基于数据挖掘的徐景藩教授诊治慢性萎缩性胃炎的医案研究

发布时间：2018-01-21 22:11

本文关键词： 慢性萎缩性胃炎数据挖掘名老中医经验徐景藩　出处：《南京中医药大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:以徐景藩教授治疗慢性萎缩性胃炎(CAG)的临床医案为研究对象,运用数据挖掘的方法,分析总结徐景藩教授对CAG的辨治经验,冀提高中医药治疗CAG的临床疗效。方法:整理收集徐景藩教授诊治CAG患者的医案,严格依据诊断标准、排除标准进行筛选,将符合纳入标准的244诊次医案资料建立数据库,对数据库中的医案进行规范与清洗,运用频数分析、关联规则和相关性分析等数据挖掘方法,重点研究医案中症状、舌象、脉象、病机、方药及相互间的规律,并结合徐景藩教授的论著思想,进一步总结徐景藩教授辨治CAG的临床经验。结果:1.一般情况:本研究共选取CAG患者医案244诊次,其中男性87诊次,女性157诊次;平均年龄54岁,主要分布在40-69岁之间。2.频数分析:所有诊次中症状出现频率较高的有痞胀、胃脘痛、嗳气、便溏;舌质出现频率较高的有舌淡红、舌红、舌微红;舌苔出现频率较高的有苔薄白、苔薄腻、苔薄黄;脉象出现频率较高的有细、弦、沉、濡;病机出现频率较高的有脾胃气虚、肝胃不和、胃阴不足、瘀血阻滞、气滞郁热、脾胃湿热;药物分类频率较高的有理气药、消食药、补气药、补血药。3.关联规则:分析244诊次医案中症状-病机、病机-药物的内在联系,总结徐景藩教授对CAG的辨治经验。4.相关性分析:分析244诊次医案中常用药物配伍规律,得出徐景藩教授治疗CAG的常用药物组合,包括炒白术和茯苓、炒白术和山药、麦冬和石斛、紫苏梗和香附、合欢花和合欢皮、黄连和藿香、法半夏和陈皮、陈皮和橘络、佛手和炙鸡内金、炒麦芽和炒谷芽、白芍和炙甘草。结论:通过研究发现,证候方面:CAG症状以痞胀、胃脘痛为主;舌质以舌淡红、舌红、舌微红为主;舌苔以苔薄白、苔薄腻、苔薄黄为主;脉象以细、弦为主。病机方面:CAG主要病机分为三类,包括脾胃气虚、胃阴不足、肝胃不和,常伴有瘀血阻滞、脾胃湿热、气滞郁热等兼证。用药方面:徐景藩教授以辨证论治为基础,同时重视CAG气机失调、运化无力的病理特点,并且善用药对、灵活选药。
[Abstract]:Objective: to study the clinical records of Professor Xu Jingfan in the treatment of chronic atrophic gastritis (CAG), and to analyze and summarize the experience of professor Xu Jingfan in the diagnosis and treatment of CAG by using the method of data mining. Methods: collect the medical records of Professor Xu Jingfan in the treatment of CAG patients, strictly according to the diagnostic criteria, exclude the criteria for screening. The data of 244 medical cases according to the standard were established, the medical records in the database were standardized and cleaned, and the methods of data mining such as frequency analysis, association rules and correlation analysis were used. Focus on the study of symptoms, tongue, pulse, pathogenesis, prescription and the law between each other, and combined with Professor Xu Jingfan's thoughts. Results: 1. General situation: in this study, we selected 244 medical cases of CAG patients, of which 87 were male and 157 were female; The average age was 54 years old, mainly distributed between 40-69 years old. Frequency analysis: the frequency of symptoms in all the visits was higher, such as distension, epigastric pain, belching, loose stools; The higher frequency of tongue appearance are light red tongue, red tongue, slightly red tongue; The high frequency of tongue coating has thin white fur, thin greasy fur, thin yellow fur; The higher frequency of pulse appearance is thin, chord, sink, acculturation; The higher frequency of pathogenesis are spleen and stomach qi deficiency, liver and stomach disharmony, stomach yin deficiency, blood stasis, stagnation of qi and heat, spleen and stomach dampness and heat; Drug classification frequency of rational qi drugs, drugs, tonifying qi drugs, blood tonic drugs .3.Association rules: analysis of 244 medical records of symptoms-pathogenesis, pathogenesis-drug internal relations. Summary of Professor Xu Jingfan's experience in differentiation and treatment of CAG. 4. Correlation analysis: analysis of 244-times of medical cases of commonly used drug compatibility law, draw the common combination of drugs for the treatment of CAG by Professor Xu Jingfan. These include stir-fried Atractylodes macrocephala and Poria, stir-fried Atractylodes macrocephala and yam, Ophiopogon and Dendrobium, Perilla pedunculus and Cortex Albizae, Albiziae and Albizae, Coptidis and Pogostemon, Fructus ternata and Pericarp, Pericarp and Orange, Buddha's hand and. Conclusion: according to the study, the symptoms of the symptoms of the symptom of "10% CAG" are bulging, epigastric pain, and epigastric pain. Tongue is light red, tongue red, tongue slightly red; Tongue coating to thin white, thin greasy fur, thin yellow coating mainly; The main pathogenesis of the disease is divided into three categories, including deficiency of spleen and stomach qi, deficiency of stomach yin, disharmony of liver and stomach, often accompanied by blood stasis, dampness and heat of spleen and stomach. On the basis of syndrome differentiation and treatment, Professor Xu Jingfan also attached importance to the pathological characteristics of CAG Qi Qi maladjustment, weak transport and utilization of drugs, as well as making good use of drug pairs and selecting drugs flexibly.
【学位授予单位】：南京中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R249;R259

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