基于数据挖掘的黄疸病医案“证-治-效”规律研究

发布时间：2018-06-28 05:00

本文选题：黄疸 + 回顾性研究　；参考：《湖北中医药大学》2017年硕士论文

【摘要】：研究目的本研究利用湖北省中医院的既往黄疸病人的住院医案数据,对回顾性医案研究的方法进行探索;挖掘治疗黄疸的核心处方、常用药物及配伍规律,开展中医治疗黄疸病的证-治-效规律研究。为中医药对黄疸的临床诊治和研究提供思路和依据。研究方法从已经扫描成图像格式的回顾性病历中,将1960-1978年间中医诊断为黄疸的病历筛出,所纳入病历须以中医药治疗为主并具备相对完整的诊疗记录,包括:入院记录、病程记录、中药处方信息、检查信息等。排除中医诊疗信息不完整、无中药治疗及死亡的病历。对符合纳入标准的病历使用电子病历系统建立数据库。对症状、体征、检验、检查、医嘱等信息进行规范化、结构化录入,经数据预处理后,利用聚类分析、复杂网络等多种数据挖掘方法及数据统计方法,挖掘分析黄疸病的证候特征、核心方药、疗效特点等。研究结果1资料情况描述性分析1.1一般资料的分析本研究最终纳入的1960-1978年间的中医诊断为黄疸的病历有520例,其中1961-1969年共278例,1970-1978年共242例;其中男性患者389例,占74.81%。女性患者131例,占25.19%,男性占多数;其中年龄最小13岁,年龄最大78岁,年龄主要集中在20-40岁之间,以青、中年为主;计算患者的住院时间,其中住院时间最短者7天,住院时间最长者235天,住院时间主要集中在15-50天。1.2诊断特征情况本研究纳入病历的中医疾病诊断全部为黄疸,其中入院时诊断为发热、感冒、积聚、外感热病者有7例;证候诊断中主要为阳黄(516例),阴黄较少(4例);西医诊断中数量最多的是急性黄疸型肝炎(409例),然后依次为黄疸型肝炎(75例)、早期肝硬化(16例)、急性黄疸型传染性肝炎(14例)、慢性肝炎(13例)等。可以看出本研究纳入的黄疸为肝源性黄疸,其中主要为急性黄疸型肝炎为代表的急性肝炎为主。但也包含了67例慢性肝病,如血吸虫病、慢性肝炎、肝硬化等。1.3既往疾病分析在纳入的黄疸病历中,既往有肝病病史者123例,既往有其他病史者7例。1.4药物一般情况分析针对520例黄疸病人使用的中药共有327种,选取频次排序的前30味中药依次为:茵陈(2485)、茯苓(2157)、郁金(1552)、姜栀子(1398)、陈皮(1327)、白芍(1169)、炒麦芽(932)、当归(911)、炒谷芽(908)、丹参(902)、泽泻(853)、姜厚朴(766)、炒白术(765)、醋香附(751)、炒神曲(735)、甘草(646)、薏苡仁(611)、生大黄(602)、败酱草(583)、车前草(574)、车前子(482)、北柴胡(473)、黄芩(473)、滑石粉(446)、黄柏(446)、白茅根(420)、板蓝根(410)、法半夏(391)、炒枳实(389)、醋青皮(380)。共有中药大类19类,其中利水渗湿药、清热药、补虚药使用频次位列前三,使用频次较高的为:理气药、活血化瘀药、消食药等,三者使用频次相近;然后其他类药物为:化痰药、止血药、化湿药、解表药、安神药、泻下药、平肝熄风药、祛风湿药、开窍药、收涩药、温里药;驱虫药、攻毒杀虫止痒药使用最少。药物归经频次最高依次为脾经、肝经、肺经、胃经及胆经。此阶段的处方药味数量集中在10-12味之间,处方较为精简。中药使用的剂量基本上符合国家规定的安全使用范围,大多数的药物剂量使用较稳定。2临床特征分析2.1总体症状分布共出现症状121种,以全身症状及消化道症状为主,常见全身症状有:乏力(2795)、小便黄赤(2756)、身目俱黄(1849)、胁痛(1143)、不寐(780)、头昏(361)、黄色鲜明(340)、口苦(210)、胸闷(178)、发热(154)、皮肤瘙痒(139)、下肢浮肿(34)、浮肿(33)、盗汗(33)、咳嗽(33)、头痛(32)、其他症状(90)等;消化道症状有食欲不振(2364)、腹胀(1874)、恶心(704)、便溏(635)、口干渴(349)、厌油(289)、呕吐(278)、便秘(239)、大便干结(230)、腹痛(149)等。基本符合肝性黄疸的症状分布。2.2舌、脉象分布舌质以舌红(3359)、舌淡红(712)为主;苔质以苔薄(2647)、苔腻(467)、苔厚(120)、苔厚腻(113)为主;苔色以苔白(2583)、苔黄(1398)、苔微黄(42)为主。提示本病以湿证、热证为主。含有脉象14种,脉象主要为脉弦(349)、脉缓(741)、脉细(433)、脉数(205)、脉滑(161)、脉沉(46)等。2.3人群划分根据社团划分出5类人群,各模块包含病人数依次为255、142、91、27、5例。根据卡方检验,对每组症状体征进行对比,发现第一类人群热象较为明显,第二类人群热象较轻,第三类人群考虑为胆腑郁热证,第四类人群介于阳黄与阴黄之间,第五类人群寒湿较重,考虑为阴黄。(1)第一类人群特异性症状体征有:苔黄、苔薄、口干渴、苔腻、口苦、脉数、发热、渴不欲饮、口渴喜饮、苔厚腻、恶寒、脉细、心烦、咳嗽、咽干等。表现俱有湿热之象,但以热象表现为重。核心方的组成是:茵陈、茯苓、栀子、郁金、陈皮、白芍、泽泻、丹参、当归、麸炒白术、炒麦芽、炒谷芽。(2)第二类人群特异性症状体征有:舌红、苔白、黄色鲜明、淡黄、苔厚腻、苔微黄、苔薄、不寐、苔腻、大便干结、口干渴、口苦、脉数、脉缓、浮肿、萎黄、渴不欲饮、渴喜冷饮、口渴喜饮、舌淡红、恶寒等。可看出该类病人表现均有湿热之象,但热象较轻,以湿为主。核心方的组成是:茵陈、茯苓、炒白术、郁金、白芍、泽泻、栀子、陈皮、炒谷芽、炒麦芽。(3)第三类人群特异性症状体征有:苔白、舌红、黄色鲜明、口干渴、胁痛、脉缓、大便干结、口苦、胸闷、头昏、渴喜冷饮、渴不欲饮、精神萎靡、大便时干时稀、脉数、苔厚腻、形体消瘦、舌淡红、不寐、苔少、小便黄、胃脘痞闷、腰酸、苔微黄、视物不清、齿衄、目胀、口甜等。可以看出该类病人郁热之象较为明显,胁痛、胸闷症状明显,为考虑为胆腑郁热证。核心方的组成是茵陈、茯苓、郁金、栀子、白芍、丹参、陈皮、炒谷芽、炒麦芽、炒神曲、当归等。(4)第四类人群特异性症状体征有:舌淡红、苔白、脉细、不寐、精神萎靡、下肢浮肿、脉弱、淡黄、刺痛、尿频、下肢酸痛、下肢疼痛、心悸、自汗、尿痛等。可以看出该类病人不能分辨出属于阳黄与阴黄,介于阴阳黄之间。核心方的组成是茯苓、茵陈、郁金、陈皮、丹参、白芍、栀子、当归、炒谷芽、炒麦芽、炒神曲。(5)第五类人群包含病人最少,只有5例,由于包含的症状较少,故将其全部症状体征列出。其包含厌油、苔白、精神萎靡、黄色晦暗、头昏、苔黄、苔厚、苔薄、舌嫩、舌红、大便干结、便溏、胸闷、畏寒、舌淡红、皮肤瘙痒、面色无华、脉迟等症状体征,明显表现出阴黄症状。核心方组成为茵陈、茯苓、厚朴、苍术、豆蔻、栀子、郁金、陈皮、滑石、炒谷芽、炒麦芽、丹参。2.4疗效分析2.4.1中医药对黄疸病症状体征的影响选取病历首次病程、中间病程、末次病程的阳性症状体征数据,通过对各病程阳性症状体征数量、频次、频率的对比,发现在中间、末次病程中也出现明显地递减,并且在住院期间较少出现入院时未出现的症状、体征,也从侧面反映大部分黄疸经中医药治疗,病情得到有效地控制。2.4.2基于肝功能指标的疗效分析利用统计学方法对病人治疗前后的黄疸指数、胆红质及谷丙转氨酶的对比。得出P值明显小于0.00,具有显著统计学意义。黄疸病人在经过系统中医药治疗后生化指标得到明显改善,证明中医药在降酶、退黄中有较好的疗效。3基于有效病历的核心方提取我们将黄疸指数的下降作为有效病历判定的标准。最后纳入有效病历479例,对应的中药方有3086个。我们基于有效病历的方药信息进行了社团划分,得出有意义的10大类,各类包含的方剂数量依次为:684、607、579、386、276、174、120、38、30、24个。我们利用多层复杂网络分别提取了各类方剂模块的核心药物组成。