基于数据挖掘方法总结晁恩祥教授治疗支气管哮喘用药特点

发布时间：2018-02-20 20:14

本文关键词： 支气管哮喘数据挖掘晁恩祥　出处：《广州中医药大学》2016年硕士论文　论文类型：学位论文

【摘要】：目的：通过对晁恩祥教授支气管哮喘患者门诊病历搜集和整理,将纳入的病历资料输入中医传承辅助平台以对其进行数据挖掘,以更为客观地分析和总结晁老治疗支气管哮喘的辨证用药经验及独特的学术思想,最终促进名医传承工作更好地实施及指导临床实践。方法：通过搜集整理2004年6月—2007年6月晁恩祥教授门诊病例中支气管哮喘且治疗有效患者共60例,将患者的一般资料、病史、诊断、辨证分型、治法及中药处方等信息分别录入至中医传承辅助平台不同模块,构建成数据库,再通过软件的频次统计得出支气管哮喘的常见证型、常见症状、常用药物及其性味、归经；利用系统中关联规则对录入病例数据分析获得核心药对或药物组合；利用复杂系统熵聚类剖析以获得新处方。结果：1、对纳入本研究支气管哮喘病案共60例,共225诊次频次统计分析,本次研究结果显示风哮证为哮证中医辨证分型中最为常见的证型,其次是肺肾气虚证、热哮证。症状频次统计结果显示出现次数前十位的症状分别为呼吸困难、咳嗽、咽痒、胸闷、流涕、口干、气短、鼻塞、大便干。药物方面,本研究纳入共有225首中药处方,使用120味中药,出现频次位于前十位的分别为地龙、蝉蜕、紫苏叶、紫苏子、紫菀、杏仁、五味子、炙麻黄、枇杷叶、牛蒡子；对四气进行统计,发现以寒、温、平性药物为主,极少用到热、凉之品；药物的五味方面,结果显示频次最多者为苦味,其次是辛味,出现频次最少的是涩味药物；药物的归经方面,出现频次最多为归肺经药物,其次为胃经、肝经、脾经,归心及小肠经药物出现频次最少。2、利用辅助平台中关联规则方法,将支持度设为170,置信度设为0.98,软件共分析出93条药物组合数据,其中出现频度位于前三的药物组合为“蝉蜕、地龙”,“紫苏叶、紫苏子”,“蝉蜕、紫苏叶”；并用关联规则分析法,将置信度设置为1时得出药物组合的用药规则共74条；使用软件生成由关联系数最高的药物组合组成核心方的网络图。3、利用复杂系统熵聚类分析可得出包括3-4味药物的核心组合,总计18个,然后利用无监督的熵层次聚类法在上述结果上可得出9个治疗支气管哮喘的新处方：鸡内金、款冬花、枳实、薤白、葛根；牡蛎、太子参、菊花、龙骨；玫瑰花、葛根、瓦楞子、厚朴；独活、荆芥、薄荷、防风、石菖蒲；白芍、淫羊藿、肉苁蓉、细辛；枸杞子、山萸肉、白芍、肉苁蓉；苍术、乌贼骨、木香、黄连；苍术、乌贼骨、厚朴、黄连；干姜、麦芽、神曲、薏苡仁、鸡内金。结论：通过数据挖掘方法可较为客观地归纳总结晁恩祥教授治疗支气管哮喘在辨证、用药规律等多个方面促进名医经验传承工作结论,及进一步新处方的发现、挖掘,最终有利于名医经验上升为较高级别的循证医学证据而更好指导临床工作。
[Abstract]:Objective: to collect and organize the outpatient medical records of Professor Chao Enxiang, and input the data into the traditional Chinese Medicine (TCM) inheritance support platform for data mining. In order to analyze and summarize more objectively Chao Lao's experience and unique academic thoughts in treating bronchial asthma, Methods: from June 2004 to June 2007, 60 patients with bronchial asthma and effective treatment were collected and sorted, and the general data of the patients were collected. The information such as history, diagnosis, syndrome differentiation, treatment method and prescription of traditional Chinese medicine were entered into different modules of the Chinese medicine inheritance assistance platform, and the database was constructed, and then the common syndrome types and common symptoms of bronchial asthma were obtained through the frequency statistics of the software. Commonly used drugs and their sexual taste, meridian, using association rules in the system to input case data analysis to obtain core drug pairs or drug combinations; Results: a total of 60 cases of bronchial asthma were included in this study, and 225 times of frequency were statistically analyzed. The results of this study showed that Fengxiao syndrome was the most common syndrome type in TCM syndrome differentiation of wheezing syndrome, followed by deficiency of lung and kidney qi syndrome and heat asthma syndrome. The results of symptom frequency statistics showed that the symptoms of the first ten times of occurrence were dyspnea, cough, pharynx itch, respectively. Chest tightness, runny, dry mouth, shortness of breath, stuffy nose, dry stool. In this study, 225 prescriptions of traditional Chinese medicine were included, 120 kinds of Chinese medicine were used, the first ten times appeared in the first ten places were respectively the dragon, cicada slough, perilla leaf, purple perilla, and Aster. Almonds, Schisandra chinensis, processed ephedra, loquat leaves, Arctium lappa; statistics of the four qi showed that the main drugs were cold, warm and flat, and rarely used hot and cool products. In the five flavors of the medicine, the results showed that the most frequent ones were bitter taste. The second is Xin Wei, the least frequent is the astringent drug; the most frequent occurrence of the medicine is the lung channel drug, the second is the stomach channel, the liver channel, the spleen channel, the second is the stomach meridian, the liver channel, the spleen meridian. By using association rule method in the auxiliary platform, the support degree was set to 170 and the confidence degree was set to 0.98. The data of 93 drug combinations were analyzed by the software, in which the first three drugs appeared as "cicada slough". By using association rule analysis, the confidence was set at 1:00 to obtain 74 drug rules of drug combination. Using the software to generate a network of drug combinations with the highest correlation coefficient. 3, and using the entropy cluster analysis of complex systems to obtain a core combination of 3-4 drugs, a total of 18. Nine new prescriptions for the treatment of bronchial asthma were obtained by using unsupervised entropy hierarchical clustering method: chicken Intragold, Radix Ophiopogonis, Fructus Aurantii, Allium macrostemon, Radix Puerariae, Oyster, Pseudostellariae, Chrysanthemum, keel, Rose, Pueraria, Radix Puerariae, Corrugated seed, Magnolia officinalis; Thorn mustard, mint, Fangfeng, Acorus calamus; Radix Paeoniae Alba, Epimedium, Cistanche, Asarum; Fructus Lycii, Fructus Corni, Radix Paeoniae Alba, Cistanche Cistanche; Atractylodes Atractylodes, squid bone, Radix Coptidis. Rhizoma Coptidis; dried ginger, malt, Shenqu, Coix seed, chicken Neijin. Conclusion: professor Chao Enxiang can be summed up objectively by data mining method in treating bronchial asthma syndrome differentiation, The rule of drug use can promote the conclusion of famous doctors' experience inheritance and further discovery and excavation of new prescriptions, which will ultimately help the famous doctors' experience to rise to a higher level of evidence-based medical evidence and better guide the clinical work.
【学位授予单位】：广州中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R249;R256.12

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