achyranthes bidentata,Atractylodes lancea and Phellodendron amurense,with support of 53.889%.The fourth-order association rule was composed of Achyranthes bidentata,Atractylodes lancea,coix seed and Phellodendron amurense,with support of 40.556%.4.Cluster analysis: The high-frequency medicines with frequency ? 15 were clustered,obtaining 6 clustering combinations: category 1: Phellodendron amurense,Atractylodes lancea,coix seed,Achyranthes bidentata and Radix angelicae tuhuo;category 2: Carthamus tinctorious,peach kernel,Ligusticum wallichii,Radix liquiritiae,Angelica sinensis and Rhizoma atractylodis macrocephalae;category 3: Asarum sagittarioides,ash bark,Rheum officinale,Smilax glabra,Rhizoma dioscoreae hypoglaucae,Clematis chinensis Osbeck,Polygonum cuspidatum,Rhizoma alismatis,Aconitum gymnandrum,Pheretima and Gentiana macrophylla;category 4: Anemarrhena asphodeloides,gypsum and cassia twig;category 5:Stephania tetrandra,Forsythia suspensa,honeysuckle,dandelion,Lysimachia christinae,Carica papaya,cortex moutan,Rehmannia glutinosa,Paeoniae Radix Rubra,Corydalis yanhusuo,Poria cocos and Plantaginis Semen;category 6: Caulis Lonicerae Japonicae,Caulis Trachelospermi,Caulis Sinomenii and Salvia miltiorrhiza Bunge.Conclusion:1.The commonly used drugs for the treatment of AGA with damp-heat accumulation syndrome by removing heat and dispersing dampness include Phellodendron amurense,coix seed,Smilax glabra,Atractylodes lancea,Achyranthes bidentata,Radix liquiritiae,Rhizoma dioscoreae hypoglaucae,Clematis chinensis Osbeck,Plantaginis Semen and Caulis Lonicerae Japonicae.2.Through the analysis of the proportion of high-frequency drugs,heat-clearing drugs,diuretic and hygroscopic drugs,blood-activating and stasis-resolving drugs and wind-dispelling and dampness-removing drugs are most widely used,accounting for the majority in high-frequency drugs.3.According to the analysis of association rules,the combination of Achyranthes bidentata,Phellodendron amurense,coix seed and Atractylodes lancea is relatively stable.The compatibility of these four drugs is commonly used in the clinical treatment of AGA with damp-heat accumulation syndrome.4.Based on the cluster analysis of drugs,Simiao pill is the basic prescription for the treatment of this disease.Additionally,it still needs to be combined with blood-activating and stasis-resolving drugs,tonic drugs and wind-dispelling and dampness-removing drugs according to clinical symptoms.