基于数据挖掘技术分析当代中医名家湿疹验方经验研究

发布时间：2018-08-04 09:08

【摘要】：[目的]病和证的结合乃是现代中医临床的主导医学形式,而“审证求机”则是中医辨证论治过程中的重要环节。深入了解湿疹的病证特点及其理、法、方、药,可以有效指导临床,进一步提升疗效。文献研究发现,古今医家对湿疹的病位认识有其共性,共识是主要病因与肺脾肾三脏密切,涉及心肝。不过对其症状、治法及处方用药的认识,各位医家的观点庞杂而欠系统整理。有见及此,本研究选择当代中医名家治疗湿疹的有效医案验案,透过强化FP-Growth算法的关联分析,寻找其组方配伍规律,和提取一些新的认识,冀能为中医临床和中医科研提供借鉴与参考。I方法]检索发表于1988年2月～2014年11月于中国知网有关中医湿疹的医案,并依据纳入排除标准,构建中医湿疹医案数据库；当开展数据探析、统计整理时,需要对原医疗信息的药物名进行全面调整、改正错别字、调整临床术语、搜索原始数据等开展一系列的预处理方案；再将符合标准入选共354诊次的中医湿疹医案,采用Medcase V3.2仓公诊籍国临床治疗信息档案进行全面性分析,形成临床医疗信息整合、存储信息库,并对信息库记载的临床信息进行载录调整与重复性的信息整合。且整理症状术语词汇共87条、累计规范1040频次的前提下,形成了集搜索、储存、规范、研究、深挖相结合的、多类信息深挖模式与框架组建的临床信息深挖系统；通过Medcase V3.2软件,经完善有关规则信息深挖测算系统、Medcase Record Mining软件、Association Rule Analysis模型、Xminer Operation Tool系统与健全FP-Growth计算系统,按照统计学方式进行探索,并总结测试结果,通过舌像、脉象、处方、治疗手段等各个方面按照中医学知识开展对中医湿疹医案经验的总结。[结果]对于频数研究而言,现今一些医生在医治湿疹疾病的过程中,发现其典型的临床症状包括：瘙痒、便干、失眠、烦躁和口干；皮损依次有渗出、丘疹、红斑、结痂、糜烂和抓痕；病变的部位依次分为全身、头面、四肢、躯干。舌象依次为舌质红、舌质淡红、苔薄白、苔黄腻、舌质淡、苔黄、苔白和苔白腻；脉象方面依次为滑、数、细、弦、沉、弱、浮、缓、濡、指纹紫、指纹紫滞、大、平、微、指纹沉滞、指纹赤、指纹紫红、虚、指纹淡紫、结、指纹红、指纹青、指纹青紫。当代医家治疗湿疹的医案中出现的高频治法依次为清热、止痒、祛风、健脾、除湿、利湿、解毒、养血、凉血、疏风、燥湿、活血、温阳、祛湿、润燥、渗湿、益气、散寒、化湿和养阴。对高频治法整合规范后,发现湿疹高频治法与上海科学技术出版社陆德铭主编的《中医外科学》中所列湿疹治法相符,说明湿疹临床治法仍以清热、利湿、养血、祛风、健脾、疏风为主；研究发现当代医家的医案治法灵活,反映湿疹病情多复杂多变、虚实寒热错杂皆有。当代医家治疗湿疹的医案中高频中药依次为白鲜皮、甘草、防风、苍术、茯苓、薏苡仁、地肤予、生地、丹皮、当归、黄柏、苦参、蝉蜕、白术、赤芍。参考上海科学技术出版社雷载权主编的《中药学》将以上的高频中药分类后,高频药物种类为：清热燥湿药、解表药、利水渗湿药、利尿通淋药、清热凉血药、补血药、清热解毒药、健脾渗湿药、凉血药等。药物内关联方面,名老医家治疗湿疹常用的15对药对,它们之间都有较高置信度。1.白鲜皮、地肤子；2.白鲜皮、苦参；3.白鲜皮、甘草；4.白鲜皮、防风；5.白鲜皮、生地；6.白鲜皮、慧苡仁；7.白鲜皮、苍歹忙；8.白鲜皮、茯苓；9.甘草、生地；10.生地、丹皮；11.苍术、黄柏;12.苍术、防风；13.苍术、薏苡仁；14.防风、甘草；15.防风、地肤子。治则治法与药物外关联方面：1.与发泄瘀热、养血、润燥外关联有较高置信度的药物是生地。2.与养血外关联有较高置信度的药物是当归。3.与祛风外关联有较高置信度的药物是防风、荆芥、当归。4.与宣表有较高置信度的药物是浮萍。5.与益气、健脾、温阳有较高置信度的药物是黄芪。6.与疏风、透邪有较高置信度的药物是麻黄。7.与补肝、补肾有较高置信度的药物是龙骨。8.与止痒外关联有较高置信度的药物是苍术、荆芥。[结论]选取了当代医家治疗湿疹的医案,然后进行数据挖掘,当中包括统计分析和关联规则分析,其结论大多都是临床行之有效或是古今适用的传统中医理论和认识,和一般教科书当中的理论相近,从而推论出应用数据挖掘进行医案分析是有效可行的。并且透过高频药物的组来总结分析湿疹常用中药的配伍应用关系。通过有关研究,发现医治规则和药物间、临床体征和药物间存在的内在联系能够通过定量的公式表达出来,令“症法药”相统一,整理了新的观点,有不少能够在临床上进行实践论证,可以看出信息深挖与健全FP-Growth系统对整理中医临床资料及学习中医知识是一个极其有效的探索手段。
[Abstract]:[Objective] the combination of disease and syndrome is the leading medical form of modern Chinese medicine, and "examining and seeking the machine" is an important link in the process of syndrome differentiation and treatment in traditional Chinese medicine. A thorough understanding of the characteristics of the syndrome and its principle, method, prescription and medicine can effectively guide the clinical and improve the curative effect. The literature study found that the ancient and modern doctors have the understanding of the eczema. The common sense is that the common understanding is that the main cause of the disease is closely related to the three organs of the lung and spleen and kidney, which involves the heart and the liver. However, the understanding of the symptoms, the treatment and prescription of the prescription, the views of the doctors are complex and not systematic. In this case, this study chooses the effective medical case of the famous contemporary Chinese medicine people to treat eczema, and seeks the correlation analysis of the FP-Growth algorithm. The law of compatibility of its groups and some new knowledge are