基于数据挖掘技术的朱佳教授从“风痰”论治咳嗽变异性哮喘的医案研究

发布时间：2018-05-11 22:04

本文选题：咳嗽变异性哮喘 + 风痰　；参考：《南京中医药大学》2017年硕士论文

【摘要】：目的:以朱佳教授多年来治疗咳嗽变异性哮喘的临床实践为基础,以数据挖掘技术为手段,重点探讨朱佳教授辨治咳嗽变异性哮喘的临证经验及学术思想,同时为咳嗽变异性哮喘的中医诊疗提供新的思路与方法。方法:收集并整理朱佳教授2014年10月～2016年12月共116例、224诊次咳嗽变异性哮喘病例,建立数据库,通过数据挖掘技术(如频数、关联及聚类分析等方法)对符合纳入标准的医案信息进行数据的挖掘处理和逻辑分析。根据统计分析结果,从症状、舌苔、脉象、病机以及具体方药等角度,多方面对数据的结果进行分析、归纳和总结。结果:224诊次中女性患者82例159诊次,男性患者34例65诊次,平均年龄44.50岁。出现频率较高的症状有咳嗽、夜间咳甚、昼夜均咳、痰白、咽喉痒则咳、痰少、阵咳,在所有诊次中分别占 87.50%、38.84%、37.95%、36.61%、36.61%、26.34%、24.55%。病机主要是风痰阻肺证,在所有诊次中占69.20%。病理因素方面,痰的频率最高,为89.73%,其次为风、虚、热,其频率依次为80.36%、37.95%、14.29%。朱佳教授治疗咳嗽变异性哮喘用药广泛,共涉及中药171味,高频药物主要有12种,分别为:炙麻黄、射干、苦杏仁、紫菀、蝉蜕、地龙、紫苏子、炙甘草、陈皮、防风、荆芥、紫苏叶,在所有诊次中分别占 85.27%、83.04%、74.55%、74.11%、72.32%、64.73%、62.95%、62.95%、54.91%、54.46%、49.55%、44.64%。结论:通过研究发现,病机方面:风痰阻肺证为朱老师辨治咳嗽变异性哮喘的基础病机。病理因素方面:主要为风、痰、虚、热,其中风与痰贯穿本病始末,亦为始动病理因素。治疗上朱老师辨病与辨证相结合,尤为重视"风邪"在本病中的作用,祛风同时不忘理痰,病久则不忘顾护正气。结合现代统计方法,挖掘出1组核心处方、4组常用药对。
[Abstract]:Objective: based on the clinical practice of Professor Zhu Jia in treating cough variant asthma for many years, and with data mining technology as the means, the clinical experience and academic thought of professor Zhu Jia in treating cough variant asthma were discussed. At the same time, it provides new ideas and methods for TCM diagnosis and treatment of cough variant asthma. Methods: from October 2014 to December 2016, 116 cases of cough variant asthma were collected and sorted out by Professor Zhu Jia, and a database was established. The data mining and logical analysis of the medical case information in accordance with the inclusion criteria are carried out by the methods of association and cluster analysis. According to the results of statistical analysis, the results of data are analyzed, summarized and summarized from the aspects of symptoms, tongue coating, pulse, pathogenesis and specific prescriptions. Results 82 female patients (159 visits) and 34 male patients 65 visits (mean age 44.50 years). The symptoms with higher frequency included cough, severe cough at night, both day and night cough, white phlegm, cough with itching throat, less phlegm and cough, which accounted for 87.50% of the total number of diagnoses. The main pathogenesis is wind-phlegm obstruction of lung syndrome, 69.20 in all visits. The frequency of phlegm was the highest (89.73), followed by wind, deficiency and heat. The frequency of phlegm was 80.36, 37.95 and 14.29 respectively. Professor Zhu Jia has used a wide range of drugs to treat cough variant asthma, involving 171 kinds of Chinese medicine. There are 12 kinds of high-frequency drugs, namely: grilled ephedra, shoot dry, bitter almond, Aster, cicada slough, Dilong, purple perilla, grilled licorice, old peel, Fangfeng, thornmustard, etc. The perilla leaves, which account for 85.27% of the total number of visits, are 83.04 and 74.55, and they are 74.11, 72.32, 64.73, 62.95, 62.95, 54.46, 49.5545 and 44.64, respectively, in the area of 62.95, 54.91, 54.46 and 44.64. Conclusion: it is found that the syndrome of wind and phlegm blocking lung is the basic pathogenesis of cough variant asthma. Pathological factors: wind, phlegm, asthenia, heat, wind and phlegm through the beginning and end of the disease, but also for the initial pathological factors. On the treatment, teacher Zhu combined disease differentiation with syndrome differentiation, especially attached importance to the role of "wind evil" in this disease, dispelling wind and not forgetting to manage phlegm, and not forgetting to protect qi for a long time. Combined with modern statistical methods, the core prescriptions of 1 group and 4 groups of common drug pairs were excavated.
【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;R256.12

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