浏览全部资源
扫码关注微信
1.中国中医科学院 中医临床基础医学研究所,北京 100700
2.上海中医药大学 附属龙华医院,上海 200032
3.湖南科技大学 数学与统计学院,湖南 湘潭 411201
4.华北电力大学 数理系,河北 保定 071003
Received:07 April 2025,
Accepted:20 May 2025,
Published Online:21 May 2025,
Published:20 July 2025
移动端阅览
徐文源,向兴华,田雅欣等.基于“真实世界研究-机器学习”双驱动的全杜仲胶囊治疗骨质疏松症优势人群特征分析[J].中国实验方剂学杂志,2025,31(14):145-152.
XU Wenyuan,XIANG Xinghua,TIAN Yaxin,et al.Analysis on Characteristics of Dominant Population of Osteoporosis Treated with Quanduzhong Capsules Based on "Real-world Research-machine Learning" Dual Drive[J].Chinese Journal of Experimental Traditional Medical Formulae,2025,31(14):145-152.
徐文源,向兴华,田雅欣等.基于“真实世界研究-机器学习”双驱动的全杜仲胶囊治疗骨质疏松症优势人群特征分析[J].中国实验方剂学杂志,2025,31(14):145-152. DOI: 10.13422/j.cnki.syfjx.20251663.
XU Wenyuan,XIANG Xinghua,TIAN Yaxin,et al.Analysis on Characteristics of Dominant Population of Osteoporosis Treated with Quanduzhong Capsules Based on "Real-world Research-machine Learning" Dual Drive[J].Chinese Journal of Experimental Traditional Medical Formulae,2025,31(14):145-152. DOI: 10.13422/j.cnki.syfjx.20251663.
目的
2
利用大样本真实世界研究(RWS)数据和机器学习算法,精准分析全杜仲胶囊治疗骨质疏松症(OP)的优势人群特征,以期为临床提供科学用药指引。
方法
2
选取2020年至2021年全国162家医院依据医嘱或药品说明书指导服用全杜仲胶囊2个月的OP患者,分析患者的多维临床数据。以治疗结束后1个月访视的疗效结局视觉模拟评分量表(VAS)评分、OP症状量表总分为分级标签,选用XGBoost模型结合SHapley Additive exPlanations(SHAP)算法,计算Shapley值确定特征贡献大小及其影响方向,解析可能的优势人群特征。
结果
2
应用全杜仲胶囊治疗OP时,通过机器学习算法识别出年龄、腰背疼痛症状和血压等因素对疗效优效与非优效分级影响较大;年龄在45~60岁、基线期腰背疼痛症状评分≥6分(中位数)和基线期腰膝酸软无力症状评分≥4分(中位数)3种特征对疗效有正向影响,而基线期血压收缩压≥132 mmHg(1 mmHg≈0.133 kPa)、舒张压≥85 mmHg和体质量指数(BMI)分级达到“超重及肥胖”对疗效有负向影响。
结论
2
通过“RWS-机器学习”双驱动的研究方式明确全杜仲胶囊治疗OP的优势人群主要存在6种特征,而同时具备3种及以上的患者更容易被归类为优效人群,呈现更显著的临床优势。
Objective
2
Leveraging large-scale real-world data and machine learning algorithms, this study conducted a precision analysis to identify the characteristics of the optimal population benefiting from Quanduzhong capsules in treatment of osteoporosis(OP), thereby providing evidence-based guidance for clinical practice.
Methods
2
The data were derived from 1 144 screened patients across 162 hospitals in China between 2020 and 2021, who received Quanduzhong capsules for two months under medical prescription or package insert guidance, and multidimensional clinical data of the patients were analyzed. Efficacy outcomes, including visual analogue scale (VAS) scores and OP symptom scores, served as classification labels. The XGBoost model coupled with SHAP(SHapley Additive exPlanations) quantified feature contributions through Shapley values, determining their magnitude and directional effects, thereby enabling the identification of potential optimal population characteristics.
