基于Apriori关联规则...虚湿盛证免疫炎症的临床疗效_朱子衡.pdf

第 29 卷第 5 期2023年 3 月Vol.29，No.5Mar.，2023中国实验方剂学杂志Chinese Journal of Experimental Traditional Medical Formulae基于 Apriori关联规则和随机行走模型研究复方雷公藤制剂（新风胶囊）改善类风湿关节炎脾虚湿盛证免疫炎症的临床疗效朱子衡1，2，万磊2，3*，刘健2*，黄传兵2，赵磊1，方妍妍2，李舒1，马熙檬1，李方泽1，胡赛赛1，陈莹莹1，程静1（1.安徽中医药大学 研究生院，合肥 230012；2.安徽中医药大学 第一附属医院，合肥 230031；3.新安医学教育部重点实验室，合肥 230031）摘要 目的：探讨新风胶囊对脾虚湿盛证类风湿关节炎患者免疫炎症指标的影响。方法：将 102例患者按随机数字表法随机分为对照组和观察组，每组各 51例。两组患者均给予甲氨蝶呤片治疗，观察组同时给与新风胶囊治疗，两组疗程均为12周。比较两组患者治疗前后 28处关节疾病活动度评分（DAS28）、视觉模拟评分（VAS）、晨僵时间、血沉（ESR）、超敏 C 反应蛋白（hs-CRP）、类风湿因子（RF）、抗环瓜氨酸肽抗体（anti-CCP）、血管内皮生长因子（VEGF）、血清淀粉样蛋白 A（SAA）的变化；比较两组患者疗效及不良发应发生率；构建 Apriori 关联规则模型、随机行走模型来评价新风胶囊对 hs-CRP、ESR、RF、SAA、VEGF、anti-CCP的改善情况。结果：本研究无病例脱落。两组治疗前各项指标无统计学差异。经 12周治疗后，观察组总有效率 90.19%（46/51），明显高于对照组的 74.51%（38/51）（24.320，P0.05）；观察组 DAS28、VAS、晨僵时间较对照组改善更为明显（P0.05）；Apriori关联规则模型结果显示，观察组新风胶囊的使用与 RF、ESR、hs-CRP、SAA、VEGF的降低有强关联关系；随机行走模型结果显示，观察组 hs-CRP、ESR、RF、SAA、VEGF的改善系数均优于对照组，对照组 anti-CCP的改善系数优于观察组；观察组对 hs-CRP、ESR、RF、SAA、VEGF的改善程度明显优于对照组（P0.05）；比较不良反应的发生率，观察组明显低于对照组（24.057，P0.05）。结论：在甲氨蝶呤片治疗基础上，给与新风胶囊治疗可有效改善类风湿性关节炎脾虚湿盛证的免疫炎症水平，降低不良反应发生率。关键词 新风胶囊；类风湿关节炎；免疫炎症；脾虚湿盛证中图分类号 R2-0；R33；R593.22 文献标识码 A 文章编号 1005-9903（2023）05-0032-07doi 10.13422/ki.syfjx.20222171 网络出版地址 https:/ 2022-10-21 13:31:14Clinical Efficacy of Compound Tripterygium wilfordii Preparation（Xinfeng Capsules）in Improving Immune Inflammation of Rheumatoid Arthritis Due to Spleen Deficiency and Dampness Exuberance Based on Apriori Algorithm and Random Walk ModelZHU Ziheng1，2，WAN Lei2，3*，LIU Jian2*，HUANG Chuanbing2，ZHAO Lei1，FANG Yanyan2，LI Shu1，MA Ximeng1，LI Fangze1，HU Saisai1，CHEN Yingying1，CHENG Jing1（1.Graduate School of Anhui University of Chinese Medicine，Hefei 230012，China；收稿日期 2022-06-21基金项目 国家自然基金面上项目（81973655）；科技部国家重点研发计划中医药现代化研究重点专项（2018YFC1705204）；全国中医药创新骨干人才培训项目（国中医药人教函 2019 128号）；安徽省高校自然科学研究项目（KJ2020A0397）；安徽高校自然科学研究项目（KJ2021A0561）；安徽省高校科学研究项目（研究生）课题（YJS20210484）第一作者 朱子衡，在读硕士，从事中医药防治风湿病研究，E-mail：通信作者 *万磊，副教授，副主任医师，硕士生导师，从事中医药防治风湿免疫病，E-mail：；*刘健，教授，主任医师，博士生导师，从事中医药防治风湿免疫病研究，E-mail：32第 29 卷第 5 期2023年 3 月中国实验方剂学杂志Chinese Journal of Experimental Traditional Medical FormulaeVol.29，No.5Mar.，20232.The First Affiliated Hospital of Anhui University of Chinese Medicine，Hefei 230031，China；3.Key Laboratory of Xinan Medicine，Ministry of Education，Hefei 230031，China）Abstract Objective：To investigate the effect of Xinfeng capsules on immunoinflammatory indicators in patients with rheumatoid arthritis（RA）due to spleen deficiency and dampness exuberance.Method：A total of 102 patients were randomly divided into control group and observation group according to the random number table method，with 51 cases in each group.All patients were treated with methotrexate tablets，while those in the observation group received additional Xinfeng capsules.The course of treatment in both groups was 12 weeks.The 28-joint disease activity score（DAS28），visual analogue scale（VAS）scores，morning stiffness time，erythrocyte sedimentation rate（ESR），high-sensitivity C-reactive protein（hs-CRP），rheumatoid factor（RF），anti-cyclic citrullinated peptide（anti-CCP）antibody，vascular endothelial growth factor（VEGF），and serum amyloid A（SAA）of the two groups before and after treatment were compared.The efficacy and incidence of adverse events were compared between the two groups.The Apriori association rule model and random walk model were constructed to evaluate the effect of Xinfeng capsules in improving hs-CRP，ESR，RF，SAA，VEGF，and anti-CCP.Result：There were no dropouts in this study.There was no statistical difference in the indicators between the two groups before treatment.After 12 weeks of treatment，the total effective rate in the observation group was 90.19%（46/51），which was higher than 74.51%（38/51）in the control group（24.320，P0.05）.DAS28，VAS score，and morning stiffness time in the observation group were improved compared with those in the control group（P0.05）.Apriori association rule model results showed that the application of Xinfeng capsules in the observation group had a strong correlation with the reduction of RF，ESR，hs-CRP，SAA，and VEGF.The results of the random walk model showed that the improvement coefficients of hs-CRP，ESR，RF，SAA，and VEGF in the observation group were all better than those of the control group，and the improvement coefficient of anti-CCP in the control group was better than that of the observation group.The improvement degree of hs-CRP，ESR，RF，SAA，and VEGF in the observation group was superior to that of the control group（P0.05）.The incidence of adverse reactions in the observation group was lower than in the control group（24.057，P0.05）.Conclusion：On the basis of the treatment with methotrexate tablets，Xinfeng capsules can effectively improve the immunoinflammatory level in RA due to spleen deficiency and dampness exuberance and reduce the incidence of adverse reactions.Keywords Xinfeng capsules；rheumatoid arthritis；immunoinflammation；spleen deficiency and dampness exuberance syndrome类风湿关节炎（RA）是多因素导致的以滑膜炎、软骨及骨破坏为特征的自身免疫性疾病，滑膜组织增生和血管翳生成是其基本病理表现1。T、B 淋巴细胞、巨噬细胞等多种免疫细胞之间