Exploratory Compatibility Regularity of Chinese Medicinal Prescription in Treating Osteoarthritis

Background: Traditional Chinese medicine (TCM) is increasingly widely used as a complementary approach for the treatment of osteoarthritis. In this paper, we examined the implicit prescription patterns behind the Chinese medicinal formulae by using association rules mining and clustering analysis, so as to explore the compatibility regularity of Chinese medicinal prescription in the treatment or control of osteoarthritis. Methods: This study was based on a participant survey conducted in First Affiliated Hospital of Anhui University of Chinese Medicine. The Chinese medicinal prescriptions of inpatients with osteoarthritis were from June 2012 to June 2016. TCM was listed according to the selected medicinal formulae and the added information was organized to establish a database. The association rules and clustering are conducted on SPSS Modeler 14.2. An initial statistical analysis was carried out to categorize the herbs according to their medicinal types, dosage, natures, flavors, channel tropism, and functions. Based on the categorization, the frequencies of occurrences were computed. At the same time, the relationship between TCM and immune and inflammatory markers was analyzed. Results: The main features from the formulae data are: (1) Warm or cold herbs in the Five Properties category are the most frequently prescribed in the 3609 medicinal formulae. Sweet or bitter herbs in the Five Flavors category in which affinity to the Spleen meridian also are the most frequently prescribed in the 3609 medicinal formulae. (2) Herbs with blood-activating and stasis-resolving, tonifying and replenishing medicinal, water-disinhibiting damppercolating, heat-clearing and detoxicating or expelling wind-damp functions that are frequently prescribed; (3) Association rule analysis extracted three frequently used pairs of herbs, which are Red flower and Tao Ren, Pu Gong Ying and Bai Hua She She Cao, Fu Ling and Ze Xie. (4) Association rule between TCM and Immunoinflammation Index showed that Du Huo and Chen Pi was associated with increased super oxide dismutase enzyme. Mai Ya and Dan Shen was associated with decreased high-sensitivity C-reactive protein, erythrocyte sedimentation rate, complement C3, complement C4, and Ig(A). Mai Ya and Fu Ling were associated with decreased IgM. Conclusions: The results indicate that there is a close relationship between osteoarthritis and spleen dysfunctions. These prescriptions focus on herbs that replenishing qi and fortifying the spleen and blood-activating and stasis-resolving. It can also dry dampness to fortify the spleen and clear heat and detoxicating. Meanwhile, he use of tonifying and replenishing herbs and spleen-strengthening herbs also forms a basic pattern of the prescriptions.