基于中医传承辅助系统挖掘刘启泉教授诊治慢性萎缩性胃炎伴肠上皮化生经验

发布时间：2018-02-04 00:56

本文关键词： 刘启泉慢性萎缩性胃炎肠上皮化生经验中医传承辅助系统数据挖掘　出处：《河北医科大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:总结并挖掘刘启泉教授治疗慢性萎缩性胃炎(chronic atrophic gastritis,CAG)伴肠上皮化生(intestinal metaplasia,IM)的经验及用药规律,以利于名老中医治疗经验的传承,并为中医治疗CAG伴IM的临床与科研提供思路及参考。方法:收集刘启泉教授2014年10月至2016年10月在河北省中医院脾胃病科门诊治疗CAG伴IM的有效病案286例,录入由中国中医科学院研究所开发的“中医传承辅助平台(V2.5)”软件,利用该软件集成的规则分析、改进互信息法、熵聚类等数据挖掘方法,分析刘启泉教授治疗CAG伴IM的用药规律及常用处方的药物特点,探索治疗CAG伴IM的新思路、新方法。结果:1基本情况:286例患者中,男性145例,女性141例;年龄集中在50-69岁之间;临床症状排前3位的是胃胀、胃痛和嗳气;舌脉以舌暗红、苔黄腻、脉弦滑为主;根据西医疾病分类,CAG伴轻、中度IM者较多,伴有糜烂者有174例;根据中医疾病分类,胃痞者为172例,胃脘痛者为114例;根据中医证型分类,胃络瘀阻证最多,其次为脾胃湿热证。2处方分析:中药“四气”统计结果显示,温性和寒性药所占比例较高,分别为48.02%、35.56%;中药“五味”统计结果显示,苦味药和辛味药使用比例较高,分别为36.19%、33.40%;药物归经统计结果显示,以脾、胃、肝三经频次最高;处方中使用频次在40次以上的药物有44味,按功效分类,共计使用14类药,其中清热药和理气药使用频次最高,其次是活血化瘀药、养阴药和安神药;关联规则分析中,通过支持度的不断上升,得到8味核心药物,包括石菖蒲、郁金、百合、白芍、延胡索、茯苓、当归、蒲公英;在关联度分析的基础上,通过复杂系统熵聚类算法,得到3-5味新方聚类核心组合,通过无监督熵层次聚类,得到治疗CAG伴IM的9首新处方。结论:1基于数据挖掘技术,分析出刘启泉教授治疗CAG伴IM临证用药多辛开苦降,寒温并用,认为热毒血瘀是病机关键,以“清热解毒,行气活血”贯穿始终,同时不忘顾护阴液及情志的调护。并开发出9首治疗CAG伴IM的新处方,推动了刘启泉教授学术思想和临床经验的传承与创新。2中医传承辅助平台软件通过数据挖掘技术,对患者的基本情况、用药情况及组方规律进行统计,为深入分析和挖掘刘启泉教授治疗CAG伴IM经验提供了良好的平台,有助于名老中医治疗经验的总结与传承,值得进一步推广和应用。
[Abstract]:Objective: To summarize and mining of Professor Liu Qiquan in treating chronic atrophic gastritis (chronic atrophic, gastritis, CAG) with intestinal metaplasia (intestinal metaplasia IM) experience and drug laws, in order to experience the old Chinese medicine treatment of inheritance, and Chinese medicine for the treatment of CAG with IM in the clinical and scientific research to provide ideas and reference methods. Collection of Professor Liu Qiquan in October 2014 to October 2016 in the medical record department of outpatient treatment of spleen and stomach effectively CAG traditional Chinese Medicine Hospital of Hebei province with IM in 286 cases, TCM inheritance auxiliary input platform developed by the research Chinese Academy of traditional Chinese medicine "(V2.5)" software analysis using the software integration rules, the improved mutual information method, entropy clustering method professor Liu Qiquan analysis, drug law for the treatment of CAG with IM and commonly used prescription drugs, a new method to explore new ideas, for the treatment of CAG with IM. Results: 1 basic conditions: in the 286 cases, male In 145 cases, 141 cases were female; the age concentrated in 50-69 years old; the clinical symptoms of the top 3 is bloating, stomach pain and belching; tongue to dark red tongue, yellow greasy moss, pulse string slide; according to the classification of diseases of Western medicine, CAG with mild to moderate IM, more, accompanied by erosion in 174 cases; according to the the classification of diseases in TCM, Weipi were 172 cases of epigastric pain in 114 cases; classified according to TCM syndromes, gastric stasis syndrome is the highest, followed by the spleen and stomach damp heat syndrome.2 prescription analysis: the statistical results of traditional Chinese medicine "four" shows that the warm and cold medicine accounted for a higher proportion, respectively 48.02%, 35.56% traditional Chinese medicine; the "Five" statistics showed that bitter and pungent drugs with a higher proportion, respectively 36.19%, 33.40%; drug owned by the statistics showed that in the spleen, stomach, liver and three with the highest frequency in the use of prescription drugs; frequency of 40 times more than 44 flavor, according to the classification of functions, the use of a total of 14 the drugs, antipyretic and Gas use the highest frequency, followed by blood stasis, nourishing yin and tranquilizing drugs; association rules analysis, through the support of the rising, get 8 kinds of core drugs, including Shichangpu, lily, turmeric, Radix Paeoniae Alba, Rhizoma Corydalis, angelica, Poria, dandelion; based on correlation analysis, through the the complex system entropy clustering algorithm, obtained 3-5 kinds of new clustering core portfolio through unsupervised hierarchical clustering entropy, get 9 new prescriptions for the treatment of CAG with IM. Conclusion: 1 based on the data mining technology, analysis of Professor Liu Qiquan for the treatment of CAG with IM clinical medicine multisymplectic open and bitter down, cold and warm, that heat blood stasis is the key pathogenesis, to detoxify, invigorate the circulation of Qi and blood throughout, while not forgetting to protecting Yin fluid and emotional nursing. And the development of a new prescription for the treatment of CAG with 9 pieces of IM, promote the inheritance of academic thought and clinical experience of Professor Liu Qiquan and the innovation of traditional Chinese medicine.2 The auxiliary platform software through the data mining technology, the basic situation of patients, medication and prescription rule statistics, provides a good platform for in-depth analysis and mining professor Liu Qiquan for the treatment of CAG with IM experience, summed up the experience and inheritance of help old Chinese medicine treatment, worthy of further promotion and application.

【学位授予单位】：河北医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R249;R259

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