腰椎间盘突出症合并膝骨关节炎的中药用药规律及安全性分析

doi:10.19803/j.1672-8629.20250950

摘要/Abstract

摘要： 目的探析中药治疗腰椎间盘突出症（Lumbar Disc Herniation, LDH）合并膝骨关节炎（Knee Osteoarthritis, KOA）的用药规律。方法检索中国中医科学院望京医院的医院信息系统数据库，筛选2023年11月15日至2025年11月15日被同时诊断为LDH、KOA的患者，收集治疗有效的中药处方，提取基础及用药信息后统计分析。根据患者用药后的病历资料结合《中华人民共和国药典》（2025年版）、药品说明书以及文献资料对患者用药安全性进行评价。结果纳入患者239例，40岁以上的女性患者占68.20%。共包含193味中药，高频药物为茯苓（143次，4.70%）、甘草（121次，3.98%）等。中药属性分析显示四气以温性（1 124次，36.97%）、平性（788次，25.92%）为主，五味以甘味（1 638次，53.88%）、苦味（1 260次，41.45%）为主，药物归经以归肝经（1 666次，54.80%）、脾经（1 207次，39.70%）为主，功效主要为祛风湿（296次，9.74%）、补肝肾（275次，9.05%）等。关联规则分析显示三七-川芎（置信度0.93，支持度0.22）、山茱萸-茯苓（置信度0.92，支持度0.23）等为核心药对。聚类分析显示共有5组药物组合。安全性评价提示中药治疗LDH合并KOA安全性良好。结论 LDH合并KOA患者基本病机为本虚标实，中药治疗以补气养血、强筋健骨治其本，活血通络止痛、祛风散寒除湿治其标，安全性良好。

关键词: 腰椎间盘突出症, 膝骨关节炎, 用药规律, 安全性, 中药复方, 共病

Abstract: Objective To explore the way traditional Chinese medicine (TCM) is used in the treatment of lumbar disc herniation (LDH) complicated with knee osteoarthritis (KOA). Methods Data on Chinese herbal medicine prescriptions and information about patients diagnosed concurrently with LDH and KOA between November 2023 and November 2025 were collected from the hospital information system database of Wangjing Hospital of China Academy of Chinese Medical Sciences and compiled into a unified Excel file. The safety of medications for these patients was assessed based on their medical records following drug administration and in conjunction with the Pharmacopoeia of the People’s Republic of China, drug package inserts and related literature. Results A total of 239 patients were included, with women ages 40 and older accounting for 68.20% of the cohort. Among the 193 TCM herbs, the most frequently used ones included Poria cocos（Schw.）Wolf (143 instances, 4.70%), and Glycyrrhiza uralensis Fisch. (121 instances, 3.98%). The properties of these herbs were predominantly warm (1 124 instances, 36.97%) and neutral (788 instances, 25.92%). In terms of flavor, sweet (1 638 instances, 53.88%) and bitter (1 260 instances, 41.45%) were dominating. The meridian tropisms involved the liver (1 666 instances, 54.80%) and spleen (1 207 instances, 39.70%). The efficacies included dispelling wind-dampness (296 instances, 9.74%) and tonifying the liver and kidney (275 times, 9.05%). Panax notoginseng（Burk.）F. H. Chen-Ligusticum chuanxiong Hort. (confidence 0.93, support 0.22) and Cornus officinalis Sieb. et Zucc.- Poria cocos（Schw.）Wolf (confidence 0.92, support 0.23) were identified as core drug pairs via association analysis. Cluster analysis revealed a total of five drug combinations. Safety evaluation indicated that the treatment of LDH combined with KOA with traditional Chinese medicine was safe. Conclusion The pathogenesis of patients with LDH combined with KOA is basically characterized by underlying deficiency and superficial excess. Clinical treatment is to focus on addressing the root cause by tonifying qi and nourishing blood to strengthen tendons and bones while treating the superficial manifestations by promoting blood circulation, unblocking meridians to relieve pain, dispelling wind, dispersing cold, and eliminating dampness.

Key words: Lumbar Disc Herniation, Knee Osteoarthritis, Patterns of Medication, Safety, Chinese Herbal Compound, Comorbidity

中图分类号:

R961
R282

郭宵飞, 樊伟铭, 康佳琪, 白建琦, 王一鸣, 郭东琪, 张平, 王源, 白雪竹. 腰椎间盘突出症合并膝骨关节炎的中药用药规律及安全性分析[J]. 中国药物警戒, 2026, 23(2): 167-173.

GUO Xiaofei, FAN Weiming, KANG Jiaqi, BAI Jianqi, WANG Yiming, GUO Dongqi, ZHANG Ping, WANG Yuan, BAI Xuezhu. Usage and Safety of Traditional Chinese Medicine in Clinical Treatment of Lumbar Disc Herniation Complicated with Knee Osteoarthritis[J]. Chinese Journal of Pharmacovigilance, 2026, 23(2): 167-173.

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