中药治疗骨质疏松合并腰椎间盘突出的临床用药规律与安全性分析

doi:10.19803/j.1672-8629.20250476

摘要/Abstract

摘要： 目的探讨中药治疗骨质疏松症（Osteoporosis,OP）合并腰椎间盘突出症（Lumbar Disc Herniation,LDH）的临床用药规律与安全性。方法回顾性收集中国中医科学院望京医院2023年1月1日至2025年4月30日,临床诊断为OP合并LDH并接受口服中药治疗的门诊病例,通过古今医案云平台（V2.3.9）对用药信息进行统计,分析治疗OP合并LDH的高频中药、配伍药对和核心处方等用药规律,并结合临床资料和文献评价评估其安全性。结果纳入病例250例,患者以中老年人群为主,占比87.2%,使用中药236味,总用药频次3 378次,高频药物有川芎、牛膝、白芍等,四气以温、平、微温为主,五味以甘、苦、辛为主,归经多集中于肝、脾、肾经,功效以补肝肾、强筋骨、祛风湿为主。关联分析显示川芎-牛膝、川芎-白芍、白芍-牛膝等高频药对,治疗OP合并LDH核心处方由川芎、牛膝、白芍等15味药物组成。联用较多的西药有碳酸钙D₃片、甲钴胺片和骨化三醇软胶囊等,中成药有丹鹿通督片、骨痛贴膏和金天格胶囊等。安全性评价提示中药治疗OP合并LDH安全性良好。结论中药治疗OP合并LDH以肝脾肾同调为基本治则,用药以补肝肾、强筋骨、祛风湿为主,安全性良好。

关键词: 骨质疏松症, 腰椎间盘突出症, 共病, 用药规律, 核心处方, 安全性分析, 数据挖掘

Abstract: Objective To analyze the clinical medications and safety of oral traditional Chinese medicine (TCM) in the treatment of osteoporosis (OP) combined with lumbar disc herniation (LDH). Methods Medical records of outpatients diagnosed with OP combined with LDH and treated with oral administration of TCM in Wangjing Hospital between January 2023 and April 2025 were collected. Data on their medications was statistically analyzed via the Ancient and Modern Medical Cases Cloud Platform (V2.3.9), including high-frequency herbs, compatibility of herb pairs, and core prescriptions for OP complicated with LDH. The safety of these medications was assessed based on clinical data and literature review. Results A total of 250 cases were included. Most of the patients were middle-aged or elderly, accounting for 87.2%. 236 types of TCM herbs were used, with a total frequency of medication use of 3,378. High-frequency herbs included Ligusticum chuanxiong Hort., Achyranthes bidentata Bl., and Paeonia lactiflora Pall. The properties of these herbs were predominantly warm, neutral or slightly warm and the flavors were mainly sweet, bitter or pungent. The meridian tropisms involved the liver, spleen, and kidney. The efficacies included tonifying the liver and kidney, strengthening tendons and bones, and dispelling wind-dampness. Association analysis showed that high-frequency herb pairs were Ligusticum chuanxiong Hort.- Achyranthes bidentata Bl., Ligusticum chuanxiong-Paeonia lactiflora Pall., and Paeonia lactiflora Pall.- Achyranthes bidentata Bl. The core prescriptions for OP combined with LDH consisted of 15 types of herbs. The most commonly used Western medicines were calcium carbonate D3 tablets, mecobalamin tablets and calcitriol soft capsules, and the Chinese patent medicines included Danlu Tongdu tablets, Gutong plaster and Jintiange capsules. Safety assessment indicated that TCM was safe in treating OP combined with LDH. Conclusion The basic principle by which TCM treats OP combined with LDH is to regulate the liver, spleen, and kidney in order to tonify the liver and kidney, strengthen tendons and bones, and dispel wind-dampness. These medications have proved to be safe clinically.

Key words: Osteoporosis, Lumbar Disc Herniation, Comorbidity, Medication Patterns, Core Prescription, Safety Analysis, Data Mining

中图分类号:

R927.1

康佳琪, 白建琦, 蔡明扬, 王源, 张平. 中药治疗骨质疏松合并腰椎间盘突出的临床用药规律与安全性分析[J]. 中国药物警戒, 2025, 22(10): 1120-1126.

KANG Jiaqi, BAI Jianqi, CAI Mingyang, WANG Yuan, ZHANG Ping. Clinical Medications and Safety of Traditional Chinese Medicine for Osteoporosis Complicated with Lumbar Disc Herniation[J]. Chinese Journal of Pharmacovigilance, 2025, 22(10): 1120-1126.

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