基于中医传承辅助系统甘爱萍教授治疗老年功能性便秘药证规律研究

发布时间：2018-05-15 01:38

本文选题：老年功能性便秘 + 名老中医经验　；参考：《湖北中医药大学》2017年硕士论文

【摘要】：目的:中医药学的发展离不开对名老中医的诊疗经验和学术思想进行总结,由于大数据时代的到来,运用数据挖掘的方法对名老中医的临床经验及学术思想进行研究成为当前的热点。数据挖掘是运用计算技术与统计的方法,从大量诊疗数据中提取有用信息,用以揭示名医的组方及用药规律。中医传承辅助平台软件集医案整理、证候及方药统计、组方用药规律分析等强大功能于一身,可实现“数据的录入-管理-查询-分析”的完整的功能。因此开展以中医传承辅助平台软件为手段,对导师甘爱萍教授诊治老年功能性便秘经验进行系统研究,具有十分重要的临床意义。方法:收集湖北省中医院甘爱萍教授门诊老年功能性便秘患者308例,填写患者姓名、性别、年龄、症状、舌苔脉象、证型、处方,填写便秘患者生活质量量表(PAC-QOL)、Wexner便秘评分系统,将患者全部信息录入中医传承辅助平台“临床采集系统”中。通过该软件中的“统计报表系统”中“医案统计”进行“体重统计”、“性别统计”、“症状统计”、“证候统计”、“治则治法统计”、“药物频次统计”、“性味归经统计”、“药物用量统计”;通过“数据分析系统”进行“症状排序”、“症状规律”、“症状聚类”分析;通过“方证分析”进行“网络展示”、“关键药物”、“关键症状”的统计分析。结果:1、症状统计显示,老年功能性便秘出现频率最高的前10位症状依次为:大便干、大便次数少、口干、大便艰难、腹胀、脘痞、呃逆、泛酸、入睡困难、大便量少。2、中医证候统计显示,甘爱萍教授辨证老年功能性便秘的常见证型为:气阴两虚证(126次)、脾气亏虚证(111次)、胃肠热结证(98次)、肝脾不和证(92次)、肠道气滞证(75次)、津亏血少证(73次)、胃热津伤证(64次)。3、治则治法统计显示,甘爱萍教授治疗老年功能性便秘的主要治法为:养阴润燥(112次)、补脾益气(109次)、滋阴清热(98次)、益气养阴(93次)、疏肝理脾(87次)、调气宽肠(66次)。4、药物统计显示,甘爱萍教授治疗老年功能性便秘的主要药物为:生白术、枳实、玉竹、浙贝母、茜草、虎杖、杏仁、蒲公英、郁李仁、生地黄、百合、瓜蒌、石斛、玫瑰花、麦冬、紫苏子、佛手、合欢花、砂仁、玄参。5、药物四气归类显示,甘爱萍教授治疗老年功能性便秘物四气信息依次是:寒性(2555次)、温性(1356次)、平性(533次)、凉性(140次)。6、药物五味归类显示,甘爱萍教授治疗老年功能性便秘五味信息分别是“五味统计”显示药物五味排序依次为:苦味(3234次)、甘味(2737次)、辛味(1098次)、酸味(329次)、咸味(166次)、涩味(38次)。7、药物归经显示,甘爱萍教授治疗功能性消化不良药物归经信息分别是:胃经(2423次)、肺经(2200次)、肝经(1589次)、脾经(1345次)、心经(1165次)、大肠经(1129次)、肾经(918次)、胆经(304次)、小肠经(259次)、膀胱经(10次)。结论:1、甘爱萍教授认为老年功能性便秘病因病机当以气阴两虚为本,内生火热、气机失调是关键。2、甘爱萍教授治疗老年功能性便秘以益气养阴为根本治法,清热存阴、理气通腑也是重要治疗方法。3、甘爱萍教授治疗老年功能性便秘用药特点有治以苦寒,佐以甘温辛,并且善用对药。
[Abstract]:Objective: the development of traditional Chinese medicine can not be separated from the diagnosis and treatment experience and academic thought of famous old Chinese medicine. Due to the arrival of the big data age, the research on the clinical experience and academic thought of the famous old Chinese medicine has become a hot spot. Data mining is a method of computing and statistics, from a large number of diagnosis and treatment. The useful information is extracted from the data to reveal the prescription of the famous doctors and the law of drug use. The software of traditional Chinese Medicine Inheritance assistant platform is set up, the syndromes, the statistics of prescription and medicine, the analysis of the rule of drug use in the group and other powerful functions, and the complete function of "data entry management inquiry analysis" can be realized. Therefore, the auxiliary platform of traditional Chinese medicine is carried out. A systematic study of Professor Gan Aiping's experience in the diagnosis and treatment of functional constipation in the elderly is of great clinical significance. Methods: 308 cases of elderly functional constipation in the outpatient department of Gan Aiping, Hubei Provincial Traditional Chinese Medical Hospital, were collected, and the patient's name, sex, age, symptoms, tongue coating pulse, syndrome type, prescription, and constipation patients were filled in. The quality of life scale (PAC-QOL) and the Wexner constipation scoring system were used to enter the whole information of the patients into the "clinical collection system" of the auxiliary platform of traditional Chinese medicine. The "statistical report system" of the software was used to carry out "weight statistics", "sex statistics", "symptom statistics", "syndrome statistics", "governance