Results
2
When applying Quanduzhong capsules for OP treatment, the machine learning algorithms identified that age, low back pain symptoms and blood pressure significantly influenced the classification of superior and non-superior therapeutic efficacy. Three characteristics showed positive impacts on efficacy, including age in the range of 45-60 years, baseline low back pain score≥6(median), and baseline knee weakness score≥4(median). Conversely, three factors demonstrated negative impacts, including baseline systolic blood pressure≥132 mmHg(1 mmHg≈0.133 kPa), diastolic blood pressure≥85 mmHg, and body mass index(BMI) reaching the overweight/obesity classification.
Conclusion
2
Through the real-world research-machine learning dual-driven research method, it is clear that there are six main characteristics of the dominant population in the treatment of OP with Quanduzhong capsules, and patients with three or more at the same time are more likely to be classified as superior population, showing more significant clinical advantages.
佚名 . 黄帝内经·素问 [M] 北京 : 人民卫生出版社 , 2005 : 85 - 88 .
Anonymous . Huangdi Neijing:Suwen [M]. Beijing : People's Medical Publishing House , 2005 : 85 - 88 .
李烨 , 童杰 , 周衍晶 , 等 . 补肾壮骨中药抗骨质疏松有效成分及其药理作用研究进展 [J]. 中国中药杂志 , 2015 , 40 ( 6 ): 1038 - 1043 .
LI Y , TONG J , ZHOU Y J , et al . Research progress on anti-osteoporotic active ingredients and pharmacological action mechanism of traditional Chinese kidney-tonifying and bone-strengthening drugs [J]. China J Chin Mater Med , 2015 , 40 ( 6 ): 1038 - 1043 .
高宏伟 , 李玉萍 , 李守超 . 杜仲的化学成分及药理作用研究进展 [J]. 中医药信息 , 2021 , 38 ( 6 ): 73 - 81 .
GAO H W , LI Y P , LI S C . Study advances in chemical constituents and pharmacological effects of Eucommia ulmoides Oliv [J]. Inf Tradit Chin Med , 2021 , 38 ( 6 ): 73 - 81 .
葛继荣 , 王和鸣 , 郑洪新 , 等 . 中医药防治原发性骨质疏松症专家共识(2020) [J]. 中国骨质疏松杂志 , 2020 , 26 ( 12 ): 1717 - 1725 .
GE J R , WANG H M , ZHENG H X , et al . Traditional Chinese medicine expert consensus on the prevention and treatment of primary osteoporosis(2020) [J]. Chin J Osteoporosis , 2020 , 26 ( 12 ): 1717 - 1725 .
佚名 . 神农本草经 [M]. 北京 : 中国医药科技出版社 , 2018 : 10 .
Anonymous . Shennong Bencaojing [M]. Beijing : China Medical Science and Technology Press , 2018 : 10 .
蔡风 , 陶绪长 , 王春红 , 等 . PVP联合全杜仲胶囊治疗骨质疏松性脊柱骨折的疗效观察 [J]. 江西医药 , 2021 , 56 ( 11 ): 1926 - 1928,1933 .
CAI F , TAO X C , WANG C H , et al . Observation on the therapeutic effect of PVP combined with Quanduzhong capsules in the treatment of osteoporotic spinal fractures [J]. Jiangxi Med J , 2021 , 56 ( 11 ): 1926 - 1928,1933 .
国家药典委员会 . 中华人民共和国药典:一部 [M]. 北京 : 中国医药科技出版社 , 2020 : 172 - 173 .
Chinese Pharmacopoeia Commission . Pharmacopoeia of the People's Republic of China:Volume 1 [M]. Beijing : China Medical Science and Technology Press , 2020 : 172 - 173 .
中华中医药学会 . 2023年度中医药重大科学问题、工程技术难题和产业技术问题 [J]. 中医杂志 , 2023 , 64 ( 14 ): 1405 - 1421 .
China Association of Chinese Medicine . 2023 Major scientific issues,engineering challenges and industrial technology problems [J]. J Tradit Chin Med , 2023 , 64 ( 14 ): 1405 - 1421 .
