基于数据挖掘技术总结阎洪臣教授治疗头痛辨证思维特点及用药规律的研究

发布时间：2018-07-16 08:46

【摘要】：目的:通过整理归纳阎洪臣教授临床诊治头痛的医案,应用数据挖掘技术,初步分析、总结阎洪臣教授治疗头痛的辨证思维特点及用药规律,传承名老中医经验。方法:通过跟师出诊,收集2013年9月至2016年2月期间阎洪臣教授诊治的头痛医案,记录整理电子版诊疗信息,筛选符合标准的医案共206例。按照名老中医临床医案管理系统的统一格式,将患者的基本情况、临床症状、舌苔脉象、辨证分型、治法、方剂、药物及药量等病例信息录入数据库,通过数据分析及处理,在当代名老中医案解析系统中进行数据挖掘及统计。通过多维分析及关联分析,得出阎洪臣教授诊疗头痛临床症状、舌苔脉象、辨证分型的频数及之间的关联,结合笔者2年余的跟诊体会,总结其治疗头痛的辨证思维特点;对用药数据进行证型-药物的多维分析及对比分析等得出阎洪臣教授治疗头痛的总体用药分布及各证型的用药分布,通过用药分析,得出各证型所应用药物的性味归经,结合中医药理论知识,得出阎洪臣教授治疗头痛的用药规律。结果:1证型分布特点:出现频次最多的证型为痰热上扰证,痰湿上阻证次之,肝郁气逆证、气虚失养证、风火上扰证、肝火上炎证等出现频率亦较高。2症状、舌脉分布特点:所纳入的206例头痛患者中,出现频次较多的症状及舌脉依次为:头痛、脉沉、头晕、舌质红、乏力、脉弦、眠差、口干、易怒、胸闷、舌质淡等,并通过多维及对比分析得出证型与症状舌脉之间的关系。3用药分布特点:用药频次较多的药物依次为:甘草、陈皮、茯苓、白芷、半夏、菊花、天麻、枳实、全蝎、蜈蚣、栀子、白术、竹茹、钩藤、远志、川芎、柴胡、川楝子、川木通、香附,并应用证型-用药分析得出各证型的用药分布特点。4各证型用药性味归经特点:痰热上扰证的用药性味依次为:辛、苦、温、平、甘,归肺、脾、胃、心、肝经;痰湿上阻证用药性味依次为:甘、苦、温、平、辛,归经依次为:肺、脾、胃、肝、心;并得出其他证型用药性味归经特点。结论:通过数据挖掘技术统计分析,总结得出阎洪臣教授治疗头痛的辨证思维特点及用药规律,包括辨证分型、症状、用药分布以及性味归经特点,为今后头痛的辨治提供了宝贵的经验。
[Abstract]:Objective: to summarize professor Yan Hongchen's clinical diagnosis and treatment of headache, apply data mining technology, analyze preliminarily, summarize the characteristics of professor Yan Hongchen's dialectical thinking and drug use in the treatment of headache, and pass on the famous and old TCM experience. Methods: from September 2013 to February 2016, the headache medical records of Professor Yan Hongchen were collected, and the information of electronic diagnosis and treatment was recorded and sorted out. According to the unified format of the clinical case management system of the famous old Chinese medicine, the basic information of the patient, clinical symptoms, tongue coating pulse, syndrome differentiation, treatment method, prescription, medicine and drug quantity were entered into the database, and the data were analyzed and processed. Data mining and statistics are carried out in the analysis system of famous old Chinese medicine cases. Through multi-dimensional analysis and correlation analysis, the authors obtained the frequency and correlation of clinical symptoms, tongue coating pulse, syndrome differentiation and classification of headache diagnosed and treated by Professor Yan Hongchen, and summarized the characteristics of dialectical thinking in the treatment of headache combined with the author's more than 2 years' experience in following diagnosis. The multi-dimensional analysis and comparative analysis of drug use data were used to obtain the overall distribution of drugs used by Professor Yan Hongchen for headache treatment and the distribution of drug use of each syndrome type. Through drug use analysis, the characteristics of the drugs used in each syndrome type were analyzed and the characteristics and classics of the drugs used in each syndrome type were obtained. Combined with the theoretical knowledge of traditional Chinese medicine, Professor Yan Hongchen for the treatment of headache drug law. Results the distribution characteristics of syndrome type: the most frequent syndromes were phlegm and heat disorder, phlegm dampness and dampness obstruction, liver stagnation and qi inversion, deficiency of qi, disturbance of wind and fire, inflammation of liver fire, and so on. The characteristics of tongue vein distribution: the frequency of symptoms and tongue vein were headache, dizziness, red tongue, fatigue, pulse string, poor sleep, dry mouth, irritability, chest tightness, light tongue and so on, among 206 patients with headache, the symptoms of frequency and frequency were: headache, dizziness, red tongue, fatigue, pulse string, poor sleep, dry mouth, irritability, chest tightness, light tongue, etc. The relationship between syndromes and tongue veins was obtained by multi-dimensional and contrastive analysis. The characteristics of drug use were as follows: liquorice, Chenpi, Poria cocos, Radix angelicae dahurica, Pinellia ternata, Chrysanthemum, Gastrodia elata, Aurantii, Scorpio, centipede, etc. Gardenia, Atractylodes macrocephala, Bamboo Ru, Hook Rattan, Radix Polygala, Ligusticum chuanxiong, Bupleurum chinensis, Needendan seed, Akebia chinensis, The distribution characteristics of drug use in each syndrome type were obtained. 4. The characteristics of drug quality of each syndrome type were as follows: Xin, bitter, warm, Ping, Gan, Gui lung, spleen, stomach, heart and liver meridian; The characteristics of phlegm dampness blocking syndrome were as follows: sweet, bitter, warm, flat, Xin, and meridian in turn: lung, spleen, stomach, liver, heart, and other syndromes. Conclusion: through statistical analysis of data mining techniques, the characteristics of syndrome differentiation thinking and drug use of Professor Yan Hongchen in the treatment of headache were summarized, including syndrome differentiation, symptoms, drug use distribution and characteristics of sexual taste and meridian. It provides valuable experience for the diagnosis and treatment of headache in the future.
【学位授予单位】：长春中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R249;R277.7

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