基于数据挖掘李铁教授治疗血小板减少性紫癜用药经验分析

发布时间：2018-06-17 02:54

本文选题：数据挖掘 + 名老中医经验　；参考：《辽宁中医药大学》2017年硕士论文

【摘要】：目的:采用数据挖掘技术分析李铁教授中医药治疗特发性血小板减少性紫癜(idiopathicthrombocy topenic purpura,ITP)的用药特色,挖掘其临证用药规律及常用药对组合,为中医药治疗血小板减少性紫癜提供新的参考。材料与方法:收集大连市中西医结合医院李铁专家门诊2015年1月6日—2016年7月6日的血小板减少性紫癜的详细资料,对所有的资料进行整理。严格按照纳入标准和排除标准进行筛选,共选取符合标准病例39例,就诊551诊次,中药处方551首。采用回顾性研究,设计实验。用Excel软件对患者性别、年龄、所用中药(药名、功效、归经)、每方的中药味数建立基本数据库,并用Excel统计分析相应的频数、频率。将药物中出现频率30%以上者作为常用药,采用SPSS软件作为数据挖掘库,对常用药物间的关联进行聚类分析。并对结果进行分析讨论。结果:1.选取血小板减少性紫癜患者39例,共就诊551诊次,用方551首。其中男性11人,女性28人,男女比为11:28,平均年龄为46岁。就诊次数在10-20次最多,平均就诊次数为14次。处方药物平均数为16味。2.血小板减少性紫癜的症候按就诊频次由高到低为:血热妄行阴虚火旺气不摄血湿热内蕴瘀血阻滞。3.涉及单味中药157味,取频率大于30%的药物为常用药,筛选出常用中药22味,用量在10-20g的药物居多。4.按功效分类常用中药,其中补益(气、血、阴、阳)类药物使用最频,清热药次之,其余依次为止血药、利水渗湿药、理气药、解表药。5.按经络归属分类可见归经涉及肝经、脾经的药物居多,其余依次为心经、胃经、肺经、肾经、胆经、膀胱经。结论:1.血热妄行、阴虚火旺、气不摄血、湿热内蕴、瘀血阻络是血小板减少性紫癜的基本病机,治以凉血止血、养阴凉血、益气养阴、利湿解毒、散血止血为基本大法,并根据患者的具体情况及季节特色进行加减运用。2.用药以补虚(气、血、阴、阳)、清热类中药为主,符合血小板减少性紫癜相关辨证理论。3.血小板减少性紫癜的治疗中,药对的应用尤为重要,统计李铁教授在治疗本病中的经验药对的使用,对临床用药及随症加减有指导意义。
[Abstract]:Objective: to analyze the characteristics of professor Li Tie in the treatment of idiopathic thrombocytopenic topenic purpura (ITP) by using data mining technique, and to find out the law of clinical application and the combination of common drugs. To provide a new reference for the treatment of thrombocytopenic purpura with traditional Chinese medicine. Materials and methods: the detailed data of thrombocytopenic purpura from January 6, 2015 to July 6, 2016 in Li Tie expert outpatient clinic of Dalian Integrated Chinese and Western Medicine Hospital were collected and all the data were sorted out. According to the criteria of inclusion and exclusion, 39 cases were selected, 551 visits were made and 551 prescriptions of traditional Chinese medicine were selected. A retrospective study was used to design the experiment. The basic database of the patient's sex, age, used Chinese medicine (name of medicine, efficacy, the number of TCM flavor of each prescription) was established by Excel software, and the corresponding frequency and frequency were analyzed by Excel. Using SPSS software as data mining database, the association between common drugs was analyzed by cluster analysis. The results are analyzed and discussed. The result is 1: 1. Thirty-nine patients with thrombocytopenic purpura were selected and 551 visits were made. There were 11 males and 28 females, with a ratio of 11: 28, with an average age of 46 years. The number of visits was the highest in 10-20, and the average number of visits was 14. The average number of prescribed drugs was 16. 2. The symptoms of thrombocytopenic purpura according to the frequency of treatment from high to low: blood fever: Yin deficiency of fire and qi do not absorb blood dampness and heat stagnation blood stasis. 3. In this paper, 157 kinds of Chinese medicine with a frequency of more than 30% were used as common drugs, and 22 kinds of common Chinese medicines were screened out, and the drug dosage of 10 ~ 20 g was the most. 4. According to the efficacy classification of common Chinese medicine, among which tonifying (qi, blood, yin, Yang) drugs are used most frequently, the second is heat-clearing drugs, the rest are hemostatic drugs, water retention and dampness drugs, Qi regulating drugs, antitabular drugs. 5. According to the classification of meridian belonging to the meridian, we can see that the meridian involves the liver, the spleen meridian is the majority, the rest are heart channel, stomach channel, lung channel, kidney channel, gallbladder channel and bladder meridian. Conclusion 1. The basic mechanism of thrombocytopenic purpura is blood stasis, stagnation of collaterals and collaterals is the basic mechanism of thrombocytopenic purpura. The basic method of treatment is to cool blood and stop bleeding, nourish yin and cool blood, nourish qi and nourish yin, promote dampness and detoxify, and disperse blood to stop bleeding. And according to the specific conditions of patients and seasonal characteristics of the use of addition and subtraction. 2. Medication to tonify deficiency (qi, blood, yin, yang, heat-clearing traditional Chinese medicine, in line with thrombocytopenic purpura related syndrome differentiation theory. 3. In the treatment of thrombocytopenic purpura, the application of drug pair is particularly important. It is of guiding significance to use the empirical drug pair of professor Li Tie in the treatment of this disease.
【学位授予单位】：辽宁中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R249;R259

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