中华中医药学会 . 2022年度中医药重大科学问题、工程技术难题及产业技术问题 [J]. 中医杂志 , 2022 , 63 ( 14 ): 1301 - 1312 .
China Association of Chinese Medicine . 2022 Major scientific issues,engineering challenges and industrial technology problems [J]. J Tradit Chin Med , 2022 , 63 ( 14 ): 1301 - 1312 .
李晶 , 王波 , 王斌 . 全杜仲胶囊联合阿仑膦酸钠治疗老年骨质疏松症的临床研究 [J]. 现代药物与临床 , 2024 , 39 ( 7 ): 1829 - 1833 .
LI J , WANG B , WANG B . Clinical study on Quanduzhong capsules combined with alendronate sodium in treatment of elderly osteoporosis [J]. Drugs Clinic , 2024 , 39 ( 7 ): 1829 - 1833 .
王鹏 , 孙齐明 . 全杜仲胶囊治疗骨质疏松性下肢骨折术后60例临床观察 [J]. 辽宁中医杂志 , 2022 , 49 ( 4 ): 135 - 137 .
WANG P , SUN Q M . Clinical observation of Quanduzhong capsule for 60 cases with postoperative osteoporotic lower limb fracture [J]. Liaoning J Tradit Chin Med , 2022 , 49 ( 4 ): 135 - 137 .
江丽杰 , 杨燕 , 唐碧华 , 等 . 全杜仲胶囊降低轻度原发性高血压肾虚证患者血压的随机对照试验 [J]. 中国中西医结合杂志 , 2022 , 42 ( 4 ): 431 - 437 .
JIANG L J , YANG Y , TANG B H , et al . Randomized controlled trial of Quanduzhong capsule on reducing blood pressure in patients with essential hypertension with Shen deficiency syndrome [J]. Chin J Integr Tradit Chin West Med , 2022 , 42 ( 4 ): 431 - 437 .
闫蕴孜 , 孙凌云 , 徐钰莹 , 等 . 转移性结直肠癌中医治疗优势人群的肠道菌群及TB淋巴细胞亚群特征分析 [J]. 世界中医药 , 2021 , 16 ( 9 ): 1391 - 1399 .
YAN Y Z , SUN L Y , XU Y Y , et al . Analysis on intestinal flora and TB lymphocyte subsets of traditional Chinese medicine beneficiaries in metastatic colorectal cancer [J]. World Chin Med , 2021 , 16 ( 9 ): 1391 - 1399 .
王磊 . 祛邪胶囊在转移性结直肠癌不同治疗阶段的优势人群研究及机制探索 [D]. 北京 : 中国中医科学院 , 2023 .
WANG L . Study on the dominant population and mechanism of Qu-xie capsule in different treatment stages of metastatic colorectal cancer [D]. Beijing : China Academy of Chinese Medical Sciences , 2023 .
许博文 , 张潇潇 , 李杰 , 等 . 基于优势人群的肿瘤中医药防治疗效提升策略 [J]. 中医杂志 , 2022 , 63 ( 4 ): 318 - 322 .
XU B W , ZHANG X X , LI J , et al . Focus on the dominant population:A new strategy to improve the effect of traditional Chinese medicine on tumors [J]. J Tradit Chin Med , 2022 , 63 ( 4 ): 318 - 322 .
徐钰莹 . 晚期结直肠癌中医优势人群判别模型的建立与动态治疗策略的探索 [D]. 北京 : 北京中医药大学 , 2021 .
XU Y Y . Establishment of a discriminant model for TCM-advantaged population in advanced colorectal cancer and exploration of dynamic therapeutic strategies [D]. Beijing : Beijing University of Chinese Medicine , 2021 .
赵国桢 , 郭诗琪 , 庞华鑫 , 等 . 基于中医临床诊疗数据的真实世界及人工智能研究思路与挑战 [J]. 中医杂志 , 2023 , 64 ( 21 ): 2170 - 2175 .
