自身免疫性肝炎中医医案诊治规律数据挖掘

发布时间：2018-03-19 00:37

本文选题：自身免疫性肝炎　切入点：中医医案　出处：《中医杂志》2017年14期 　论文类型：期刊论文

【摘要】：目的通过分析当代中医诊治自身免疫性肝炎的医案初步探讨其临床诊治规律。方法分别检索中国知网、中国生物医学数据库、维普期刊数据库、万方数据库、广州中医药大学名医数据库1990年1月至2016年2月期间的中医或中西医结合诊治自身免疫性肝炎的医案,提取医案详细信息包括中医证型、中医病位证素、中医病性证素、使用药物,采用描述性统计分析、频数分析、聚类分析对数据进行统计分析,同时运用复杂网络分析绘制核心药物网络图。结果共纳入医案80则,涉及中医证型13个,出现频次前3位的证型分别为瘀血阻络(29)、湿热内蕴(24)、肝郁脾虚(17);涉及中医病性证素13种,出现频次前3位的证素分别为血瘀(33)、湿(32)、热(31)。医案中涉及中药方剂28种,出现频次前3位的方剂分别为茵陈蒿汤(22)、柴胡疏肝散(7)、逍遥散(5)、小柴胡汤(5)、一贯煎(5);共使用中药169味,平均每则医案使用药物14.6味,出现频次前5位的药物分别为茵陈(45)、甘草(42)、赤芍(37)、柴胡(34)、白术(31)。使用频次3的药味有84味,聚类分析可分为9类;复杂网络分析得到不伴有黄疸的自身免疫性肝炎的治疗核心药物为柴胡、白术、白芍、茯苓、甘草、当归、黄芪,伴有黄疸的自身免疫性肝炎的治疗核心药物为茵陈、大黄、赤芍、黄芩。结论自身免疫性肝炎常见瘀血阻络证、湿热内蕴证,其病性以血瘀、湿、热多见,治疗药物以补虚、清热、利水渗湿、活血化瘀药为主。
[Abstract]:Objective to explore the rule of clinical diagnosis and treatment of autoimmune hepatitis by analyzing the medical records of modern Chinese medicine. Methods to search the database of Chinese knowledge network, Chinese biomedical database, Weipu periodical database and Wanfang database, respectively. From January 1990 to February 2016, the database of famous doctors of Guangzhou University of traditional Chinese Medicine and traditional Chinese Medicine (TCM) or combination of traditional Chinese Medicine and Western Medicine for the diagnosis and treatment of autoimmune hepatitis. The detailed information of medical records including TCM syndrome type, TCM disease site syndrome element, TCM disease syndrome element, TCM disease syndrome element, Using drugs, descriptive statistical analysis, frequency analysis and cluster analysis were used to analyze the data. At the same time, complex network analysis was used to draw the core drug network map. The results included 80 medical cases and 13 TCM syndromes. The first 3 syndromes were blood stasis blocking collaterals 29N, damp-heat internal accumulation 24N, liver stagnation and spleen deficiency 17N, and 13 syndromes related to TCM diseases, and the first 3 syndromes were blood stasis 33, dampness 32 and heat 31. 28 kinds of traditional Chinese medicine prescriptions were involved in the medical records. The first three prescriptions were Yinchenhao Tang (22), Chaihu Shugan San (7N), Xiaoyao San (5N), Xiao Chaihu decoction (5N), and decoction of Xiaochaihu (5N), which was used in a total of 169 kinds of Chinese medicine, with an average of 14.6 flavors per medical case. The drugs in the first five places of frequency were Yinchan 45, Glycyrrhiza uralensis 42, Radix Paeoniae Rubra 37, Radix Bupleurum 34, Atractylodes macrocephala 31. Complex network analysis showed that the core drugs for the treatment of autoimmune hepatitis without jaundice were Bupleurum chinense, Atractylodes macrocephala, Radix Paeoniae Alba, Poria cocos, Glycyrrhiza uralensis, Radix angelicae Sinensis, Astragalus membranaceus, and rhubarb. Conclusion the common syndromes of blood stasis and internal accumulation of dampness and heat in autoimmune hepatitis are blood stasis, dampness and heat. The main therapeutic drugs are tonifying deficiency, clearing heat, promoting water and infiltrating dampness, activating blood circulation and removing blood stasis.
【作者单位】：广东省中医院;
【基金】：广东省中医院中医药科学技术研究专项(YN2014PJ04)
【分类号】：R249;R259

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