(1)模块1的核心药物为:茵陈、茯苓、泽泻、栀子、车前子、陈皮、郁金、炒白术、大黄、猪苓、厚朴、板蓝根。为茵陈蒿合四苓散加减。(2)模块2核心方的药物组成:茵陈、郁金、白芍、败酱草、茯苓、丹参、陈皮、香附、当归、薏苡仁、栀子、车前草、板蓝根、龙胆。(3)模块3核心药物为:当归、丹参、郁金、茯苓、茵陈、青皮、柴胡、陈皮、白芍、炒白术、炒谷芽、炒麦芽、栀子。(4)模块4核心药物组成:茵陈、茯苓、泽泻、炒麦芽、炒谷芽、栀子、郁金、炒神曲。(5)模块5核心药物组成:茵陈、茯苓、炒神曲、厚朴、滑石粉、陈皮、法半夏、甘草。(6)模块6核心药物组成:大黄、芒硝、栀子、黄柏、枳实、厚朴、茵陈。(7)模块7核心药物组成:茯苓、白芍、牡丹皮、党参、甘草、郁金、黄芩。(8)模块8核心药物组成:青蒿、龙胆、大黄、炒麦芽、炒谷芽等。(9)模块9核心药物组成:海金沙藤、车前草、青蒿、金钱草、金银花、红糖。(10)模块10核心药物组成:车前草、茵陈、赤茯苓、鸡内金、栀子、芦根、神曲、枳壳。结论通过数据分析的方法对回顾性住院病历研究做了有益探索,为我院继续开展回顾性研究积累了经验。通过利用数据挖掘方法,分析了黄疸病的5类人群,各类人群的特异性症状、体征及核心方药。并从症状体征的变化、生化指标的改善的角度对黄疸病历做了疗效分析。基于有效病历进行方剂的社团划分,提取出10类常用核心方。通过对我院19年间治疗黄疸病的“证-治-效”规律研究,可以看出此一时期虽然处于学术研究的低谷期,但在治疗黄疸中仍体现了比较高的诊疗水平。该时期治疗黄疸病的学术思想是清热与利湿兼顾,不忘活血与解毒,重视理脾和调肝,扶正与祛邪共施。常用茵陈五苓散、茵陈蒿汤、栀子柏皮汤、大承气汤等经方及其他时方治黄,沿袭晚清至民国时期重视从血分、肝胆脾入手诊治黄疸的思想,并且与现代名老中医治疗黄疸的理论相似,说明此一时期我院治疗黄疸病的经验已经比较成熟和全面。本研究所得出的结果也可为临床治疗黄疸疾病提供一些思路。
[Abstract]:The purpose of the study was to explore the methods of the retrospective medical case study by using the data of hospitalized medical cases of patients with previous jaundice in Hubei Provincial Traditional Chinese Medical Hospital, to excavate the core prescriptions of jaundice, the commonly used drugs and compatibility rules, to carry out the TCM treatment of jaundice, and to study the clinical diagnosis and treatment and research of jaundice. For the retrospective medical records, which have been scanned into image format, the Chinese medicine has been diagnosed as the medical record of jaundice in 1960-1978 years. The medical records must be mainly treated with traditional Chinese medicine and have a relatively complete record of diagnosis and treatment, including admission records, medical records, prescription information of traditional Chinese medicine, inspection information and so on. The information of diagnosis and treatment is incomplete, there is no medical history of traditional Chinese medicine and death. The database is set up for the use of electronic medical records system which meets the standard of medical records. The information of symptoms, signs, inspection, inspection, medical orders and other information are normalized, structured and recorded, and after data preprocessing, data mining methods and data statistics such as cluster analysis, complex network and so on are used. Methods, the characteristics of the syndrome of jaundice, the core prescriptions and the characteristics of the curative effect were analyzed. Results 1 descriptive analysis of the results of the research results, 1.1 general data of the data were analyzed in the last 1960-1978 years of the study. There were 520 cases of jaundice diagnosed in 1960-1978 years, of which 278 cases were 1961-1969 years, and 1970-1978 years were 242 cases, and the male patients were 389, and 74 .81%. women were 131 cases, accounting for 25.19%, and male accounted for the majority. The age was 13 years old and the oldest was 78 years old. The age was mainly between the age of 20-40 and the middle age. The time of hospitalization was calculated, the shortest hospitalization time was 7 days, the longest hospitalization time was 235 days, and the hospitalization time was mainly concentrated in the diagnosis of the.1.2 diagnosis of 15-50 days. The diagnosis of TCM diseases included in the medical record was jaundice, of which 7 cases were diagnosed as fever, cold, accumulation, and exogenous fever. The diagnosis was mainly Yang Huang (516 