基于无监督数据挖掘的功能性便秘证候分布及组方规律研究

发布时间：2018-06-02 01:24

本文选题：功能性便秘 + 临床研究　；参考：《北京中医药大学》2016年博士论文

【摘要】：第一部分：证候分布研究目的：运用流行病学横断面研究方法,并结合文献研究方法,初步探讨功能性便秘的证型分布特点,为临床研究的客观化和规范化提供依据。方法：1文献研究：对期刊数据库进行计算机检索,收集功能性便秘的证候研究文献。对符合纳入标准的文献,采用Excel软件,对中医辨证分型的信息进行采集和分析；2临床研究：通过临床病例资料收集,收集符合罗马Ⅲ标准中功能性便秘的诊断标准者109例,应用多元统计方法进行分析和总结,探讨功能性便秘中医证候分布规律。结果：1 109例患者中热秘证患者最多,占48.62%,其次是气秘证占25.69%,其中女性多于男性,年龄分布以青年组18-35岁年龄组所占比例最大,与饮食习惯有较大关系。从饮食偏嗜分布情况看：辛辣肥甘占绝大多数,嗜食肥甘厚味者占29.36%,喜食辛辣者占23.85%；从职业分布特点看,长期伏案多坐少动的办公室职员发病率较高(34.86%)。2在功能性便秘证候研究的842篇文献中,共筛选出27个证型,其中26个可以分别归结到传统便秘四分型中,湿邪内滞型、瘀血内阻型为新发现证型。结论：1功能性便秘的证型分布特点以热秘证患者最多,气秘证居其次,与性别、年龄、饮食、职业相关。2湿邪内滞型、瘀血内阻型为新发现功能性便秘证型,值得临床关注。第二部分：组方规律研究目的：基于数据挖掘技术并依托中医传承辅助平台,挖掘《中医方剂大辞典》治疗便秘组方规律；通过文献的收集、整理和分析,明确历代治疗便秘的组方变化及继承概况；结合文献研究方法,提示方药剂量规律,初步探讨功能性便秘的组方规律。方法：1文献研究：整理《中医方剂大辞典》收录治疗“便秘”方剂,以中医传承辅助系统为平台,采用软件集成的改进互信息法、复杂系统熵聚类、无监督的熵层次聚类等无监督数据挖掘方法,分析便秘治疗的组方规律。通过文献的收集、整理和分析,梳理历代治疗便秘的组方变化及继承概况；并梳理影响便秘的相关因素及中药的作用机制。结果：1基于对筛选出的478个治疗便秘的方剂进行分析,得到所包含的297种药物及其使用频次。通过聚类分析,得到潜在的新药物组合29个,进一步演化出核心组合16个,并最终聚合成8个候选新方。2通过梳理历代治疗便秘的组方变化及继承规律,并探讨不同年龄、性别用药策略的不同以及结合现代中药药理药效机制研究,充分揭示”大肠主津”深刻内涵和临床指导价值。3基于中医基础理论,结合文献研究方法,较好的阐释了剂量规律的内涵和外延。结论：1通过中医传承辅助系统软件所提取得到的8个组成简练,作用靶向明确,新处方,为临床治疗功能性便秘具有一定的参考价值,为进一步开发便秘治疗新药奠定理论基础。2治疗便秘的核心就是要从“大肠主津”理论出发,针对津液循行过程中的关键环节,有针对性地辨证用药、合理选择药量,有助于提高临床疗效。第三部分：导师学术思想研究目的：利用中医传承辅助平台,挖掘导师治疗功能性便秘组方规律；结合文献研究方法,总结便秘反复的原因及对策；通过临床病例分析,初步总结导师治疗功能性便秘的辨证论治规律。方法：1临床研究：收集导师门诊治疗功能性便秘病例106例,以中医传承辅助系统为平台,采用软件集成的改进互信息法、复杂系统熵聚类、无监督的熵层次聚类等无监督数据挖掘方法,分析治疗便秘的组方规律。2文献研究：通过文献的收集、整理和分析,探讨功能性便秘迁延反复的原因及对策；结合病例研究探究导师辨证论治规律。结果：1通过中医传承辅助系统软件所提取得到的7个新处方,体现了丁老师善用气药组方思路。2湿滞为秘常被临床忽视,湿性黏滞、饮食失控易造成迁延反复,从湿滞论治便秘、限食疗法用于便秘治疗值得重视。结论：1导师治疗功能性便秘重视调畅气机,临床常以香苏散加减,让津液输布,使“肠滑而便易”。2限食疗法是解决便秘的有效方法。
[Abstract]:The first part: the research objective of the syndrome distribution: using the epidemiological cross-sectional study method and combining with the literature research method, we preliminarily discuss the characteristics of the syndrome distribution of functional constipation, and provide the basis for the objectification and standardization of the clinical research. Methods: 1 literature research: the computer retrieval of the journal data base and the collection of functional constipation. To collect and analyze the information of TCM syndrome differentiation, 2 clinical studies: collect 109 cases of functional constipation in Rome III standard through the collection of clinical case data and collect 109 cases of the diagnostic standard of functional constipation in Rome III standard. Results: the TCM syndrome distribution of energy constipation. Results: 1109 cases of patients with heat syndrome were the most, accounting for 48.62%, followed by 25.69% of the gas secretions, among which women were more than men, and the age distribution was the largest in the young group of 18-35 years old, and had a great relationship with the eating habits. 29.36% of the people who eat fat and sweet taste, 23.85% of the hot food, and the high incidence of the office staff in the long-term volt case and less dynamic (34.86%).2 in the 842 literature of the functional constipation syndrome, 26 of which can be attributed to the traditional constipation type four, and the damp evil internal stagnation, Conclusion: the syndrome type of blood stasis is a new type of evidence. Conclusion: the syndrome distribution of 1 functional constipation is characterized by most of the patients with the syndrome of heat constipation, and the gas secreting syndrome is the second, with sex, age, diet and occupation related.2 damp evil internal stagnation, blood stasis type is a newly discovered functional constipation syndrome, which is worthy of clinical attention. The second part: the purpose of the research on the rule of the group: Based on the number of rules According to the mining technology and relying on the auxiliary platform of traditional Chinese medicine inheritance, the law of the prescription of TCM prescription was excavated and the prescription of constipation was treated. Through the collection of documents, collation and analysis, the composition and inheritance of constipation in the past generation were clearly defined, and the prescriptions of prescriptions were suggested in the literature research method, and the prescription rules of functional constipation were preliminarily discussed. 