ZHAO G Z , GUO S Q , PANG H X , et al . Research ideas and challenge of real world study and artificial intelligence based on clinical diagnosis and treatment data of traditional Chinese medicine [J]. J Tradit Chin Med , 2023 , 64 ( 21 ): 2170 - 2175 .
WANG B , XIAO L , CHEN P , et al . Uncovering the role of traditional Chinese medicine in immune-metabolic balance of gastritis from the perspective of cold and hot:Jin Hong tablets as a case study [J]. Chin Med , 2024 , 19 ( 1 ): 134 .
王吉庆 , 张蕾 , 徐世芬 , 等 . 基于机器学习的真实世界健康人舌象与年龄及性别相关性研究 [J]. 世界科学技术—中医药现代化 , 2024 , 26 ( 11 ): 2806 - 2814 .
WANG J Q , ZHANG L , XU S F , et al . Study on the correlation between machine learning-based tongue features of healthy individuals in the real world and age and gender [J]. World Sci Technol-Mod Tradit Chin Med , 2024 , 26 ( 11 ): 2806 - 2814 .
国家药品监督管理局药品审评中心 . 药物真实世界研究设计与方案框架指导原则(试行) [EB/OL].( 2023-02-06 )[ 2024-12-23 ]. https://www.cde.org.cn/main/att/download/ad3cb815748211ec5ca6a33978e6976b https://www.cde.org.cn/main/att/download/ad3cb815748211ec5ca6a33978e6976b .
Center for Drug Evaluation,National Medical Products Administration . Guiding Principles on Real-World Drug Study Design and Protocol Framework(Trial Implementation) [EB/OL].( 2023-02-06 )[ 2024-12-23 ]. https://www.cde.org.cn/main/att/download/ad3cb815748211ec5ca6a33978e6976b https://www.cde.org.cn/main/att/download/ad3cb815748211ec5ca6a33978e6976b .
HUANG Q , ZOU X , CHEN Y , et al . Personalized glucose-lowering effect of chiglitazar in type 2 diabetes [J]. iScience , 2023 , 26 ( 11 ): 108195 .
LAN L , HU G , LI R , et al . Machine learning for selecting important clinical markers of imaging subgroups of cerebral small vessel disease based on a common data model [J]. Tsinghua Sci Technol , 2024 , 29 ( 5 ): 1495 - 1508 .
CRESPO-DIAZ R , WOLFSON J , YANNOPOULOS D , et al . Machine learning identifies higher survival profile in extracorporeal cardiopulmonary resuscitation [J]. Crit Care Med , 2024 , 52 ( 7 ): 1065 - 1076 .
中华医学会骨质疏松和骨矿盐疾病分会 . 原发性骨质疏松症诊治指南(2011年) [J]. 中华骨质疏松和骨矿盐疾病杂志 , 2011 , 4 ( 1 ): 2 - 17 .
Chinese Society of Osteoporosis And Bone Mineral Research . Guidelines for the diagnosis and treatment of primary osteoporosis(2011) [J]. Chin J Osteoporosis Bone Mineral Res , 2011 , 4 ( 1 ): 2 - 17 .
万丽 , 赵晴 , 陈军 , 等 . 疼痛评估量表应用的中国专家共识(2020版) [J]. 中华疼痛学杂志 , 2020 , 16 ( 3 ): 177 - 187 .
WAN L , ZHAO J , CHEN J , et al . Expert consensus on the application of pain evaluation questionnaires in China(2020) [J]. Chin J Painol , 2020 , 16 ( 3 ): 177 - 187 .
郑筱萸 . 中药新药临床研究指导原则(试行) [M]. 北京 : 中国医药科技出版社 , 2002 : 364 .
ZHENG X Y . Clinical Guiding Principles for New Traditional Chinese Medicine Drugs:Trial Implementation [M]. Beijing : China Medical Science and Technology Press , 2002 : 364 .
王娟 , 褚小刚 . 全杜仲胶囊联合红花逍遥片治疗绝经后骨质疏松38例 [J]. 中国老年学杂志 , 2014 , 34 ( 4 ): 1086 - 1087 .