cases), less Yin Yellow (4 cases); the most of the western medicine diagnosis was acute jaundice hepatitis (409 cases), and then the jaundice hepatitis (75 cases) and the early cirrhosis (16 Cases of acute jaundice type infectious hepatitis (14 cases), chronic hepatitis (13 cases) and so on. It can be seen that the jaundice in this study is hepatoteric jaundice, mainly for acute jaundice hepatitis as the representative of acute hepatitis, but also contains 67 cases of chronic liver disease, such as schistosomiasis, chronic hepatitis, cirrhosis and other.1.3 disease analysis in the yellow into the yellow. In the history of jaundice, 123 cases of previous history of liver disease, 7 cases of previous history of.1.4 medicine general analysis for 520 cases of jaundice used in the total of 327 kinds of Chinese medicine, the first 30 traditional Chinese medicine in order to select the frequency sequence are: Yin Chen (2485), Poria (2157), tulip (1552), ginger Gardenia (1398), orange peel (1327), Radix Paeoniae (1169), stir fried malt (932), angelica) (911) fry Valley buds (908), Salvia miltiorrhiza (902), Alisma orientalis (853), Jiang Houpu (766), stir fry Atractylodes (765), vinegar (735), licorice (646), coix seed (611), raw rhubarb (602), Plantago (583), Plantago (583), Plantago (574), Radix bupleurum, Radix Scutellariae, cypress, Radix Isatidis, Radix Isatidis, fry trifoliate Real (389), vinegar green (380). There are 19 categories of Chinese traditional medicine, among which water leudiation and humidifying drugs, antipyretic drugs and deficiency drugs are used in the first three, the use frequency is high: Qi medicine, blood circulation removing stasis medicine, digestion medicine and so on, the three use frequency similar; then the other drugs are phlegm medicine, hemostat, humidifying medicine, antipyretic drug, diarrhea medicine, leveling liver extinguishing. The dosage of wind medicine, dispelling wind and wetting medicine, taking astringent medicine, warming Li medicine, deworming medicine, attacking poison and killing antipruritic medicine are the least. The highest frequency of drug return is the spleen meridian, liver meridian, lung meridian, stomach meridian and bile meridian. The prescription of prescription is concentrated between 10-12 flavors at this stage, the prescription is more concise. The dosage of traditional Chinese medicine is basically in conformity with the safety regulations stipulated by the state. Using the range, most of the drug dose used more stable.2 clinical features analysis of 2.1 general symptoms of the total symptoms of 121 symptoms, mainly systemic symptoms and digestive tract symptoms, common systemic symptoms are: fatigue (2795), urinating yellow (2756), body yellow (1849), hypochondriac pain (1143), insomnia (780), dizziness (361), yellow (340), oral pain (210), chest distress (210). 