针对承气汤类方古代医案运用数据挖掘技术探究其临床价值

发布时间：2018-07-15 11:26

【摘要】：目的：以承气汤类方古代医案为对象运用数据挖掘手段探究其临床应用的价值。方法：以承气汤类方各方剂名为关键词,搜索《中华医典》医论医案部分,制订适合本研究的古代医案纳入标准,对纳入的医案进行整理归纳,建立承气汤类方古代医案数据库,运用统计学方法及数据挖掘手段,如频数分析、因子分析、聚类分析等一系列方法对该数据库中医案的症状、处方用药等内容进行分析、挖掘,探究承气汤类方的证候及药物使用特点,从而印证其临床应用的适应性及价值。结果：搜索得承气汤类方古代医案共155则,纳入古代医案96则。对医案进行统计、数据挖掘可得： (1)在古代医案中,承气汤类方可以治疗内、外、妇、五官、骨伤等多种疾病。其中应用最多的还要属脾胃疾病、神志病以及外感热病,其所占百分比分别为45.83%、13.54%、12.50%。 (2)古代医案承气汤类方所治疗的症状按频次高低顺序排在前五的依次为大便闭、发热、腹痛、腹胀、烦躁谵语。(3)承气汤类方常用药物中除构成承气汤类方的药物如厚朴、枳实、芒硝、桃仁、甘草等使用频次较高外,其余运用较多的种类有清热药如犀角、生地,活血药如五灵脂、生蒲黄。结论： (1)承气汤类方起源于东汉时期的《伤寒论》,并于唐宋时期有了初步发展,金元时期为该类方的发展中期,直至明清,伴随温病学派的兴起,带动了承气汤类方的发展与创新,从而进入类方发展的高峰期。 (2)后世发展出的承气汤变证方与原方证治相比主要区别体现在病理因素不同、病位不同、兼证不同以及病性虚实不同。 (3)承气汤类方在临床应用中可以治疗内、外、妇、儿、五官、骨伤等多学科的多种疾病,但主要的还是运用于脾胃疾病、神志病以及外感热病这三大类疾病之中。 (4)其主治症状除了现代临床经常适用的便秘、腹痛、腹胀、发热外,烦躁、谵语、头痛几赤等神志及头而部症状亦表现得十分突出。 (5)承气汤类方之基础药物如大黄、芒硝、厚朴、甘草外,常用加减药类还包括清热药如犀角、生地,活血药如五灵脂、生蒲黄。
[Abstract]:Objective: to explore the clinical value of Chengqi decoction by data mining. Methods: according to the names of various prescriptions of Chengqi decoction as the key words, we searched the part of the medical records of the Chinese Medical Code, worked out the standard for the inclusion of the ancient medical cases suitable for this study, and summarized the included medical cases. The database of ancient medical records of Chengqi decoction was established, and a series of methods, such as frequency analysis, factor analysis and cluster analysis, were used to analyze the symptoms of medical records and prescription drug use in the database by means of statistical methods and data mining methods, such as frequency analysis, factor analysis, cluster analysis and so on. To explore the syndromes and drug use characteristics of Chengqi decoction, so as to confirm the adaptability and value of its clinical application. Results: a total of 155 ancient medical records of Chengqi decoction were searched and included in 96 ancient medical cases. Statistics of medical records, data mining can be obtained: (1) in ancient medical cases, Chengqi decoction can treat many diseases, such as internal, external, female, facial, bone injury and so on. The most commonly used diseases were spleen and stomach disease, mind disease and exogenous fever, which accounted for 45.83% and 13.54% 12.50%, respectively. (2) the symptoms treated by Chengqi decoction in ancient medical records were in order of defecation closure, fever, abdominal pain, abdominal distension, irritability and delirium according to the order of frequency. (3) in the common medicine of Chengqi decoction, except for the medicine of Chengqi decoction such as Magnolia officinalis and Fructus Aurantii, The use frequency of mirabilite, peach kernel, licorice and so on is higher, and the other more kinds of heat-clearing medicine such as rhinoceros horn, raw land, blood activating medicine such as five Lingli, fuhuang. Conclusion: (1) Chengqi Tang decoction originated from the Eastern Han Dynasty, and had a preliminary development in Tang and Song dynasties. The Jin and Yuan dynasties were the middle period of its development, until the Ming and Qing dynasties, accompanied by the rise of febrile disease school. It drives the development and innovation of Chengqi decoction, thus entering the peak period of development. (2) the main difference between Chengqi decoction and the original prescription is that the pathological factors are different, the disease position is different, the syndromes are different, and the deficiency and reality of the disease are different. (3) Chengqi decoction can be used to treat many kinds of diseases, such as internal, external, female, infant, facial, bone injury and so on, but it is mainly used in the diseases of spleen and stomach, mind disease and external febrile disease. (4) in addition to constipation, abdominal pain, abdominal distension, fever, irritability, delirium, headache, etc. (5) besides rhubarb, mirabilite, Magnolia officinalis, Glycyrrhiza uralensis, Fang Zhi basic drugs of Chengqi decoction include heat-clearing drugs such as rhino horn, raw land, blood activating drugs such as five Lingli, and fuhuang.
【学位授予单位】：南京中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R249

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