基于聚类分析的陈民教授治疗老年高血压病用药规律研究

发布时间：2018-03-22 11:10

本文选题：老年高血压病　切入点：聚类分析　出处：《辽宁中医药大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:本研究通过收集整理陈民教授治疗EH患者的病例资料,对其处方用药进行相关统计分析,探索总结其治疗EH的核心药物、药类、药对、聚类方组等,总结陈民教授独到的用药规律及辨治经验,为今后治疗EH提供理论和临床依据、为医者治疗本病提供新思路。资料与方法:收集2014年2月至2016年12月期间,于辽宁省中医院老年病科门诊就诊的EH患者的中药首诊处方。采集患者的姓名、性别、年龄、用药等信息并录入Excel表中,统计出用药频数频率,归经、功效分类,结果转换成可分析数据,用统计学软件(SPSS22.0)对数据进行聚类分析,得出结论。结果:1.根据病例纳入、排除标准进行筛查和收集,共纳入115例处方,得132味药,用药总频次为2951次,高频用药频率25%的有50味,其中前13味为核心用药。2.用药频数在10次以上(含10次)的有81味,占累积总频次的92.88%,是治疗本病的常用药物。3.归经最多的为:肝经;较多的依次为:脾经、肾经、心经、肺经、胃经;较少的依次为:大肠经、胆经、心包经、小肠经、膀胱经、三焦经。4.使用频数最多的前七类药依次为补虚药、清热药、活血化瘀药,安神药、平肝息风药、利水渗湿药、理气药,总频数为2128次,占总频次的77.64%。5.将前50味高频药进行聚类分析,得到10个常用药对及7个聚类方组。结论:1.由治疗EH药物分析可知,陈师常用补虚药治疗本病,佐以清热、活血化瘀,安神、平肝息风、利水渗湿、理气等药物,反映了EH本虚标实的特殊病机特点,并以补虚固本为先,辨证泻实为要的用药特点。2.由药物归经可知,陈师用药注重肝、脾、肾、心、肺、胃多脏腑并调。3.补虚药在治疗中占主导地位,其次是清热药、活血化瘀药,安神药、平肝息风药、利水渗湿药、理气药,这七类药是导师治疗EH的主要药物。4.由聚类药对及聚类方组可知,导师对EH的临证治则以调理肝肾阴阳为主,注重固护后天脾胃运化,益气养血,具体针对“风、热、痰、瘀、郁”等病理因素,灵活加减,辨治用药。
[Abstract]:Objective: to collect and sort out the data of Professor Chen Min's treatment of EH patients, and to analyze the related statistics of prescribing drugs, and to explore and summarize the core drugs, drugs, drug pairs and cluster prescriptions for the treatment of EH. In order to provide theoretical and clinical basis for the treatment of EH in the future, and to provide a new idea for the treatment of this disease, Professor Chen Min's unique law of drug use and experience of differentiation and treatment are summarized. Data and methods: collected from February 2014 to December 2016, The first prescription of traditional Chinese medicine for EH patients in the outpatient department of geriatrics of Liaoning Provincial traditional Chinese Medicine Hospital. The information of name, sex, age, drug use were collected and entered into Excel table, and the frequency of drug use, meridian induction and efficacy classification were calculated. Results the data were transformed into analyzable data and cluster analysis was carried out with statistical software SPSS 22.0. Results: 1.Results: 1.According to the inclusion of cases and exclusion criteria, screening and collection were carried out. A total of #number1# prescriptions were included and 132 drugs were obtained. The total frequency of the use of drugs was 2951 times. The frequency of high frequency drug was 25%, among which the first 13 were core drugs .2.Eighty one of them had the frequency of more than 10 times (including 10 times), accounting for 92.88% of the cumulative frequency, which was the common medicine for the treatment of this disease. The most common medicine was: liver meridian; The more frequently used drugs are spleen Meridian, Kidney Meridian, Heart Meridian, Lung Meridian, stomach Meridian; the lesser ones are: large intestine Meridian, gallbladder Meridian, pericardial Meridian, small intestine Meridian, bladder Meridian, TriJiao Channel. Drugs for activating blood circulation and removing blood stasis, medicine for soothing the mind, medicine for calming the liver and relieving wind, medicine for promoting water and infiltrating dampness, medicine for regulating qi, the total frequency is 2128 times, accounting for 77.64.5.The first 50 high-frequency drugs are analyzed by cluster analysis. 10 common drug pairs and 7 cluster prescription groups were obtained. Conclusion 1. According to the analysis of the treatment of EH, Chen Shi commonly used tonifying drugs to treat this disease, with the drugs of clearing heat, activating blood circulation and removing blood stasis, calming the liver and relieving the wind, promoting water and seepage, regulating qi, and so on. It reflects the characteristics of the special pathogenesis of EH, and takes reinforcing deficiency and strengthening the original as the first, and the medicine characteristic of syndrome differentiation and diarrhea is important. 2. According to the medicine, Chen Shi pays attention to the liver, spleen, kidney, heart, lung, and so on, the medicine of Chen Shi is focused on the liver, spleen, kidney, heart, lung, and so on. Stomach multiple zang-fu organs and regulating .3. tonifying and deficiency drugs play a leading role in the treatment, followed by heat-clearing drugs, blood circulation drugs, tranquilizing drugs, calming the liver and relieving the wind medicine, promoting water and infiltrating dampness medicine, regulating qi medicine, These seven kinds of drugs are the main drugs for the treatment of EH by tutors .4.From the cluster medicine pair and the cluster prescription group, the clinical treatment of EH by the tutor is mainly to regulate the liver and kidney yin and yang, pay attention to protecting the spleen and stomach from the day after the day after, and nourish the blood, and specifically aim at "wind, heat, phlegm, blood stasis," Yu "and other pathological factors, flexible addition and subtraction, differentiation and treatment of medication."
【学位授予单位】：辽宁中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R249;R259

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