178) fever (154), skin pruritus (139), edema (34), swollen (33), night sweating (33), cough (33), headache (32), other symptoms (90), digestive tract symptoms (2364), abdominal distention (1874), nausea (704), loose stool (635), vomiting, vomiting, constipation, abdominal pain, etc.. Basically conforms to hepatic jaundice. The symptoms distribution.2.2 tongue, the pulse image distribution tongue with red tongue (3359), lingual red (712) mainly, moss with moss thin (2647), moss (467), moss thick (120), moss thick (113) mainly, moss with moss white (2583), yellow moss (1398), yellow moss yellow (42) mainly. Suggesting that the disease is wet syndrome and heat syndrome is 14, pulse is mainly pulse chord (349), vein slowly (741), vein fine ( 433), pulse number (205), pulse skating (161), pulse sinks (46) and other.2.3 groups were divided into 5 groups according to the community. The number of patients in each module was 255142,91,27,5 in turn. According to Chi square test, the symptoms and signs of each group were compared. The heat image of the first group was more obvious, the second groups were lighter in heat image, and the third groups were considered to be the heat of the gallbladder. Syndrome, fourth groups of people are between yellow and Yin Yellow, fifth groups of people with heavy cold and dampness, considered as Yin Huang. (1) the first group of special symptoms and signs are: moss yellow, moss, thirst, moss, tongue, fever, thirst, thirst, thirst and drink, thirsty, cold, cold, pulse, vexed, coughing, pharynx dry and so on. There is a hot image, but with a hot image, but heat image, but heat image, but heat image, but heat image, but heat image, but heat image, but heat elephant, but heat elephant, but heat elephant, but heat elephant, but heat elephant, but heat elephant, but heat elephant, but heat elephant, but heat elephant, but heat elephant, but heat elephant, but heat elephant, but heat elephant, but heat elephant, but heat elephant, but heat elephant, but heat elephant, but heat elephant, but heat elephant, but heat elephant, but heat elephant, but heat elephant, but heat elephant, but heat elephant, but heat elephant, but heat elephant, but heat elephant, but heat elephant, but heat elephant, but heat elephant, but heat elephant, but heat elephant, but heat elephant, but heat elephant, but heat elephant, but heat elephant, but heat elephant, but heat elephant, but heat elephant, but heat elephant, but heat elephant, but heat elephant, but heat elephant, but heat elephant, but heat elephant, all The composition of the core is: Artemisia, Poria, gardenia, tulip, tulip, peel, Radix Paeoniae, Radix Paeoniae, Rhizoma Alisma, Rhizoma Alisma, Rhizoma Alisma, Rhizoma Alisma, Radix Angelicae, Radix Angelicae, Radix Angelicae, Rhizoma Alisma, stir fry, fried Valley buds. (2) the symptoms and signs of the second groups are: tongue red, white, yellow, yellowing, yellowing, yellowish moss, thin moss, insomnia, stool dry knot, mouth thirst, mouth pain, pulse number, pulse number, pulse number, bran, puffiness There is no desire to drink yellow, thirsty, thirst for cold drink, thirst and drink, pale red tongue and cold, and so on. It can be seen that the symptoms of this kind of patients are damp and hot, but the thermal image is light and wet. The composition of the core is: Yin Chen, tuckahoe, roasted alba, tulips, Alisma Alisi, gardenia, tangerine, fried Valley buds, fried malt. (3) the symptoms of the third groups are: moss white, lingual red. Bright yellow, thirsty, hypochondriac, slow pulse, mouth pain, chest tightness, dizziness, thirst, cold drink, thirst, dispirited, dry time, thin veins, thick skin, thin body, light red, insomnia, little moss, yellowing, stomach and epigastric depression, low back, slight yellows, dilation, sweetness and so on. More obvious, hypochondriac pain, chest tightness symptoms