数据挖掘严光俊教授运用“治肠六法”治疗“慢性结肠炎”的临床经验

发布时间：2018-05-14 11:14

本文选题：慢性结肠炎 + 治肠六法　；参考：《湖北中医药大学》2017年硕士论文

【摘要】：目的本次临床研究是以中医基础理论为指导,运用“中医医案知识服务与共享系统”对导师严光俊教授治疗慢性结肠炎的临床医案进行病案采集和数据挖掘分析,分析疾病、证型、治法和用药之间的关系,总结和探讨严师应用“三降五法学说”中的“治肠六法”治疗“慢性结肠炎”的临床应用规律,对丰富慢性结肠炎的中医分型、治法及用药具有积极的推动作用。方法收集严光俊教授2015年01月至2017年01月间在荆州市中医医院门诊及住院病房处方诊治的部分慢性结肠炎的病历资料,严格按照纳入与排除标准进行筛选,将符合研究标准的509例医案资料(主要包括患者基本信息、四诊资料、证型、药物)录入“中医医案知识服务与共享系统”并应用系统的数据处理标准化模块对数据进行标准化处理。运用系统设置的关联规则及置信度等数据处理方法,对医案信息进行挖掘处理,分析严光俊教授运用“治肠六法”治疗慢性结肠炎的用药特色,总结其运用规律和经验。结果(1)严师临床运用“治肠六法”治疗慢性结肠炎—便秘频次分别为:理气通降法(26.9%)润肠通降法(24.6%)益气通降法(19.7%)清化通降法(14.2%)清热通降法(7.4%)温阳通降法(7.1%);慢性结肠炎—泄泻频次为:清化通降法(53.5%)益气通降法(31.5%)温阳通降法(15%)。(2)严光俊教授在诊治慢性结肠炎时常用药物有:茯苓、白术、山药、陈皮、香附、当归、白扁豆、紫苏梗、大腹皮、黄连、枳壳、法半夏、柴胡、太子参、桔梗、木香、芡实、豆蔻、玉竹、泽泻、火麻仁、麦冬、川芎、黄芩、补骨脂、苍术、六神曲、薏苡仁、柏子仁、肉桂等。(3)总结出慢性结肠炎归属不同范畴的不同证型中各治法中的用药频率、核心处方、用药特色及药对应用。结论(1)通过不断总结、综合、分析,严师将慢性结肠炎症状特点总结为“结”、“泄”、“坠”、“胀”、“痛”。(2)严师认为胃肠道疾病主在一“通”字,通则结解,通则胀消,通则坠除,通则泄止,通则痛除,以“通”为治肠病的核心。(3)严师在应用“治肠六法”治疗慢性结肠炎时多从中焦脾胃着手,其药精效宏,用药也多中正平和,较少使用孟浪之品,恐攻伐之用坏肠道通降之机。并且临证时也会因时、因地、因人、因病加减用药及剂量,常常以常规剂量取得较好疗效。中医医案知识与服务共享平台对于挖掘中医临床经验、发现隐性规律为临床诊疗疾病提供支撑具有重要意义。
[Abstract]:Objective this clinical study is based on the basic theory of traditional Chinese medicine, using the "knowledge Service and sharing system of TCM Medical record" to collect and analyze the medical records of Professor Yan Guangjun's treatment of chronic colitis, and to analyze the disease. The relationship among syndromes, treatment methods and drug use is summarized and discussed. The clinical application law of "treating intestinal six methods" in "three descending and five legal theories" in Yan Shi's treatment of "chronic colitis" is summarized and discussed, so as to enrich the TCM classification of chronic colitis. Treatment and drug use have a positive role in promoting. Methods from January 2015 to January 2017, Professor Yan Guangjun collected the medical records of some chronic colitis cases that were prescribed in the outpatient and inpatient wards of Jingzhou traditional Chinese Medicine Hospital, and screened them strictly according to the criteria of inclusion and exclusion. The data of 509 medical records (including the basic information of patients, the data of four diagnoses, the types of syndromes), which meet the research criteria, will be collected. Medicine) is entered into the "knowledge Service and sharing system of TCM Medical record" and the data processing standardization module is used to standardize the data processing. By using the data processing methods such as association rules and confidence degree set up by the system, the information of medical records is excavated and processed, and the characteristics of the drug used by Professor Yan Guangjun in the treatment of chronic colitis with "six methods of treating intestines" are analyzed, and the application law and experience are summarized. Results 1) the frequency of treating chronic colitis and constipation by treating chronic colitis with "six methods of treating intestines" by strict teachers were as follows: regulating qi and clearing up and lowering methods: 26.9) moistening the intestines and clearing up and descending methods (24.6cm) supplementing qi and clearing up and descending methods (19.775) clearing away heat and clearing up and lowering methods (7.4) warming Yang and lowering methods (7.1m); The frequency of enteritis and diarrhea is as follows: Qinghua Tongshang (53.5) Yiqi and descending (31.5) warming Yang and decreasing (15).) Professor Yan Guangjun's commonly used drugs in the diagnosis and treatment of chronic colitis are: Poria cocos. Atractylodes macrocephala, yam, pericarp, angelica sinensis, white lentils, perilla pedicel, abdominal skin, Coptis chinensis, Fructus Aurantii, Radix Pinelliae, Radix Bupleurum, Radix Pseudostellariae, Platycodon grandiflorum, Radix Euryale, Cardamom Cardamom, Phyllostachys edulis, Rhizoma Alismatis, Magnoliae, Rhizoma Ophiopogonis, Rhizoma Chuanxiong, Scutellaria Fructus psoralen, Atractylodes, Liu-Shen qu, Coix seed, Burberry seed, Cinnamon, etc.) summarized the frequency, the core prescription, the characteristics and the application of drugs in different syndromes of chronic colitis. Conclusion 1) through continuous summing up, synthesizing and analyzing, Yan Shi summed up the symptoms of chronic colitis as "knot", "catharsis", "fall", "distension", "pain". The general principles of expansion and elimination, the general rule of falling, the general principle of relief, the general principle of pain, "Tong" as the core of the treatment of bowel disease. 3) Yan Shi in the application of "treatment of the intestinal six methods" treatment of chronic colitis from the spleen and stomach, its drug essence effect is great, medication is also more moderate and peaceful, Less use of Menglang products, fear of cutting with bad intestinal access to the opportunity. And clinical symptoms will also be due to, because of, because of people, because of diseases, drugs and dosage, often with conventional dose to obtain better curative effect. The knowledge and service sharing platform of TCM medical records is of great significance to excavate the clinical experience of TCM and find the hidden law to provide support for clinical diagnosis and treatment of diseases.
【学位授予单位】：湖北中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R249;R259

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