基于数据挖掘技术的血府逐瘀汤医案证治规律研究

发布时间：2018-04-28 11:18

本文选题：气滞血瘀证 + 血府逐瘀汤　；参考：《南京中医药大学》2017年硕士论文

【摘要】：研究目的:运用数据挖掘技术,梳理和归纳与气滞血瘀证相关的血府逐瘀汤在临床各类疾病中的研究现状、疾病特征及核心指征,并明确血府逐瘀汤适用人群的流行特点、发病规律、应用范围和诊疗思路,以便更加准确的运用血府逐瘀汤对临床各类疾病进行诊断与辨证,更好的服务于临床与患者,并可从一定程度上反应气滞血瘀证的疾病特点。研究方法:本研究对气滞血瘀证的理论及血府逐瘀汤的运用进行整理和分析,并通过搜集2006年1月—2015年12月期间运用血府逐瘀汤加减治疗疾病的临床文献,筛选出430例符合要求的有效验案来加以整理归纳,设计Excel表格,建立数据库,将入选患者的性别、年龄、发病季节、症状、疾病分类、舌诊、脉诊、病程、加减用药、病因、中医病名、西医病名、情绪状况等资料规范化后纳入数据库,运用数据挖掘技术进行分析,其中包括频数频率统计分析、系统聚类分析、关联规则分析等,并对挖掘的结果进行分析归纳、探讨总结。研究结果:在430例医案患者中,男女患病比例为1:1.31;发病年龄中18～65岁的青中年人群占89.25%;一年四季发病较均匀,但以春季略多,占36.08%;病程在3个月以上的占65.33%;情绪不畅占发病诱因的51.74%,劳累过度、受凉或外感风寒、外伤等为其常见病因;血府逐瘀汤患者多见于神经精神疾病(25.35%)、心血管疾病(12.79%)、妇科疾病(12.56%)。在出现频率大于5%的各类血府逐瘀汤疾病中,心血管疾病症状中心胸憋闷、心前区疼痛、心慌心悸聚为一类,出现频率最高;神经精神疾病症状中失眠、烦躁或忧郁、头痛聚为一类,出现频率最高;妇科疾病症状中经色暗、经血夹块、痛经、月经量少聚为一类,出现频率最高;皮肤科疾病症状中皮肤瘙痒、红色皮疹或风团聚为一类,出现频率最高;外科疾病是以身体各部位外伤疼痛为主,如腰部疼痛(19.33%)、胸痛(19.33%)、头痛(11.54%)、胁肋胀痛(19.33%)、局部损伤疼痛(30.77%);内分泌与代谢疾病症状中功能性发热、多汗分别各聚为一类,出现频率最高;消化系统疾病症状中腹胀、腹痛、食欲不振聚为一类,出现频率最高;五官科疾病的症状出现的频次频率相近,聚类分析图表各项指标较为独立,故无明显聚类意义。在430例患者的关联舌象中,苔薄白与质暗红最为常见,且苔薄白最易伴有质暗红;关联脉象中,以弦细脉与细涩脉最为常见,及细脉最易相伴弦脉与涩脉;关联舌脉中,质暗红与弦脉、涩脉与质暗红最为常见,及质暗红最易伴有弦脉、涩脉最易伴有质暗红;关联临床症状中,失眠与烦躁最为常见,且失眠最易伴有烦躁。加减用药除用以增强活血行气的功效外,亦多辅以补益气血之品,如黄芪、熟地黄、白芍等。研究结论:该数据挖掘分析结果基本反映了与气滞血瘀证相关的血府逐瘀汤在临床各类疾病中的研究现状、疾病特征及核心指征。
[Abstract]:Objective: to use data mining technology to sort out and sum up the research status, disease characteristics and core indications of Xuefu Zhuyu decoction related to Qi stagnation and Blood stasis Syndrome in clinical diseases, and to clarify the epidemic characteristics of Xuefu Zhuyu decoction for population. In order to use Xuefu Zhuyu decoction more accurately to diagnose and differentiate all kinds of clinical diseases, to better serve the clinical and patient, and to reflect the disease characteristics of qi stagnation and blood stasis syndrome to a certain extent. Methods: this study collated and analyzed the theory of Qi stagnation and blood stasis syndrome and the application of Xuefu Zhuyu decoction, and collected the clinical documents of treating diseases with Xuefu Zhuyu decoction from January 2006 to December 2015. We selected 430valid cases to sort out and sum them up, designed Excel forms, set up a database, selected patients' sex, age, onset season, symptoms, disease classification, tongue examination, pulse examination, course of disease, addition and subtraction medication, etiology. The data of TCM disease name, western medicine disease name, emotional condition and so on have been standardized into the database and analyzed by using data mining technology, including frequency frequency statistical analysis, systematic cluster analysis, association rule analysis, etc. The results of mining are analyzed and summarized. Results: among 430 patients with medical records, the ratio of male to female was 1: 1.31; the proportion of young and middle-aged people aged 18 to 65 was 89.25; the incidence of the disease was more uniform in the seasons of the year, but it was slightly more in spring. 36.08; the disease course was more than 3 months accounted for 65.33; emotional retardation accounted for 51.74 of the inducement, overwork, cold or external cold, trauma and other common causes; Xuefu Zhuyu decoction patients were found in neuropsychiatric diseases, cardiovascular diseases, 12.79 points, gynecological diseases 12.5656. Among the various kinds of Xuefu Zhuyu decoction with frequency of more than 5%, cardiovascular disease symptoms include chest choking, pain in the precardiac area, palpitations and palpitation, and the highest frequency of occurrence; insomnia, irritability or depression in the symptoms of neuropsychiatric diseases, Headache is one of the most frequent; symptoms of gynecological diseases are dark in color, blood clip, dysmenorrhea, menstrual volume is less, the frequency of occurrence is the highest; skin itching in skin disease symptoms, red rash or wind reunion as a class, Most frequently; surgical diseases are mainly traumatic pain in various parts of the body, such as pain in the waist (19.33), chest pain (19.33), headache (11.54), flank pain (19.33), local injury (30.77); functional fever, hyperhidrosis, and hyperhidrosis in endocrine and metabolic diseases. The symptoms of digestive system diseases include abdominal distension, abdominal pain, loss of appetite, the frequency of occurrence is the highest, the frequency of symptoms of five functional diseases is similar, the cluster analysis chart each index is independent, Therefore, there is no obvious clustering significance. In 430 cases of associated tongue images, thin white fur and dark red fur are the most common, and white fur is most likely to be accompanied by dark red. In the associated pulse, string vein and thin vein are the most common, and thin vein is the most easily associated with string and astringent vein; in the associated tongue vein, the most common is the string vein and the fine vein, and in the associated tongue vein, the most common is the chord vein and the astringent vein. Qualitative dark red and string vein, astringent vein and quality dark red are the most common, and quality dark red is the most easily accompanied by string pulse, astringent vein is most easily accompanied with quality dark red; among the related clinical symptoms, insomnia and irritability are the most common, and insomnia is most likely to be accompanied with irritability. In addition to the use of drugs to enhance the effectiveness of blood circulation, but also supplemented with the quality of qi and blood, such as astragalus, Rehmannia glutinosa, Radix Paeoniae Alba and so on. Conclusion: the data mining results basically reflect the research status, disease characteristics and core indications of Xuefu Zhuyu decoction related to qi stagnation and blood stasis syndrome in clinical diseases.
【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;R289.5

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