基于数据挖掘的张鸣鹤教授辨治类风湿关节炎经验探讨

发布时间：2018-06-24 02:54

本文选题：张鸣鹤 + 类风湿关节炎　；参考：《山东中医药大学》2016年硕士论文

【摘要】：目的:采用数据挖据方法,统计分析张鸣鹤教授诊治的类风湿关节患者的病历、医案,结合实际临床,阐明其辨治思路、遣方用药规律,总结临证经验,以促其学术思想的更好传承。方法:通过收集、整理门诊病历及医案样本,提取并预处理其中相关诊疗信息,如症状、中药处方等,以“中医传承辅助系统V2.5”为工具,建立数据库,使用系统所集成的频数分析、Apriori规则算法、无监督熵层次聚类法、复杂系统熵聚类法等数据挖掘方法,对部分临床症状、体征及治疗类风湿关节炎的处方进行分析,并参照对张教授的实际问访内容作综合探讨。结果:频数统计结果显示,211例患者的症状、体征以关节疼痛、关节肿胀最为普遍,分别占到95.26%,70.14%;266个处方共涵盖98味中药,分属于14个药物类别,常用的药味有大血藤、羌活、金银花、独活、虎杖、雷公藤、川牛膝、猪苓等,最主要的药用类别涉及清热药、祛风除湿药、利水渗湿药、活血化瘀药。经关联分析得出了处方中核心药物彼此间的配伍规律及主方整体组配模式。经熵聚类的组方规律分析挖掘出16个潜在药物组合,演化成8个新处方。结论:热毒与湿邪是RA最重要的病理因素,本病的核心病机是湿热毒阻痹经络;张教授将清热解毒、祛湿通络作为基本治法,组方是以清热解毒祛湿为原则,同时又辨证权衡药味加减、辨位引经用药,体现出“病证结合”的辨治思维;针对某些特殊病机、临床表现或是兼证的加减配伍,是对基本治法和组方的丰富与拓展,体现出其遣方用药的灵活性。
[Abstract]:Objective: to analyze the medical records and medical records of rheumatoid joints diagnosed and treated by Professor Zhang Minghe by using the method of data digging, to clarify the thinking of differentiation and treatment, to summarize the clinical experience, and to summarize the clinical experience. In order to promote the better transmission of his academic ideas. Methods: through collecting and sorting out outpatient medical records and medical records samples, extracting and pretreating the related diagnosis and treatment information, such as symptoms, prescription of traditional Chinese medicine and so on, the database was established with the aid system of traditional Chinese Medicine (TCM), V2.5. Some clinical symptoms, signs and prescriptions for treating rheumatoid arthritis were analyzed by using some data mining methods, such as Apriori rule algorithm, unsupervised entropy hierarchical clustering method and complex system entropy clustering method. And with reference to Professor Zhang's actual interview content for a comprehensive discussion. Results: the results of frequency statistics showed that the symptoms and signs of 211 patients were joint pain and joint swelling, which accounted for 95.260.14.The 266 prescriptions covered 98 kinds of traditional Chinese medicine, belonging to 14 kinds of drugs, the commonly used drugs were Dipterygium sinensis, Notopterygium Notopterygii. Honeysuckle, Duhuo, Polygonum cuspidatum, Tripterygium wilfordii, Achyranthes bidentata, Polyporus umbellata, etc. Based on the correlation analysis, the compatibility of the core drugs in the prescription and the overall combination pattern of the principal prescription were obtained. According to the rule of entropy clustering, 16 potential drug combinations were found and evolved into 8 new prescriptions. Conclusion: heat toxin and dampness evil are the most important pathological factors in RA, the core pathogenesis of this disease is damp-heat and toxin blocking and blocking meridian, Professor Zhang takes clearing heat and detoxifying toxin, dispelling dampness and dredging collaterals as the basic treatment method, and the composition prescription is based on the principle of clearing heat and detoxicating toxin and removing dampness. At the same time, the combination of disease and syndromes is reflected in the thinking of differentiation and treatment, and the combination of the clinical manifestations and the combination of symptoms and signs is the enrichment and expansion of the basic treatment method and the prescription. It reflects the flexibility of its prescriptions.
【学位授予单位】：山东中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R249;R259

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