WANG J , CHU X G . Treatment of postmenopausal osteoporosis with Quanduzhong capsule combined with Carthamus Xiaoyao tablets 38 cases [J]. Chin J Gerontol , 2014 , 34 ( 4 ): 1086 - 1087 .
JOHANSEN M B , CHRISTENSEN P A . A simple transformation independent method for outlier definition [J]. Clin Chem Lab Med , 2018 , 56 ( 9 ): 1524 - 1532 .
CHEN Y , YANG Z , LIU Y , et al . Exploring the prognostic impact of triglyceride-glucose index in critically ill patients with first-ever stroke:Insights from traditional methods and machine learning-based mortality prediction [J]. Cardiovasc Diabetol , 2024 , 23 ( 1 ): 443 .
韩向莉 , 娄志杰 , 邵岩 . 骨质疏松症中医病名病机、临床实验及内外辨证治疗研究近况 [J]. 医学理论与实践 , 2017 , 30 ( 13 ): 1905 - 1907 .
HAN X L , LOU Z J , SHAO Y . Recent advances in TCM nomenclature and pathogenesis,clinical trials and internal-external syndrome differentiation-based therapies for osteoporosis [J]. J Med Theory Pract , 2017 , 30 ( 13 ): 1905 - 1907 .
贺自克 , 王上增 . 杜仲水提物上调Nur77表达促进骨髓间充质干细胞增殖和成骨分化 [J]. 中国组织工程研究 , 2023 , 27 ( 15 ): 2371 - 2378 .
HE Z K , WANG S Z . Eucommia ulmoides Oliver aqueous extract promotes bone marrow mesenchymal stem cell proliferation and osteoblastic differentiation through upregulating Nur77 protein expression [J]. Chin J Tissue Eng Res , 2023 , 27 ( 15 ): 2371 - 2378 .
李姣 , 黄委委 , 陶林 , 等 . 中药促骨髓间充质干细胞成骨分化的研究进展 [J]. 吉林中医药 , 2021 , 41 ( 4 ): 544 - 548 .
LI J , HUANG W W , TAO L , et al . Research progress of Chinese materia medica in promoting osteogenic differentiation of bone marrow mesenchymal stem cells [J]. Jilin J Tradit Chin Med , 2021 , 41 ( 4 ): 544 - 548 .
刘聪 , 郭非非 , 肖军平 , 等 . 杜仲不同部位化学成分及药理作用研究进展 [J]. 中国中药杂志 , 2020 , 45 ( 3 ): 497 - 512 .
LIU C , GUO F F , XIAO J P , et al . Research advances in chemical constituents and pharmacological activities of different parts of Eucommia ulmoides [J]. China J Chin Mater Med , 2020 , 45 ( 3 ): 497 - 512 .
李凯 , 宋敏 , 刘路 , 等 . 补肾中药通过调控MAPK信号通路防治骨质疏松症的研究进展 [J]. 中药新药与临床药理 , 2022 , 33 ( 12 ): 1733 - 1738 .
LI K , SONG M , LIU L , et al . Research progress of kidney-tonifying Chinese herbs on the prevention and treatment of osteoporosis via regulating MAPK signaling pathway [J]. Tradit Chin Drug Res Clin Pharmacol , 2022 , 33 ( 12 ): 1733 - 1738 .
朱福群 , 唐芳瑞 , 刘荣华 . 杜仲强筋健骨的药理作用及临床应用研究进展 [J]. 江西中医药大学学报 , 2015 , 27 ( 4 ): 92 - 96 .
ZHU F Q , TANG F R , LIU R H . The pharmacological effects and clinical application in strong gluten bone health of Eucommia ulmoides Oliver [J]. J Jiangxi Univ Tradit Chin Med , 2015 , 27 ( 4 ): 92 - 96 .
0
Views
9
下载量
0
CSCD
Publicity Resources
Related Articles
Related Author
Related Institution