extracted. We can provide reference and reference.I methods for Chinese medicine clinical and traditional Chinese medicine research and retrieve medical cases related to Chinese medicine eczema published from February 1988 to November 2014. According to the exclusion criteria, the database of medical case of Chinese medicine eczema is constructed. At the time, it is necessary to adjust the drug name of the original medical information comprehensively, correct the wrong words, adjust the clinical terms, search the original data and so on to carry out a series of preprocessing plans; then, the medical case of the Chinese medicine eczema, which conforms to the standard admission 354 times, has been analyzed comprehensively by the medical records of Medcase V3.2. The bed medical information is integrated, the information storage is stored, and the clinical information recorded in the information base is integrated with the information of the clinical information. There are 87 terms of the symptom terminology and the cumulative standard of 1040 frequency. It forms a combination of search, storage, specification, research, deep excavation, multi type information deep excavation mode and frame set up. Information deep excavation system; through Medcase V3.2 software, through the improvement of the relevant rules information depth measurement system, Medcase Record Mining software, Association Rule Analysis model, Xminer Operation Tool system and sound FP-Growth computing system, explore according to statistical methods, and summarize the test results, through the tongue, pulse, prescription, treatment. Methods and other aspects in accordance with the knowledge of traditional Chinese medicine to carry out a summary of the experience of Chinese medicine eczema. [results] for frequency research, some of the doctors in the process of treating eczema, found that the typical clinical symptoms include pruritus, stool, insomnia, irritability, and dry mouth; skin lesions are exudative, papules, erythema, scab, erosion. And scratches; the site of the lesion is divided into whole body, head, limbs, trunk. The tongue is in turn red tongue, pale red tongue, pale moss, greasy tongue, yellowish tongue, yellow moss, white and white moss; the pulse image in turn is slippery, number, fine, chord, weak, floating, gentle, fingerprints, purple, fingerprints, fingerprints, fingerprints, fingerprints, fingerprints, fingerprints, fingerprints, fingerprints, red and imaginary fingerprints. The high-frequency treatment in the medical case for the treatment of eczema in the medical case of contemporary medical treatment is the order of clearing heat, stopping itching, removing wind, invigorating the spleen, dehumidifying, dehumidification, detoxification, nourishing blood, cooling blood, drying wet, blood circulation, warming Yang, removing dampness, moistening dryness, moistening, moistening, humidifying and nourishing yin. High frequency therapy is consistent with the treatment of eczema listed in "Chinese medicine surgery", edited by Shanghai science and Technology Press, Lu De Ming. It shows that the clinical treatment of eczema is still characterized by clearing