1 literature study: sorting out the prescription of "constipation" in the dictionary of traditional Chinese medicine prescriptions, using the auxiliary system of traditional Chinese medicine as the platform, using the improved mutual information method of software integration, entropy clustering of complex system, unsupervised entropy hierarchical clustering and other unsupervised data mining methods, analyzing the organizing rule of constipation treatment. And analysis, combing the group changes and inheritance of constipation in the past generation, and combing the related factors affecting constipation and the mechanism of traditional Chinese medicine. Results: 1 based on the analysis of the selected 478 prescriptions for constipation, 297 kinds of drugs and their frequency of use were obtained. Through cluster analysis, the potential new drug combination 29 was obtained. In addition, we further evolved 16 core combinations, and finally aggregated into 8 candidate new parties,.2, by combing the group changes and inheritance laws of constipation in the past generation, and exploring different age, gender medication strategies and combining the pharmacological effects mechanism of modern Chinese medicine to reveal the profound connotation and clinical guidance value of the "large intestine". 3 based on the basic theory of traditional Chinese medicine and combined with literature research methods, the connotation and extension of the law of dose are explained well. Conclusion: 1 the 8 components extracted by the traditional Chinese Medicine Inheritance auxiliary system software are concise, the target is clear and the new prescription has a certain reference value for the clinical treatment of functional constipation, and the further development of constipation treatment. The new medicine lays the foundation for the.2 treatment of constipation, which is the core of the treatment of constipation from the "large intestine master and Tianjin" theory, aiming at the key link in the process of the body fluid circulation, with the targeted drug differentiation, the rational selection of the dosage, and the improvement of the clinical efficacy. The third part: the purpose of the study of the academic thought of the tutor: using the auxiliary platform of traditional Chinese medicine to excavate the tutor Treatment of functional constipation prescription rules, combined with literature research methods, summed up the causes of repeated constipation and countermeasures; through the clinical case analysis, preliminary summary of the rule of syndrome differentiation and treatment of functional constipation by tutor. Method: 1 clinical study: collect 106 cases of functional constipation in the tutor outpatient department, and take the auxiliary system of traditional Chinese medicine as the platform Using the improved mutual information method of software integration, entropy clustering of complex system, unsupervised entropy hierarchical clustering and unsupervised data mining methods, this paper analyzes the.2 literature study of constipation in the treatment of constipation: through the collection of literature, collation and analysis, the reasons and Countermeasures of the continuation of functional constipation are discussed, and the case study is used to explore the tutor syndrome differentiation. The rule of treatment. Results: 1 the 7 new prescriptions obtained through the software of the traditional Chinese Medicine Inheritance auxiliary system show the idea that the wet stagnation of.2 is often neglected in clinical practice, wet sticky, the diet is easy to cause the recurrence, the constipation is cured by the wet stagnation theory, and the treatment for constipation is worth paying attention to. Conclusion: 1 tutors are treated. The treatment of functional constipation attaches importance to regulating the Qi and Qi. In the clinic, it is often used to add and subtract the Xiang Su San, so that the body fluid can be transported, so that.2's limited diet therapy is effective for the treatment of constipation.
【学位授予单位】：北京中医药大学
【学位级别】：博士
【学位授予年份】：2016
【分类号】：R256.35

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