基于数据挖掘的吕仁和教授治疗小儿原发性肾病综合征经验传承研究

发布时间：2018-05-10 13:56

本文选题：吕仁和 + 小儿原发性肾病综合征　；参考：《北京中医药大学》2017年硕士论文

【摘要】：背景:肾病综合征是以大量蛋白尿、低蛋白血症、水肿和高脂血症为主要临床表现的一组临床症候群,是小儿常见的肾脏疾病之一,研究表明,原发性肾病综合征约占小儿肾病综合征的90%。目前西医治疗主要以激素和(或)免疫抑制剂为主,虽取得一定疗效,但小儿易出现反复感冒后复发,生长发育受限,记忆力减退等神经系统发育受阻的副作用。吕仁和教授在治疗小儿原发性肾病综合征方面具有独特的学术理念,且疗效显著。在信息化的今天,数据挖掘技术为我们提供了提炼老专家经验的新方式,对传承名老中医经验具有很大推动作用。目的:采用数据挖掘技术对吕仁和教授治疗小儿原发性肾病综合征的经验进行探索,探求其证治规律,以总结吕仁和教授治疗该病的经验及独特的学术思想。方法:收集并筛选于2008年8月～2017年2月间就诊于吕仁和教授专家门诊的小儿原发性肾病综合征患者的病例资料。对于合格的病例进行数据预处理,然后建立Excel数据库,运用SAS 9.1软件进行频数统计和聚类分析,频数统计包括病因、症状体征、证型、药物、激素不同分期的症状体征、证型、药物以及初诊、末次就诊的症状体征、理化检查;聚类分析,对频数在5次以上,累积频率为95.95%的80味中药进行聚类分析,采用R型聚类,类平均法计算,以探求吕教授常用药对和药串。结果:1.频数统计结果:(1)病因:以禀赋不足最多见,频率高达77.77%,其次为外感,频率达22.22%。(2)证型:以气阴两虚最多见,频率为20.33%,其次为血热瘀滞,频率为14.99%。(3)药物:27例病例、451诊次的处方药物总频数3086次,其中使用频数前27味的中药,频数均在20次以上,累积频率达78.68%,是治疗小儿原发性肾病综合征的主要药物。(4)疗效:初诊和末次就诊出现3次以上的症状体征数分别为9个和5个,初诊蛋白尿以中、重度为主,累积频率为55.56%,末次就诊以正常蛋白尿为主,频率为77.78%。2.聚类分析:得到吕教授治疗小儿原发性肾病综合征常用药对6对,药串3串。
[Abstract]:Background: nephrotic syndrome is a group of clinical syndromes with large proteinuria, hypoproteinemia, edema and hyperlipidemia as the main clinical manifestation. It is one of the common renal diseases in children. Primary nephrotic syndrome accounts for about 90% of nephrotic syndrome in children. At present, the main treatment of western medicine is hormone and (or) immunosuppressant, although it has certain curative effect, but children are prone to relapse after repeated colds, limited growth and development, memory loss and other side effects of nervous system development retardation. Professor Lv Renhe has a unique academic idea in the treatment of pediatric primary nephrotic syndrome, and the curative effect is remarkable. Today, data mining technology provides us with a new way to refine the experience of old experts, which has a great role in promoting the inheritance of famous old Chinese medicine experience. Objective: to explore the experience of Professor Lv Renhe in the treatment of pediatric primary nephrotic syndrome by using data mining technique, to explore the rule of syndrome and treatment, and to summarize Professor Lv Renhe's experience in treating this disease and his unique academic ideas. Methods: the data of children with primary nephrotic syndrome were collected and screened from August 2008 to February 2017. The data of qualified cases were preprocessed, then Excel database was established, frequency statistics and cluster analysis were carried out by using SAS 9.1 software. Frequency statistics included etiology, symptoms and signs, syndromes, drugs, hormones, symptoms and signs in different stages, syndromes and syndromes. Drugs, symptoms and signs of the first visit, physical and chemical examination, cluster analysis, the frequency of more than 5 times, cumulative frequency of 95.95% of 80 Chinese medicine cluster analysis, using R-type clustering, cluster average calculation, In order to explore Professor Lu common medicine pair and drug string. The result is 1: 1. Frequency statistics results: etiology: the most common etiology was the deficiency of endowment, the frequency was as high as 77.77 and the second was external feeling, and the frequency was 22.22.t2) syndrome type: Qi and Yin deficiency was the most common, the frequency was 20.33 and the next was blood heat stasis. The total frequency of prescribing drugs was 3086 times, of which the first 27 kinds of traditional Chinese medicines were used more than 20 times. The cumulative frequency was 78.68, which was the main drug for the treatment of pediatric primary nephrotic syndrome. The number of symptoms and signs more than three times at first visit and the last visit were 9 and 5, respectively. The first diagnosed proteinuria was mainly moderate and severe. The cumulative frequency was 55.56, the last visit was normal proteinuria, the frequency was 77.78. Cluster analysis: professor Lu in the treatment of children with primary nephrotic syndrome, 6 pairs of drugs, drug string 3 strings.
【学位授予单位】：北京中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R249;R272

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