基于中医传承辅助系统的治疗子宫肌瘤方剂组方规律分析

发布时间：2018-05-18 14:48

本文选题：子宫肌瘤 + 中医传承辅助平台系统　；参考：《广州中医药大学》2017年博士论文

【摘要】：目的:1.基于中医传承辅助平台系统(V2.5)研究分析子宫肌瘤的组方规律,研究内容包含药物频次结果、常用药对、核心组合及新方等,系统研究中医药治疗子宫肌瘤的组方规律。2.基于中医传承辅助平台系统(V2.5)研究李坤寅教授治疗子宫肌瘤的用药规律,采用数据挖掘技术,总结李坤寅教授治疗子宫肌瘤的治疗特色。方法:1.拟定检索策略,检索中国知网数据库(CNKI),使用高级检索,检索项选"全文",检索词"子宫肌瘤"、"ve瘕",匹配项选"模糊",排序方式为"时间",共检索出1997年～2016年中医药治疗子宫肌瘤的临床相关文献1021篇。依据纳入标准和排除标准,最终筛选出337首方剂。将上述方剂由双人录入中医传承辅助平台系统(V2.5)的相应模块,采用软件的规则分析、改进互信息法、复杂系统熵聚类及无监督的熵层次聚类等方法进行分析,获取药物频次结果、常用药对、核心规律、核心组合、新方分析等结果,并以可视网络图展示出来,分析现代医家治疗子宫肌瘤的用药规律。2.门诊收集并筛选李坤寅教授治疗子宫肌瘤的临床有效病例,由双人录入中医传承辅助平台系统(V2.5),采用软件的规则分析、改进互信息法、复杂系统熵聚类及无监督的熵层次聚类等方法进行分析。根据李坤寅教授在患者月经期和非月经期用药思路的变化,分别进行总体方剂分析、月经期方剂分析和非月经期方剂分析,总结李坤寅教授治疗子宫肌瘤的用药规律,探讨其治疗子宫肌瘤的治疗特色。成果:1.文献方剂研究:(1)中药治疗子宫肌瘤的337首方剂中,共有270味药物,用药频次排在前十位的药物为:莪术、当归、三棱、赤芍、桃仁、茯苓、黄芪、牡蛎、桂枝、牡丹皮。以活血化瘀药物为主。月经期用药的方剂有40首,包含135味药物,月经期用药频次排在前十位的药物为:当归、黄芪、党参、蒲黄、益母草、香附、赤芍、白术、茜草、茯苓。非月经期用药的方剂有144首,包含204味药物,非月经期用药频次排在前十位的药物为:莪术、三棱、当归、桃仁、赤芍、茯苓、桂枝、牡丹皮、黄芪、牡蛎。(2)整体用药中,3～5味的核心药物组合共有37个,治疗子宫肌瘤的新处方7个。2.临床方剂研究(1)李坤寅教授治疗子宫肌瘤患者40例,共有方剂296首,将所有药物频次进行统计,共有144味中药,药物频次之和为3924次。总体药物频次排在前十位的药物为:甘草、茯苓、竹茹、柏子仁、山药、山茱萸、续断、合欢皮、陈皮、熟地黄。月经期药物频次排在前十位的药物为:甘草、益母草、续断、三七、蒲黄、山药、海螵蛸、党参、茜草、白术。非月经期药物频次排在前十位的药物为:甘草、茯苓、柏子仁、竹茹、山茱萸、山药、合欢皮、陈皮、熟地黄、淫羊藿。总体药性排在前三位的药物是:平、温、寒。月经期排在前三位的药物是:温、平、寒。非月经期排在前三位的药物是:平、温、寒。总体用药五味排在前三位的是:甘、苦、辛。月经期和非月经期用药五味排在前三位的是:甘、苦、辛。总体用药归经排在前五位的药物分别是肾、肝、脾、肺、心。月经期用药归经排在前五位的药物分别是肝、脾、肾、心、胃。非月经期用药归经排在前五位的药物分别是肾、脾、肝、肺、心。(2)基于关联规则分析常用药物组合有柏子仁-茯苓(-竹茹,合欢皮,甘草,熟地黄),山茱萸-山药(-茯苓,柏子仁-茯苓),月经期常用药物组合有益母草-甘草(-蒲黄,续断,三七),蒲黄-三七(-续断,益母草)。核心组合有竹茹-海螵蛸-茯苓,竹茹-党参-茜草,竹茹-橘红-枳实,竹茹-海螵蛸-白花蛇舌草,海螵蛸-牡蛎-龙骨等。基于复杂系统熵聚类得出的新处方有竹茹-海螵蛸-茯苓-茜草,法半夏-山药-莲须-枳实,山茱萸-淫羊藿-益母草-熟地黄-山药-地骨皮,续断-橘红-合欢皮-首乌藤-菟丝子,海螵蛸-三七-益母草-茯苓-蒲黄。(3)3～5味的核心药物组合共有46个,治疗子宫肌瘤的新处方5个。结论:1.中医传承辅助平台系统对子宫肌瘤文献进行分析,治疗子宫肌瘤的药物中以活血化瘀药物为主,其中包含桂枝茯苓丸的药物。核心组合的药物包括活血药、行气药、补血药、温阳药、软坚散结药。2.中医传承辅助平台系统对李坤寅教授治疗子宫肌瘤的有效病例处方分析,月经期用药和非月经期用药存在明显差异(包括药物频次、药物组合、新处方等),在不同月经周期的用药思路亦不同。总体用药和非月经期用药中健脾渗湿药、补肾药、安神药、化痰药等应用频率较高,月经期用药则以活血化瘀药、化瘀止血药、益气健脾药等应用频率较高。研究结果为中医药治疗子宫肌瘤在临床和基础研究方面提供新的依据,但仍需要专家判读、实验研究等方法的验证。3.李坤寅教授治疗子宫肌瘤一般采用中药汤剂、中成药(桔荔散结片)、配合饮食指导等多种方法综合治疗,以达到治疗疾病的目的。
[Abstract]:Objective: 1. based on the inheritance auxiliary platform system (V2.5) of traditional Chinese medicine (V2.5) research and analysis of the law of uterine fibroids, the research contents include the results of drug frequency, common drug pair, core combination and new prescription, and systematically study the prescription of Chinese medicine for the treatment of uterine fibroids.2. based on the inheritance auxiliary platform system of traditional Chinese medicine (V2.5) to study the treatment of the uterus by Professor Li Kunyin The rule of drug use, using data mining technology to summarize the treatment characteristics of Professor Li Kunyin in the treatment of uterine myoma. Methods: 1. to draw up the retrieval strategy, retrieve the Chinese knowledge network database (CNKI), use advanced retrieval, search term "full text", search term "uterus myoma", "ve", "fuzzy" matching item, sort way for "time", and retrieve a total of 1997. 