基于数据挖掘方法的张书信教授治疗慢性便秘经验研究

发布时间：2018-01-03 03:33

  本文关键词：基于数据挖掘方法的张书信教授治疗慢性便秘经验研究　出处：《北京中医药大学》2016年硕士论文　论文类型：学位论文

  更多相关文章： 治疗经验 数据挖掘 慢性便秘

【摘要】：背景：便秘是肛肠科门诊常见病种之一,临床常表现为：排便周期延长；或周期不长,但粪质干结,排便艰难；或粪质不硬,虽有便意,但便出不畅的病症。便秘既是可见于其他疾病伴发的一个症状,又可以是单独的一个病证。病程超过6个月者为慢性便秘。中医内治法治疗慢性便秘有一定的优势,不同于西方医学之针对症状治疗。中医学根据患者体质、症状等表现,四诊合参,审证求因,经过辨证论治,往往能找到病因根本所在,从而解决便秘问题。导师张书信教授长期从事临床及科研工作,对慢性便秘的治疗积累了丰富的经验,且临床疗效显著。目的：应用数据挖掘技术对张书信教授门诊治疗慢性便秘医案数据资料进行探索性研究,挖掘张书信教授治疗慢性便秘的辩证、用药思路,为继承张书信教授中医经验提供一种新方法。方法：选取2015年1月至2016年1月期间经张书信教授于北京中医药大学附属东直门医院肛肠科门诊,诊断为慢性便秘的患者144例医案资料,通过“医案数据处理系统”进行数据的预处理及数据存储,然后将数据资料导入“中医医案数据库”,通过一般描述性分析、频数分析、数据关联分析等统计分析方法,进行数据挖掘,并对得到的结果进行讨论分析,获得结论。结果：1.144例研究对象中,男性42人(29.16%),女性102人(70.84%),男女人数比为1：2.43。按年龄分类：年龄小于40岁者40人(27.78%),年龄在40-59岁之间者45人(31.25%),年龄在60岁以上者59人(40.97%)；2.病因病机分析：慢性便秘主要病因有：主要有久病正虚、饮食不节、情志伤、年老体衰、禀赋不足、寒邪侵袭,病机前10位分别为阴虚津亏、气阴两虚、脾虚气陷、脾胃气虚、血虚肠燥、气机郁滞、气血两虚、肺脾气虚、脾肾两虚、脾肾阳虚,可以发现,阴虚、气虚、血虚、气滞、阳虚是主要病机,通过病因病机的频数分析,反映出临床便秘患者以正虚为主；3.症候分析：便秘患者辩证主要为气虚证、阴虚证、气阴两虚证、血虚证、气机郁滞证、气血两虚证、阳虚证、胃肠湿热证、肠胃积热证、寒凝气滞证；4.症状及体征分析：频次分析结果取前15位,发现常见舌脉：红舌、少苔、淡红舌、白苔、薄白苔、脉细数、薄黄苔,常见症状：大便干、排便不畅、食欲减退、倦怠乏力、腹胀、口干、眠差、大便不通,一定程度上反映出临床便秘患者多阴虚、气虚表现；5.病位分析：提示慢性便秘病位主要是大肠、脾、胃、肝、肾、肺为主；6.立法分析：结果显示主要以为补脾益气、益气养阴、养血补血、行气导滞、气血双补为主；7.张书信教授门诊治疗慢性便秘最常用的药物是生白术、当归、枳实、白芍、酒苁蓉、虎杖、火麻仁、决明子、生地黄、蜜紫菀、茯苓、熟地黄、升麻、莱菔子、黄芪、何首乌、厚朴、玄参、百合、太子参、麦门冬、桃仁、枳壳、神曲、郁李仁、生甘草、槟榔、泽泻、瓜蒌、大黄。主要为补虚、行气、润肠药物,医案处方中常用的药物配伍有生白术、枳实、当归、芍药四味药。结论：慢性便秘主要病机以本虚为主,包括气虚、血虚、阴虚、阳虚四个方面,主要病位在大肠、脾、胃、肺、肾。治疗慢性便秘常以补虚为主,提出治疗便秘以补虚为本、从肺论治、从肾论治的思路。治疗便秘不拘泥于通便,而善于寻找病因,符合中医治病求本之原则,临床获得良好的疗效。用药方面,张书信老师善于运用生白术、枳实、当归、芍药、火麻仁、肉苁蓉、虎杖、蜜紫苑、黄芪、升麻、桃仁等药物治疗便秘。
[Abstract]:Background: constipation is one of the common diseases outpatient anorectal diseases, the clinical manifestation is: defecation cycle; or cycle is not long, but the fecal dry, difficult defecation; or fecal matter is not hard, although it is intended, but out of the poor condition. Both constipation found in other diseases with a symptom of hair again, can be a separate course of disease and syndrome. For more than 6 months for chronic constipation. Traditional Chinese medicine treatment of chronic constipation have certain advantages, different from western medicine for the treatment of symptoms of TCM. According to the constitution of the patients, symptoms and other symptoms, four diagnostic methods, for trial, after diagnosis and treatment, can often find the cause of the essence, so as to solve the problem of constipation. Professor Zhang Shuxin has long been engaged in clinical and research work, the treatment of chronic constipation has accumulated rich experience, and has significant clinical effect. Objective: the application of data mining technology to a professor of outpatient letters The treatment of chronic constipation cases data for exploratory research, mining professor Zhang Shuxin in the treatment of chronic constipation dialectical medication ideas, provide a new method for the inheritance of traditional Chinese medicine experience. Professor Zhang letters: During from January 2015 to January 2016 by a letter to Professor anorectal Department of Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine clinic, diagnosed 144 cases of patients with chronic constipation medical information, data preprocessing and data storage through the medical data processing system, and then the data into the database of medical records of Chinese medicine, through descriptive analysis, frequency analysis, correlation analysis and other statistical data analysis, data mining, and discusses the analysis of the results obtained. Results: 1.144 subjects, 42 males, 102 females (29.16%) (70.84%), the number of male to female ratio was 1:2.43. by age. 绫伙細骞撮緞灏忎簬40宀佽，

本文编号：1372195