胸痹辨证规律研究

发布时间：2018-01-31 08:36

本文关键词： 胸痹病位特征病性特征辨证规范辨证模型　出处：《南京中医药大学》2017年硕士论文　论文类型：学位论文

【摘要】：研究目的:现如今,关于胸痹辨证分型的研究成果丰富。国家虽然出台了胸痹心痛病证的诊断标准与证候分类(附录1),但其所归纳的6个证型依然无法全面概括临床中出现的复杂多变的证候,诸多医家仍以其临证经验加以辨证施治。故难以形成对胸痹辨证施治的统一认知,中医对胸痹辨证的标准化尚存在诸多值得探讨的地方。本研究在吴承玉教授所建立的藏象辨证理论体系的指导下,通过对胸痹的病名溯源、病因病机以及辨证分型等研究,结合胸痹患者的基本情况,运用流行病学调查等进行统计学分析,研究胸痹病证的辨证规律。研究意义:藏象辨证理论体系建立在准确、规范的临床信息的基础之上,继而提取病位与病性特征,将病位与病性有机结合,以形成相对规范的证。藏象辨证理论体系以"以象测脏,从证辨证"为原则,对临床实践中具有复杂性、善变性的证灵活把握,是对中医学辨证原理与规律的应用与体现。本研究通过对历代文献的整理与溯源,以及运用现代流行病学调查等方法,以"从症辨证"、"辨病与辨证相结合"为原则,并结合现代中医诊断思路辨病为先、辨证随后的思想,将脏腑辨证体系与病位、病性组合规律应用于胸痹病证,构建胸痹辨证新模式。将胸痹病证的病位、病性特征用数学语言加以描述,以建立病位与病性组合的胸痹辨证数学模型,并结合案例分析其可行性与实用性。藏象辨证理论体系与辨证数学模型的结合,使胸痹辨证更加灵活准确易于操作,有利于指导胸痹病证的诊治。研究方法:本研究通过搜集查阅大量的中医文献资料,对历代文献中记载的胸痹心痛进行整理归纳。通过对比不同时期的文献资料,对胸痹心痛的病名源流、病因与病机、病位与病性分别进行整理归纳。通过查阅现代络病理论的文献资料,探讨其对胸痹心痛的认知与治疗。历代对胸痹的辨证分型与辨证方法繁多,加之现代中医辨证各存已见尚不规范,故将简便规范的藏象辨证理论体系与数学辨证模型相结合,使复杂的辨证过程简单化,将胸痹的临床信息层次化。通过回顾性的流行病学调查研究方法,临床收集438例胸痹病例,在症状审核规范后进行数据统计,采用统计学分析研究方法如聚类分析、主成分分析等,分析胸痹病证的病位、病性、病位结合病性的分布规律,构建"胸痹病证诊断信息表",总结胸痹的基本证与复合证的组合规律。应用模糊数学原理,构造模糊隶属函数,建立胸痹辨证的数学模型。应用关联分析,计算其置信度,最终进行辨证模型测试。研究结果:整理归纳历代文献资料与438例胸痹病例的调查结果,提出"痰瘀阻心"的基本证,并以此为基础提出胸痹的病位与病性相兼的复合证,使胸痹的现代中医辨证更加规范。建立胸痹辨证的数学模型,实现对辨证模型的初步探索。
[Abstract]:Research objective: nowadays, the research on syndrome differentiation and classification of chest arthralgia is rich. Although the country has issued the diagnosis standard and syndrome classification of chest arthralgia syndrome (appendix 1). However, the six syndrome types still can not fully summarize the complex and changeable syndromes that appear in the clinic, and many doctors still use their clinical experience to treat them, so it is difficult to form the unified cognition of syndrome differentiation and treatment of chest arthralgia. The standardization of syndrome differentiation of chest arthralgia in traditional Chinese medicine is still worth discussing. Under the guidance of the theory system of Tibetan syndrome differentiation established by Professor Wu Chengyu, the origin of chest arthralgia is traced to the source of the disease. Etiology and pathogenesis as well as syndrome differentiation and other studies combined with the basic situation of patients with chest arthralgia the use of epidemiological investigation to carry out statistical analysis. Study on the syndrome differentiation of chest arthralgia. Significance: the theoretical system of syndrome differentiation of Tibet image is based on accurate and standardized clinical information, and then extract the characteristics of disease and disease, and combine disease with disease. In order to form a relatively standardized syndrome, the theoretical system of syndrome differentiation of Tibet image is based on the principle of "using image to measure viscera, from syndrome differentiation of syndrome", which is flexible to grasp the complex and changeable syndrome in clinical practice. It is the application and embodiment of the principle and law of syndrome differentiation in traditional Chinese medicine. This study is based on the collation and tracing of the literature of the past dynasties, as well as the use of modern epidemiological investigation to "syndrome differentiation from symptoms". "differentiation of diseases and syndrome differentiation" as the principle, and combined with the modern Chinese medicine diagnosis thinking of disease differentiation first, then the thought of syndrome differentiation, Zang-fu organs syndrome differentiation system and disease position, disease combination law applied to chest arthralgia syndrome. To establish a new model of syndrome differentiation of chest arthralgia. The characteristics of disease of chest arthralgia syndrome are described by mathematical language, in order to establish a mathematical model of syndrome differentiation of chest arthralgia combined with disease position and disease. Combined with the case analysis of its feasibility and practicability, the combination of the theoretical system of syndrome differentiation and mathematical model of syndrome differentiation makes the syndrome differentiation of chest obstruction more flexible, accurate and easy to operate. This study is helpful to guide the diagnosis and treatment of chest arthralgia syndrome. Research methods: this study through the collection of a large number of traditional Chinese medicine literature materials. By comparing the literature of different periods, the origin, etiology and pathogenesis of chest arthralgia were analyzed. Through consulting the literature data of modern collateral disease theory, it discusses the cognition and treatment of chest arthralgia and heartache. There are many methods of syndrome differentiation and syndrome differentiation for chest arthralgia in past dynasties. In addition, the existence of modern TCM syndrome differentiation has not yet been standardized, so the simple and standardized Tibetan syndrome differentiation theory system and mathematical dialectical model are combined to simplify the complex syndrome differentiation process. The clinical information of chest arthralgia was stratified. 438 cases of chest obstruction were collected by retrospective epidemiological investigation and statistics were carried out after the symptoms were checked and standardized. Using statistical analysis methods, such as cluster analysis, principal component analysis, to analyze the disease location, disease, disease combined with disease distribution law, build "chest arthralgia syndrome diagnosis information table". The combination law of basic syndrome and compound syndrome of chest arthralgia is summarized. The fuzzy membership function is constructed by applying fuzzy mathematics principle, and the mathematical model of syndrome differentiation of chest arthralgia is established. The degree of confidence is calculated by using correlation analysis. Finally, the syndrome differentiation model test. Results: collate and summarize the literature and 438 cases of chest obstruction investigation results, put forward the basic syndrome of "phlegm stasis obstruction of the heart". On this basis, the author puts forward the combined syndrome of the disease position and disease of chest arthralgia, which makes the modern TCM syndrome differentiation of chest arthralgia more standardized, and establishes the mathematical model of the syndrome differentiation of chest arthralgia, and realizes the preliminary exploration of the syndrome differentiation model.
【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】：R256.22

【相似文献】