1021 articles related to the treatment of uterine myoma in Chinese medicine from year to 2016. According to the inclusion criteria and the exclusion criteria, 337 prescriptions were selected. The above-mentioned prescription was introduced into the corresponding modules of the traditional Chinese Medicine Inheritance auxiliary platform system (V2.5), and the software rules were used to change into the mutual information method, the entropy clustering of complex system and the unsupervised entropy. Analytic hierarchy clustering method was used to obtain the results of drug frequency, common drug pair, core rule, core combination, new analysis and so on. The results were displayed with visual network diagram and analyzed by modern doctors in the treatment of uterine fibroids in.2. clinic. The traditional Chinese Medicine Inheritance auxiliary platform system (V2.5), using the software rules analysis, improving the mutual information method, the entropy clustering of complex system and the unsupervised entropy hierarchical clustering method. According to Professor Li Kunyin's changes in the menstrual and non menstrual period, the general prescription analysis, the menstrual phase prescription analysis and non menstruation were carried out respectively. Period prescription analysis, summarize the medicine rule of Professor Li Kunyin in the treatment of uterine myoma and discuss the therapeutic characteristics of the treatment of uterine myoma. Results: 1. literature and prescription study: (1) among 337 prescriptions for the treatment of myoma of uterus, there are 270 drugs in the treatment of uterine myoma, and the first ten drugs in the first ten places are zedoary turmeric, angelica, prism, red peony, peach kernel, Poria, astragalus, peony In the menstrual period, there are 40 prescriptions for the use of blood circulation and removing stasis drugs. There are 135 prescriptions for the menstrual period, including 135 drugs and the first ten drugs in the menstrual period: Danggui, Radix Astragali, Radix Codonopsis, Pu Huang, Herba Leonuri, Radix Paeoniae Paeoniae, Atractylodes, tuckahoe. There are 144 prescriptions for non menstrual period, including 204 drugs and non menstrual medication. Frequency of the first ten drugs are: zedoary, prism, angelica, peony, peony, peony, peony, peony, Poria, cinnamon, cinnamon, peony, peony, astragalus, oysters. (2) a total of 3~5 core drug combinations in 37, 7.2. Clinical Prescriptions for the treatment of uterine myoma (1) 40 cases of myoma of uterus treated by Professor Li Kunyin, with a total of 296 prescriptions, will all The frequency of drug frequency is 144 traditional Chinese medicine, and the frequency of drug frequency is 3924 times. The general drug frequency of the first ten drugs is Glycyrrhiza, Poria, bamboo Ru, Bai Ziren, yam, dogwood, dip, the skin of Acacia, tangerine, the top ten drugs in the menstrual period: licorice, Leonurus, continuum, 37, Pu Huang, yam, sea The top ten drugs in the non menstrual period are: licorice, tuckahoe, cypress, bamboo Ru, Fructus Corni, yam, acacia, tangerine, radix rehmanniae, Epimedium. The first three drugs are: flat, warm, cold. The first three drugs in the period of menstruation