heat, humid, blood raising, dispelling wind, invigorating the spleen, and sparsely wind. The high frequency Chinese medicine in the medical case for the treatment of eczema is in turn: white fresh skin, licorice, wind proof, Atractylodes, Poria, coix seed, ground skin, radix, Radix Angelicae, Cortex Phellodendri, Radix Sophorae, cicada, Atractylodes, radix paeoniae rubra. According to the classification of Chinese medicine above the high frequency medicine of Shanghai science and Technology Publishing House, the high frequency drugs are classified as: clearing heat dampness medicine, Antipyretic drugs, diuretic drugs, diuresis, antipyretic, blood medicine, blood clearing and detoxifying drugs, spleen invigorating and humidifying drugs, cold blood medicine, and other 15 pairs of drugs commonly used by old doctors to treat eczema, they all have high reliability.1. white fresh skin, ground skin, 2. white fresh skin, Sophora flavescens; 3. white fresh skin, licorice; 4. white fresh skin, windproof. 5. white fresh skin, raw land; 6. white fresh skin, Hui's kernels; 7. white fresh skin, black and bad; 8. white fresh skin, Poria; 9. licorice, 10. raw land, red skin; 11. Atractylodes, cypress; 12. Atractylodes, coix seed; 14. windbreak, licorice; 15. wind, skin. Treatment method and drug related aspects: 1. and circulation stasis heat, nourishing blood stasis, moistening dryness The drug associated with high reliability is the high reliability of the drug associated with the.2. and the blood raising. The drug associated with the.3. and the dispelling wind is a drug with high reliability. The drugs with higher reliability are the duckweed.5. and the Yiqi, the invigorating spleen and the warm yang, which have high reliability of the drug are Astragalus.6. and sparse wind. The drugs with high reliability are ephedra.7. and liver filling, and the drugs with high reliability for the kidney have higher reliability. The drug which has higher reliability of the association of the keel.8. and the antipruritic is Atractylodes, and Jing. [Conclusion] selected the medical cases of the modern doctors to treat eczema, and then carry on the data mining, including the statistical analysis and the association rules analysis, which are most of the conclusions. The theory and understanding of traditional Chinese medicine, which is effective in clinical practice or in ancient and modern times, is similar to the theory in general textbooks. Thus it is effective and feasible to deduce the analysis of medical cases by using data mining. And through the group of high frequency drugs, the relationship of Wu Yingyong with the common Chinese medicine used in eczema is summarized and analyzed. The internal connection between the clinical physical signs and the drugs can be expressed in a quantitative formula, so that the "symptomatic medicine" is unified and a new viewpoint is arranged. Many can be proved in clinical practice. It can be seen that the information deep and sound FP-Growth system is one of the clinical data and knowledge of traditional Chinese medicine. An extremely effective means of exploration.
【学位授予单位】：南京中医药大学
【学位级别】：博士
【学位授予年份】：2016
【分类号】：R249;R275.9

【相似文献】