王灿晖教授辨治慢性萎缩性胃炎经验的数据挖掘研究

发布时间：2018-04-09 15:03

本文选题：慢性萎缩性胃炎　切入点：数据挖掘　出处：《南京中医药大学》2017年硕士论文

【摘要】：目的:以全国名老中医王灿晖教授多年来的临床实践为基础,结合数据挖掘技术,对王灿晖教授临床辨治慢性萎缩性胃炎的临证经验进行研究和探讨,以传承并发扬名老中医的临床经验。方法:收集王灿晖教授2012年3月-2016年11月临床诊疗慢性萎缩性胃炎医案,严格依照医案纳入标准和医案排除标准进行筛选,并对筛选后的医案进行预处理,将符合标准的158例(418诊次)医案的临床资料建立数据库,运用频数分析、关联规则、聚类分析等方法,挖掘医案中的症状、证型、方药等内容,并结合王灿晖教授的临证经验对挖掘结果进行分析和总结。结果:418诊次中男性76例235诊次,女性82例183诊次,平均年龄54.20岁。主症出现频率较高的有胃脘胀满、胃脘隐痛、嘈杂,在所有诊次中分别占58.37%、22.97%、12.20%;兼症出现频率较高的有口干、纳差、嗳气、口苦、便溏、大便秘结、神疲乏力、寐差,在所有诊次中分别占42.34%、27.03%、26.08%、19.14%、15.79%、10.05%、9.81%、8.13%;舌象组合主要有苔薄黄+质淡、苔薄白+质淡、苔薄白+质暗红,频率分别为21.77%、19.38%、10.77%;脉象主要为细脉、弦脉、细弦脉,频率分别为90.43%、43.06%、33.49%;证型主要有脾胃虚弱型、脾胃湿热型、胃络瘀血型、肝胃气滞型,频率分别为87.80%、33.73%、32.78%、32.30%;药物使用频率大于5%的中药共计39味,其中频率大于65%的药物有白术、太子参、莪术、枳壳、仙鹤草、鸡内金、白花蛇舌草、茯苓,此8味中药亦是药物关联的核心药物;药味频率大于7%的中药类别有健脾益气药、清热祛湿药、活血化瘀药、消食化积药、理气和中药,且累计频率可达65.96%;使用频率大于50%的加减方剂主要有枳术丸和四君子汤;聚类分析得到2首处方和4组药对。结论:通过研究发现,病机:脾胃气虚是本病的基本病机,在此基础上,兼有湿热、郁热、阴虚、气血失和等;遣方用药:以健脾益气药、清热祛湿药、活血化瘀药、消食化积药、理气和中药为主;基本治法:益气清热、理气和血;治疗特点:重视病证结合;用药特色:补益与消运并重;滋养与化湿并用;敛阴与祛瘀并行;用药平和且灵活。
[Abstract]:Objective: based on the clinical practice of Professor Wang Canhui, a famous traditional Chinese medicine, and combining with data mining technology, the clinical experience of professor Wang Canhui in treating chronic atrophic gastritis was studied and discussed.In order to pass on the clinical experience of traditional Chinese medicine.Methods: professor Wang Canhui's medical records of clinical diagnosis and treatment of chronic atrophic gastritis from March 2012 to November 2016 were collected.Setting up a database of 158 cases of medical records that meet the standard, and using methods such as frequency analysis, association rules, clustering analysis, etc., to dig up the contents of symptoms, syndrome types, prescription drugs, etc., in medical records.Combined with Professor Wang Canhui's clinical experience, the mining results are analyzed and summarized.Results 76 cases of male and 183 times of female were diagnosed 235 times, 82 cases of female. The average age was 54.20 years old.The eight herbs are also the core drugs associated with the drug. The herbs with a frequency of more than 7% have the following categories: invigorating spleen and tonifying qi, clearing away heat and removing dampness, promoting blood circulation and removing blood stasis, taking away food and promoting accumulation, regulating qi and traditional Chinese medicine.The accumulative frequency can reach 65.96, and the main prescriptions used more than 50% are Zhizhu pills and Sijunzi decoction, 2 prescriptions and 4 groups of drug pairs are obtained by cluster analysis.Conclusion: through the study, it is found that the pathogenesis: deficiency of spleen and stomach qi is the basic pathogenesis of the disease, on the basis of which there are damp-heat, heat stagnation, yin deficiency, and disharmony of qi and blood, etc. The prescription for dispensing medicine is: invigorating spleen and invigorating qi, clearing away heat and dispelling dampness, activating blood and removing blood stasis, etc.The basic treatment methods are as follows: tonifying qi and clearing heat, regulating qi and blood; treating characteristics: attaching importance to the combination of disease and syndrome; using medicine characteristic: nourishing and removing dampness; combining nourishing and removing dampness; collecting yin and removing blood stasis;The medication is gentle and flexible.
【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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