rule" "Statistics", "drug frequency statistics", "sex taste after statistics", "drug dosage statistics"; through the "data analysis system" to carry out "symptoms sort", "symptoms law", "symptom clustering" analysis; through the "syndrome analysis" to carry out "network display", "key drugs", "key symptoms" statistical analysis. Results: 1, symptoms Statistics show that the first 10 symptoms of the highest frequency of functional constipation in the elderly are: stool, less stool, dry mouth, difficult stool, abdominal distention, epigastric and epigastric, hiccup, pantothenic acid, difficulty in falling asleep, and less stool.2. The common syndromes of TCM syndrome differentiation are: Qi Yin two deficiency syndrome (126 times), spleen qi syndrome (126 times), temper tantrums Deficiency syndrome (111 times), gastrointestinal heat syndrome (98), liver and spleen disharmony (92 times), intestinal qi stagnation syndrome (75 times), deficiency of Tianjin blood deficiency syndrome (73 times) and stomach heat and Tianjin syndrome (64 times).3, the main treatment method of treating senile functional constipation was: Nourishing Yin and moistening dryness (112), supplementing spleen and replenishing qi (109), nourishing yin and clearing heat (98 times), Yiqi nourishing yin (93 (87 times), liver and spleen (87 times), Qi regulating qi (66 times), statistics show that the main medicine for the treatment of Senile Functional Constipation: Sheng Bai Shu, Fructus aurantii, Fructus aurantii, Fritillaria, Polygonum cuspidatum, almond, dandelion, Yu Li Ren, dandelion, rehmannia, Fructus Trichosanthes, Dendrobium, rose, Ophiopogon, purple sodas, acacia, Amomum,.5. The four gas classification showed that the four Qi information in the treatment of Senile Functional constipation was in turn: cold (2555 times), temperature (1356 times), flatness (533 times), cool sex (140 times).6, five flavors of drugs, and Gan Aiping's five flavor information on Senile Functional constipation were "five statistics", respectively, indicating that the order of five flavours was the order of bitter taste (32). 34 times), sweet (2737), bitter (1098), acid (329 times), saltiness (166 times), astringency (38).7, the drug was treated to the meridian, Gan Aiping was treated for functional dyspepsia, the meridian (2423 times), the lung (2200), the liver (1589 times), the spleen meridian (1345), the meridian (1165), the intestine meridian (1129), the kidney meridian (918 times), the bile meridian (304) 259 times, small intestine meridian (259 times) and bladder meridian (10 times). Conclusion: 1, Professor Gan Aiping believes that the etiology and pathogenesis of functional constipation in the elderly should be based on Qi and yin deficiency, internal heat, Qi machine maladjustment is the key.2, Professor Gan Aiping's treatment of senile functional constipation is the basic treatment of Treating Senile Functional Constipation with Qi and Yin nourishing, clearing heat and preserving Yin, Qi Qi and Fu Fu is also an important treatment method.3, Gan Aiping Professor treatment of Senile Functional Constipation medication characteristics are treated with bitter cold, with Gwen Xin, and good use of drugs.

【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;R256.35

【参考文献】