Drug use rules in cervical spondylosis of nerve root with qi stagnation and blood stasis syndrome based on data mining

Objective To summarize the medication rule of traditional Chinese medicine in treating cervical spondylosis of nerve root with qi stagnation and blood stasis syndrome.

Methods The literature related to the treatment of qi stasis and blood stasis syndrome of nerve root type cervical spondylosis by TCM compound in the past 20 years were searched from China National Knowledge Infrastructure, Wanfang Database and PubMed database, and so on, and the prescriptions with complete TCM composition and their specific dosage were extracted. The drug frequency, drug dosage, nature and taste, meridian, meridial distribution were recorded, and association rules and cluster analysis were conducted on the high-frequency traditional Chinese medicine (TCM).

Results A total of 61 literatures were included, including 61 prescriptions and 102 TCM drugs. The top 5 most frequently used Chinese herbs were Gancao 6 g, Danggui 15 g, Chuanxiong 10 g, Baishao 15 g, Gegen 20 g. The drugs, mainly entering the liver channel, had warm nature and pungent taste, and the main functions of promoting blood and regulating the menstrual cycle, and relieving pain. With support >0.50 and confidence >0.85, the drug combinations with high correlation were Baishao-Gegen, Danggui-Chuanxiong, Gegen-Gancao. With support >0.10 and confidence >0.60, the drug dose combinations with high correlation were Chuanxiong 15 g and Danggui 15 g, Chuanxiong 15 g and Honghua 15 g, Gegen 30 g and Gancao 6 g. The clustering analysis of TCM and TCM dose showed the efficacy was mainly promoting blood circulation and removing blood stasis, activating qi and relieving pain. The dosage of Gegen, Shenjincao, Danshen, Danggui, Baishao, Yanhusuo, Guizhi, Huangqi were higher (≥ 15 g). In the study of prescription and prescription dose cluster analysis, the prescription structure mainly consisted of the combinations of core drug pair, such as Chuanxiong-Danggui, Taoren-Honghua, Biashao-Gancao, and the experienced prescription functioning in activating blood circulation and removing blood stasis was represented by "Taohong Siwu Decoction".

Conclusion This study initially summarizes the medication rules of single TCM and TCM combination in treating syndrome of qi stagnation and blood stasis of nerve root type cervical spondylosis. The drug use focuses on soothing liver qi, regulating qi and blood, and removing blood stasis. The treatment principle is main based on promoting blood and removing stasis, activating qi and relieving pain, supplemented by dredging collaterals, pain relief, tendon and muscle relaxation, providing reference and theoretical basis for the clinical application of TCM in the treatment of cervical spondylosis.