基于古今医案数据分析的肺痈证治规律研究

发布时间：2018-07-06 19:06

本文选题：肺痈 + 古今医案　；参考：《黑龙江中医药大学》2016年博士论文

【摘要】：目的：本文以医案文献研究为基础,采用计算机技术以及统计学分析方法,结合专业知识,对肺痈医案进行数理统计和数据分析,从中挖掘肺痈证治规律,以期为肺痈的基础研究及临床实践提供参考。方法：通过对历代肺痈医案的收集整理分析,借助数理统计与数据挖掘方法,结合现代计算机技术,建立肺痈相关数据库,利用SAS9.1统计软件对录入的数据进行频数、因子、聚类、典型相关、关联规则等数理分析和数据挖掘,对肺痈医案的病因、病势、症状、方药等内容进行分析。结果：1.一般资料分布情况结果显示：古今肺痈医案中男性的肺痈发病几率高于女性；古今肺痈医案中肺痈发病几率,按年龄划分,由高到低依次为：青年、中年、儿童、老年。2.辨证情况分析结果显示：古今肺痈医案中发病原因占比由高到低依次为：外邪化热、内热复感、酒食积热、痰热壅盛；古今肺痈医案中病势占比由高到低依次为：溃脓期、恢复期、成痈期、初期。3.证治规律研究结果显示：古今肺痈医案各个分期高频症状及高频症状归类；古今肺痈医案各个分期高频药物、高频药物属性归类及高频药物组合；古今医案肺痈总库中具有典型相关性的高频症状群与高频药物群；古今医案肺痈总库中符合关联规则的高频症状及高频药物。结论：概括出肺痈主要病理基础为气结、痰热、瘀阻；常见证型包括外邪犯肺、气滞痰壅、痰热壅盛、痰饮郁阻、痰瘀互结、热毒炽盛、正虚邪恋、气阴两虚8个主要证型；常用类药以清热药及化痰止咳平喘药为主；总结出常用方药,如葶苈大枣泻肺汤、桔梗汤、苇茎汤、泻白散、犀黄丸等；主要治法包括清热疏肺法、清热解毒法、清热攻下法、开泻法、化瘀法、排脓法、清养补肺法、健脾补肺法及补肾益肺法9种治法；总结出“以整体观念指导分期辨治；结合体质预判转归；以通治壅——治肺兼顾肝脾,择机通腑泄热,重调气血津液。”的动态多维诊疗模式,为肺痈辨治提供新思路。
[Abstract]:Objective: based on the literature study of medical records, this paper used computer technology and statistical analysis method, combined with professional knowledge, to analyze the medical records of lung carbuncle by mathematical statistics and data analysis, and to excavate the law of syndrome and treatment of lung carbuncle from the medical records. In order to provide reference for the basic research and clinical practice of lung carbuncle. Methods: through collecting and analyzing the medical records of lung carbuncle in the past dynasties, with the help of mathematical statistics and data mining methods, combining with modern computer technology, the database of lung carbuncle was established, and the frequency and factor of the input data were analyzed by using SAS9.1 statistical software. Clustering, canonical correlation, association rules and other mathematical analysis and data mining, the causes of lung carbuncle cases, disease symptoms, prescription and so on are analyzed. The result is 1: 1. The results of general data distribution showed that the incidence rate of lung carbuncle in male was higher than that in female in ancient and modern lung carbuncle medical records, and the incidence rate of lung carbuncle in ancient and modern lung carbuncle medical records was: youth, middle age, children, old age. The results of syndrome differentiation analysis showed that in the medical records of lung carbuncle in ancient and modern times, the proportion of the causes of lung carbuncle from high to low was in turn: heat from external pathogens, resensation of internal heat, accumulation of heat by wine and food, accumulation of phlegm and heat, and the proportion of disease potential from high to low in ancient and modern medical cases of lung carbuncle was: the period of abscess and abscess. Convalescence stage, carbuncle stage, initial stage. The results of study on the rule of syndrome and treatment showed that the high frequency symptoms and symptoms of each stage were classified in the medical records of lung carbuncle in ancient and modern times, the high frequency drugs, the attribute of high frequency drugs and the combination of high frequency drugs in each stage of the cases of lung carbuncle were classified. The high frequency symptom group and the high frequency medicine group in the lung carbuncle general storehouse of the ancient and modern medical records and the high frequency symptom and the high frequency medicine which accord with the association rule in the lung carbuncle general storehouse of the ancient and modern medical records. Conclusion: the main pathological basis of lung carbuncle is Qi knot, phlegm heat and stagnation, common syndromes include external evil invading lung, stagnation of qi and phlegm, accumulation of phlegm and heat, stagnation of phlegm, phlegm and blood stasis, heat and toxin, deficiency of qi and yin, and deficiency of qi and yin. The common kinds of drugs are mainly heat-clearing drugs and phlegm relieving cough and antiasthmatic drugs; the common prescriptions are summarized, such as Tinglida-zao Xiefe decoction, Platycodon decoction, Reed stem decoction, Xiebai San, Xiexihuang pills, etc. The main treatment methods include clearing away heat and thinning the lungs, clearing away heat and detoxifying, and clearing away heat and attacking. The methods of opening and reducing diarrhea, removing blood stasis, expelling pus, clearing and nourishing the lung, invigorating the spleen and invigorating the lung, and tonifying the kidney and invigorating the lung are 9 kinds of treatment methods. Choose the opportunity to vent heat, re-regulating qi and blood body fluid. " The dynamic multi-dimensional diagnosis and treatment model provides a new way for differentiation and treatment of lung carbuncle.
【学位授予单位】：黑龙江中医药大学
【学位级别】：博士
【学位授予年份】：2016
【分类号】：R249;R256.13

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