郭立中教授运用解表法辨治慢性病的临床经验研究

发布时间：2018-03-20 20:20

本文选题：郭立中　切入点：解表法　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】：[目的]以导师近三年来运用解表法诊治的社区慢性病病案为研究对象,应用计算机数据挖掘技术,结合人工统计分析,探讨导师从表论治慢性病的临床经验及学术思想,以进一步深化对中医解表法的理论认识,并提高对慢性病辨治的临床疗效。[方法]在跟师抄方学习的三年时间里,对导师在南京华飞卫生所、宁西门诊部及铁心桥社区卫生服务中心从表论治慢性病的病案进行全面收集、整理,并按照统一的纳入标准、排除标准进行筛选,将符合条件的829例病案资料全部利用Medcase V3.2仓公诊籍国医脉案数据记录挖掘系统建立病案采集、存贮数据库;运用R语言数据挖掘及WPS数据处理系统,以治法研究为切入点,运用频次频率对比分析方法重点探讨各种解表法相应的临床表现、舌脉、处方用药之间的关系,并对数据结果进行分析、归纳、提炼、总结。[结果]829例患者中,其中男性309例,占37.27%;女性520例,占62.73%。年龄分布:儿童(0-9岁)1例,占0.12%,青少年(10-19岁)32例,占3.86%,青中年(20-39岁)324例,占 39.09%,中老年(40-59 岁)330 例,占 39.81%,老年(60-89 岁)142 例,占 17.13%。导师运用解表法的主要症状中频率大于5%的依次有:怕冷(9.26%),汗少(9.22%),腰酸痛(5.54%),寐差(5.32%),口干(5.04%),颈项僵硬(4.74%);主要舌象中频率大于6%的依次有:质淡红(19.26%),苔薄白(15.01%),边有齿印(10.86%),体胖大(6.17%);主要脉象中频率大于10%的依次有:紧脉(31.35%),浮脉(23.52%),滑脉(10.50%);主要病机中频率大于8%的依次有;风寒束表(27.79%),太少两感(16.90%),寒湿凝滞(14.63%)和气血不畅(8.42%);主要药物中频率大于2%的主要有:生姜(9.47%),桂枝(8.00%),朱茯神(7.41%),苍术(6.52%),石菖蒲(4.83%),法半夏(4.52%),白芷(4.04%),陈皮(3.45%),藿香(2.88%),细辛(2.63%),制附片(2.30%),麻黄(2.30%)。[结论]1、导师从表论治的社区慢性病以中老年女性患者为主;2、导师从表论治的社区慢性病主要临床症状:怕冷、汗少、腰酸痛、颈项僵硬及寐差、口干;主要舌脉:质淡红,苔薄白,边有齿印,脉(浮、紧、滑等);主要病机:风寒束表,太少两感,寒湿凝滞和气血不畅;主要药物:生姜、桂枝、朱茯神、苍术、石菖蒲、法半夏、白芷、陈皮、藿香、细辛、制附片和麻黄等。
[Abstract]:[objective] to explore the clinical experience and academic thought of the tutor in treating chronic diseases from the surface by using computer data mining technology and artificial statistical analysis, taking the history of chronic diseases diagnosed and treated by the tutor in the past three years as the research object. In order to further deepen the theoretical understanding of traditional Chinese medicine (TCM) method of releasing tables, and to improve the clinical efficacy of treating chronic diseases. [methods] during the three years of studying with the teacher, the tutor was in Nanjing Huafe Health Center. The Ningxi outpatient department and the Tiexinqiao Community Health Service Center collected and sorted out the medical records of chronic diseases according to the table, and screened them according to the unified inclusion criteria and exclusion criteria. The data of 829 medical records were collected and stored by Medcase V3.2 medical record data mining system, and the R language data mining and WPS data processing system were used as the breakthrough point of medical treatment research, and the data mining system of R language and WPS data processing system were used to set up the medical records data collection and storage database, and the R language data mining system and the WPS data processing system. Frequency frequency contrast analysis method was used to discuss the relationship among clinical manifestations, tongue pulse and prescription medication of various methods of dissolving table, and the data were analyzed, summarized, refined and summarized. [results] among 829 patients, 309 cases were male. 37.27%; 520 women, 62.73.The age distribution is as follows: one child aged 0-9 years, one child aged 0.12a, 32 adolescents aged 10-19 years, accounting for 3.86um, 324 young and middle-aged persons aged 20-39 years, 39.09.The middle and old people aged 40-59 years have 330 cases, accounting for 39.81s.142 cases are aged 60-89 years. Account for 17.13. among the main symptoms of using the chart method, the frequency of which is greater than 5%: afraid of cold, 9.26m, less sweat, 5.54g, 5.32, 5.04, and 4.74; the frequency of the main tongue is more than 6%; the frequency of the main tongue is more than 6%; the main tongue is more than 19.26261.The tongue is thin and white and 15.01T, and the main tongue is more than 6% in the order of the frequency of the major symptoms: 9.26, 9.22, 5.54, 5.32, 5.04, 4.74, respectively; the frequency of the main tongue images is more than 6%. The frequency of the main pulse was greater than 10%; the frequency of the main pulse was greater than 10%; the frequency of the main pulse was greater than 31.35%, the floating vein was 23.52%, the slippery vein was 10.50%, and the frequency of the main pathogenesis was more than 8%. The frequency of the main drugs is more than 2%: Ginger 9.4770, Guizhi 8.00, Zhu Fu Shen 7.41, Rhizoma Atractylodes 6.522, Rhizoma Atractylodes 6.522am, Rhizoma Atractylodes 4.833, Rhizoma Atractylodes 6.522am, Rhizoma Atractylodes 4.833, Rhizoma Atractylodes 6.52am, Angelica angelicae 4.04m, Radix angelicae dahurica 4.04m, Chen Pei 3.4545, patchouli 2.88. The main clinical symptoms of the community chronic diseases treated by mentors were middle-aged and elderly female patients, and the main clinical symptoms of community chronic diseases treated by mentors were: fear of cold. Less sweat, sore waist, stiff neck and poor sleep, dry mouth; main tongue vein: light red, thin fur white, edge with teeth marks, veins (floating, tight, slippery, etc.); main pathogenesis: wind and cold bundle table, too little two senses, cold and wet stagnation and unobstructed qi and blood; Main drugs: ginger, Guizhi, Zhu Fu Shen, Atractylodes Atractylodes, Acorus calamus, Atractylodes ternata, Radix angelicae dahurica, Pericarp, Pogostemon, Asarum, Atractylodes and Ephedra et al.
【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】：R249

【相似文献】