are warm, flat, cold. The first three drugs in the non menstrual period. Material is: flat, warm, cold. The total drug five in the top three are: Gansu, bitter, symplectic. Menstrual period and non menstrual period five taste in the top three are: Gan, bitter, symplectic. The drugs in the first five are the kidney, liver, spleen, lung, heart. The drugs of the first five are the liver, spleen, kidney, heart, stomach. Non menstrual period. The drugs used in the first five places are kidney, spleen, liver, lung, heart. (2) based on association rules, the commonly used drug combinations are cypress kernel Poria (- bamboo Ru, leucacea, licorice, Radix Rehmanniae), cornel - yam (- Poria cocos, cypress Poria cocos), and a combination of Herba Leonuri - Glycyrrhiza (- Pu Huang, dip, 37) and Pu Huang - 37 (- continued) during the period of menstruation The core combination includes bamboo Ru - cuttlebone - Poria, bamboo Ru - Codonopsis - alizardo, bamboo Ru - orange red - trifoliate orange, bamboo Ru - cuttlebone - oysters - oysters - Oyster - keel and so on. The new prescription based on complex system entropy clustering has bamboo Ru - sea cuttlebone - tuckahoe - alizari, French yam - Lotus - Fructus aurantii, Cornus officinalis - Herba Leonurus - ripening Radix rehmanniae - yam, dipede, dip - orange red - Acacia skin - CVF - dodder, cuttlebone - 37 - Leonurus tuckahoe - Pu Huang. (3) 3~5 core drug combinations, 46 new prescriptions for the treatment of uterine myoma. Conclusion: 1. traditional Chinese medicine auxiliary platform system for uterine myoma is analyzed, and the drugs for the treatment of uterine myoma are alive. It includes the drugs of Guizhi Fuling pill, including the medicine of Guizhi Fuling pill. The core combination medicine includes the blood activating medicine, the gas medicine, the blood supplement medicine, the warm Yang medicine, the soft hard powder and the.2. traditional Chinese Medicine Inheritance auxiliary platform system to analyze the effective cases of Professor Li Kunyin in the treatment of uterine myoma. There are obvious differences in the use of drugs in the menstrual period and the non menstrual period. Drug frequency, drug combination, new prescription, etc., different medication ideas in different menstrual cycles are also different. In the general and non menstrual period, the use of invigorating the spleen and wetting medicine, kidney tonifying medicine, Anshen medicine, phlegm medicine and so on is high, and the use of drugs for activating blood and removing blood stasis, removing blood stasis and promoting spleen medicine is higher in the period of menstrual period. Medicine for the treatment of uterine myoma provides a new basis for clinical and basic research, but it is still necessary for the experts to judge and test the methods of experimental research..3. professor Li Kunyin commonly used Chinese medicine decoction, Chinese patent medicine (orange lyi powder), combined with dietary guidance and other methods to achieve the purpose of treatment of the disease.
【学位授予单位】：广州中医药大学
【学位级别】：博士
【学位授予年份】：2017
【分类号】：R273

【参考文献】