基于数据挖掘技术探讨胰腺癌临床用药规律的研究

发布时间：2018-03-15 09:18

本文选题：胰腺癌　切入点：数据挖掘　出处：《山东中医药大学》2016年博士论文　论文类型：学位论文

【摘要】：目的:探寻胰腺癌的古文献命名归属,挖掘医家治疗胰腺癌的临床用药规律。方法:文献研究以中国知网、《中华医典》光盘等计算机检索为主,辅以手工检索,以“中医解剖”、“伒”、“附脾之物”、“脾之副脏”、“散膏”、“甜肉”、“脾”、“总提”、“积聚”等为关键词,对中医学近千种古籍文献和现代文献进行检索,筛选与中医解剖、胰腺实体、积聚密切相关的内容,厘清中医解剖学发展滞缓原因,研究胰腺实体,并纳入广义的积聚概念进行胰腺癌的古文献研究;用药规律研究则基于数据挖掘技术,收集1978年至今中国知网、万方数据知识服务平台等数据库收录的中医治疗胰腺癌的文献,搜集中医处方,并建立现代医家处方数据库。导师处方则通过于山东中医药大学附属医院门诊跟诊予以收集,建立导师处方数据库。运用SPSS Statistics 17.0软件对处方进行频数分析和聚类分析,运用Clementine 12.0软件的Apriori算法进行关联分析,挖掘现代医家和导师治疗胰腺癌的基本规律及药物之间的配伍关系。结果:文献研究发现胰腺的功能包含在中医脾的功能之中,胰腺癌与广义的积聚关系密切。临床研究发现,现代医家治疗胰腺癌的高频药物为茯苓、白术、白花蛇舌草、柴胡、黄芪、党参、莪术、半支莲、丹参和薏苡仁,补虚药使用频率最高,清热药、活血祛瘀药次之,药味以苦、甘、辛为主,药性以平、温、微寒、寒为主,药物多归脾、肝、胃和肺经,常用药对有谷芽与麦芽、桃仁与红花、茵陈与栀子、半夏与陈皮、菝葜与红藤等,注重补虚药的应用和配伍。导师治疗胰腺癌的高频药物为莪术、柴胡、郁金、白术、蚤休、延胡索、枳壳、半夏、白芍、陈皮、莱菔子、麦芽、白花蛇舌草、生甘草、木香、薏苡仁和厚朴。活血祛瘀药使用最为广泛,理气药次之,药味以苦、辛、甘为主,药性以温、微寒、平、寒为主,药物亦多归脾、肝、胃和肺经,常用药对有半夏与陈皮、白英与蛇莓、生地与天花粉、白术与枳壳、葛根与羌活、槟榔与火麻仁等,尤为重视活血祛瘀药的应用与配伍。结论:1.胰腺的功能归中医脾所主。2.广义的积聚可作为胰腺癌的古文献命名归属。3.医家治疗胰腺癌的基本原则是一致的,注重补虚药、活血祛瘀药、理气药、清热药的应用,并通过配伍增强疗效。
[Abstract]:Objective: to explore the naming of ancient literature on pancreatic cancer and to find out the rule of clinical use of medicine for pancreatic cancer. Methods: the literature was mainly searched by computer such as the Chinese knowledge Network, the Chinese Medical Code and CD, and was supplemented by manual retrieval. With the key words of "anatomy of traditional Chinese medicine", "Li", "thing with spleen", "accessory viscera of spleen", "powder cream", "sweet meat", "spleen", "total extract", "accumulation", etc., nearly one thousand ancient books and modern literature of traditional Chinese medicine were searched for screening and screening with traditional Chinese medicine anatomy, pancreatic entity, etc. Accumulation of closely related content, clarify the reasons for the slow development of traditional Chinese medicine anatomy, study pancreatic entities, and incorporate a broad concept of accumulation to carry out the ancient literature study of pancreatic cancer, while the study of drug use law is based on data mining technology, Collect the literature on the treatment of pancreatic cancer in Chinese medicine collected from 1978 to now in databases such as China Zhiwang, Wanfang data and knowledge Service platform, and collect Chinese medicine prescriptions. In addition, the database of prescriptions of modern doctors was established, and the prescriptions of mentors were collected through out-patient consultation in the affiliated hospitals of Shandong University of traditional Chinese Medicine, and the database of prescriptions of tutors was established. The frequency analysis and cluster analysis of prescriptions were carried out by using SPSS Statistics 17.0 software. By using Apriori algorithm of Clementine 12.0 software, the association analysis was carried out to find out the basic law of modern doctors and mentors in the treatment of pancreatic cancer and the compatibility between drugs. Results: the function of pancreas was found to be included in the function of spleen in traditional Chinese medicine. Clinical studies have found that the high frequency drugs used by modern physicians for the treatment of pancreatic cancer are Poria cocos, Atractylodes macrocephala, Atractylodes nigra, Radix Bupleurum, Radix Astragali, Codonopsis, Curcuma, Radix Salviae Miltiorrhizae, Radix Salviae Miltiorrhizae and Coix seed. The medicine of tonifying deficiency is the most frequently used, the medicine of clearing away heat, activating blood circulation and removing blood stasis is the second, the medicine flavor is bitter, sweet, Xin mainly, the medicine is mainly flat, warm, slight cold, cold mainly, the medicine is mostly returned to spleen, liver, stomach and lung meridian, common medicine has grain germ and malt, peach kernel and safflower, Yinchen and Gardenia, Pinellia ternata and Pericarpium, Smilax china and red vine, etc., pay attention to the application and compatibility of tonifying drugs for pancreatic cancer. Semen Raphani, Malt, Sargassum, Glycyrrhiza uralensis, Radix Magnoliae, Coix seed and Magnolia officinalis. Drugs for activating Blood Circulation and removing Blood stasis are the most widely used, followed by drugs for regulating Qi, bitter, Xin, and Gan as the main drugs, the medicine is mainly warm, slightly cold, flat, cold, and the medicine is mostly returned to the spleen. Liver, stomach and Lung Meridians, commonly used for the treatment of Pinellia ternata and Chen Peel, White English and Snake berries, Raw Land and Trichosanthus, Atractylodes macrocephala and Fructus Aurantii, Pueraria and Notopterygium, Betelnut and Flamella seed, etc. Particular attention was paid to the application and compatibility of drugs for activating blood circulation and removing blood stasis. Conclusion 1.The function of pancreas belongs to the spleen of traditional Chinese medicine. 2.Generalized accumulation can be named as the ancient literature of pancreatic cancer .3.The basic principles of physicians in the treatment of pancreatic cancer are consistent and pay attention to tonifying deficiency medicine. Blood-activating drugs, qi-regulating drugs, heat-clearing drugs, and through compatibility to enhance the efficacy.
【学位授予单位】：山东中医药大学
【学位级别】：博士
【学位授予年份】：2016
【分类号】：R735.9

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