中国中医基础医学杂志2026，Vol.32Issue(2)：401-406,6.
1153例寒湿痹阻证类风湿关节炎患者真实世界用药规律研究
A Real-World Study on Medication Patterns in 1,153 Patients with Rheumatoid Arthritis of Cold-Dampness Obstruction Syndrome
摘要
Abstract
Objective To analyze the medication patterns of traditional Chinese medicine(TCM)in treating rheumatoid arthritis(RA)of cold-dampness obstruction syndrome(Hanshi Bizu Zheng)based on data mining,providing clinical reference.Methods A retrospective analysis was conducted on clinical data of RA patients from the"Ask Rheumatism Patient Platform"between January 2019 and December 2022.Statistical methods,including frequency analysis,association rule analysis,and hierarchical clustering analysis,were applied to the TCM prescriptions.Results The study included 1,153 clinical records.Among them,437 cases(37.90%)showed significant improvement in the Clinical Disease Activity Index(CDAI).Commonly used formulas included Guizhi Shaoyao Zhimu Tang and Wutou Tang.High-frequency herbs included Baishao(Paeoniae Radix Alba),Gancao(Glycyrrhizae Radix Et Rhizoma),and Mahuang(Ephedrae Herba),totaling 27 herbs.Common herb combinations in the treatment included Baishao-Gancao and Baishao-Guizhi.Through hierarchical clustering analysis,four distinct herb clusters were identified.Among these,Cluster Ⅱ—comprising herbs such as Baishao,Gancao,Guizhi(Cinnamomi Ramulus),Zhimu(Anemarrhenae Rhizoma),and Fangfeng(Saposhnikoviae Radix)—may serve as the core prescription for managing RA characterized by cold-dampness obstruction syndrome.In the long-disease-duration group,herbs for activating blood,dispelling wind,tonifying the liver and kidney were predominant,while in the short-disease-duration group,herbs for dispersing pathogens,relieving the exterior,strengthening the spleen,and resolving dampness were more common.The improvement rate for the main symptom(aversion to wind and cold)was 32.87%,while improvement rates for accompanying symptoms(fatigue,insomnia,poor appetite)were 28.45%,30.27%,and 27.32%,respectively.After excluding herbs recommended in the Guidelines for Combined Disease and Syndrome Diagnosis and Treatment of Rheumatoid Arthritis,it was found that Jianghuang(Curcumae Longae Rhizoma)and Xuduan(Dipsaci Radix)improved fatigue;Qianghuo(Notopterygii Rhizoma Et Radix)and Shudihuang(Rehmanniae Radix Praeparata)improved insomnia;and Gusuibu(Drynariae Rhizoma)and Shudihuang improved poor appetite.Conclusion In real-world clinical practice,TCM demonstrates certain efficacy and identifiable medication patterns in treating RA of cold-dampness obstruction syndrome.Cluster Ⅱ may represent the core prescription for reducing CDAI in patients.Some herbs not only alleviate main symptoms but also significantly improve common accompanying symptoms.关键词
类风湿关节炎/寒湿痹阻证/用药规律/CDAI/真实世界Key words
Rheumatoid arthritis/Cold-dampness obstruction syndrome/Medication patterns/CDAI/Real-world study分类
医药卫生引用本文复制引用
申钲瑶,杨煜辰,姜泉,马协丽,刘子夏,常甜,巩勋..1153例寒湿痹阻证类风湿关节炎患者真实世界用药规律研究[J].中国中医基础医学杂志,2026,32(2):401-406,6.基金项目
国家自然科学基金项目(82274507) （82274507）
中央高水平中医医院临床科研业务费项目(HLCMHPP2023087) （HLCMHPP2023087）