obvious, to consider the syndrome of gallbladder depression. The core components are Yin Chen, Poria cocos, tulip, gardenia, Radix Paeoniae, Radix Salviae, tangerine, fried Valley buds, fried malt, fried divine music, angelica, angelica and so on. (4) the symptoms and signs of the fourth groups of people are: pale red tongue, white, thin, sleepless, swollen lower limbs, weak, weak, yellowish, tingling. Frequency of urine, soreness of lower limbs, pain of lower limbs, palpitation, sweating, urine pain and so on. It can be seen that this kind of patient can not distinguish between Yang Huang and Yin Huang, between yin and Yang yellow. The composition of the core is Poria, Artemisia, tulip, orange peel, Salvia miltiorrhiza, Radix Paeoniae, gardenia, fried malt, stir fry the Shenqu. (5) only 5 cases of the fifth groups include the patients. The symptoms are less, so the symptoms and signs are listed. They include the oil, the white, the spirit, the yellow dark, dizziness, the moss, the thickness of the tongue, the tongue, the tender tongue, the dry knot of the tongue, the loose stools, the cold, the faint red tongue, the skin pruritus, the symptoms of the skin, the dyke and the Yellow symptoms. Ling, Magnolia, Atractylodes, nutmeg, gardenia, tulips, tangerine, talcum, talcum, fried Valley buds, fried malt, Salvia miltiorrhiza.2.4 effect analysis of the effect of 2.4.1 traditional Chinese medicine on the symptoms and signs of jaundice, the first course of medical records, the middle course, the last course of positive symptoms and signs, through the number of symptoms, frequency, frequency of the positive symptoms of the disease, found in the comparison, found in the number of symptoms, frequency, frequency of the positive symptoms of the disease, found in the contrast, found in the number of symptoms, frequency, frequency of the positive symptoms of the disease in the comparison, found in the number of symptoms, frequency, frequency of the positive symptoms of the disease in the comparison, found in the number of symptoms, frequency, frequency of the positive symptoms of the course of the disease in the comparison, found in the number of symptoms, frequency, frequency of the positive symptoms of the disease in the comparison, found in the number of symptoms, frequency, frequency of the positive symptoms in the course of the disease. During the course of the last time, there was also a significant decrease in the course of the disease, and the symptoms, signs, and most jaundice were treated by traditional Chinese medicine in the hospital during the hospitalization. The condition of the disease was effectively controlled by the analysis of the curative effect of.2.4.2 based on the liver function index, and the jaundice index, bile red before and after the treatment of the patients was used. The contrast between the quality and the glutamic Pyrex aminotransferase showed that the P value was obviously less than 0. The biochemical indexes of the patients with jaundice were obviously improved after the system of traditional Chinese medicine treatment. It proved that the traditional Chinese medicine has a good effect in reducing the enzyme and retreating yellow..3 is based on the core of the effective medical records to take the decline of the jaundice index as an effective disease. In the end, 479 cases of effective medical records are included, and there are 3086 Chinese medicines. We divide the community based on the information of the effective medical records, and get 10 significant categories. The number of various kinds of prescriptions in turn are 684607579386276174120,38,30,24. We extract various kinds of parties with multi-layer complex network respectively. Core drugs of the agent module. (1) the core drugs of module 1 are: Yin Chen, Poria cocos, Alisma orientalis, gardenia, Plantago, tulip, roasted alba, rhubarb, Polyporus, cortex magnolia, Radix Isatis Root. (2) module 2 core drugs: Yin Chen, tulip, Paeonia lactiflora, sauces, Poria, Salvia miltiorrhiza, Chen peel, Xiang Fu, angelica, Chinese angelica, coix seed, gardenia (3) module 3 core drugs are: Angelica, Salvia miltiorrhiza, tulip, tuckahoe, Poria, chchen, Radix Bupleuri, peel, white peony, roasted alba, fried malt, gardenia. (4) module 4 core drugs: Yin Chen, tuckahoe, Alisma, fried malt, fried Valley buds, gardenia, tulip, fried divine comedy. (5) module 5 core drugs: Yin Chen, tuckahoe, fry. (5) module 5 core drugs Shen Qu, Magnolia, talcum, tangerine, French Banxia, licorice. (6) module 6 core drugs: rhubarb, mirabilite, gardenia, Cortex Phellodendri, Fructus aurantii, Magnolia officinalis, (7) module 7 core drugs: Poria, Paeonia lactiflora, peony skin, Radix Codonopsis, licorice, tulip, Scutellaria. (8) module 8 core drugs: Artemisia, rhubarb, rhubarb, fried malt, fried Valley buds, etc. (9) module 9 core medicine. Composition: hay sands, Plantago, Artemisia, Herba Artemisia, Lonicera, honeysuckle, red sugar. (10) module 10 core drugs: Plantago, Artemisia, red Poria, chicken gold, gardenia, reed root, Shen Qu, Fructus aurantii. Conclusion through data analysis methods for retrospective study of hospitalized medical records have done a useful exploration for our hospital to continue to carry out retrospective study accumulated experience. By means of data mining, the specific symptoms, signs and core prescriptions of 5 types of jaundice were analyzed, and the curative effect of jaundice was analyzed from the changes of symptoms and signs and the improvement of biochemical indexes. Based on the effective medical records, 10 kinds of common core parties were extracted. The study of "syndrome treatment effect" of jaundice in the past 19 years shows that although it is in the low period of academic research, it still manifests a high level of diagnosis and treatment in the treatment of jaundice. The academic thought for the treatment of jaundice in this period is both heat clearing and dampness, not forgetting to live blood and detoxification, paying attention to spleen and regulating liver, strengthening and dispelling evil spirits. The common use of Yin Chen Wuling powder, Artemisia wormwood soup, gardenia peel soup, Dachengqi soup, and other times Fang Zhihuang, followed the late Qing Dynasty to the Republic of China during the period of the Republic of China to pay attention to the idea of treating jaundice from the blood, the liver and the spleen and spleen into the palpation, and similar to the theory of modern famous old Chinese medicine for the treatment of jaundice. The results obtained in this study can also provide some ideas for clinical treatment of jaundice.
【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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