马鸿斌主任医师辨治慢性肾盂肾炎的经验总结

发布时间：2019-04-18 23:56

【摘要】：目的:总结马鸿斌主任医师辨证论治慢性肾盂肾炎的临证经验,主要通过临床跟师学习,收集导师临床治疗慢性肾盂肾炎的典型病例,总结概括导师治疗本病的经验,并将导师的学术思想继承发扬。方法:(1)收集导师马鸿斌主任医师治疗慢性肾盂肾炎的门诊处方,运用数据挖掘技术探讨导师马鸿斌主任医师治疗慢性肾盂肾炎的用药规律。(2)主要通过临床上跟随导师学习,根据临床病例及导师的用药特点,整理并总结导师马鸿斌主任医师治疗慢性肾盂肾炎的经验。(3)本经验总结总共通过收集的4例典型临床病例,根据马鸿斌主任医师分型治疗特点,来评价导师分型论治慢性肾盂肾炎的治疗效果。结果:(1)根据导师马鸿斌主任医师临床治疗慢性肾盂肾炎的用药特点和选方特点,从95个处方中进行了详细的总结和数据统计,基于关联规则分析的组方规律研究,基于熵聚类的方剂组方规律研究,基于复杂系统熵聚类的药物核心组合分析,分别的选出了频次前三位用药主要为茯苓、续断、甘草;前三位药物组合分别是“黄柏,续断”,“甘草,茯苓”,“牛膝,续断”;演化出核心药物组合3-4味,并得到4个新处方。最后又从四气五味统计了导师的用药特点,其对味甘,性温的药物使用较为频繁。(2)导师马鸿斌主任医师根据本病的临床特点,将慢性肾盂肾炎分为4种证型,即肾虚湿热证(热重型),肾虚湿热证(湿重型),肾阳亏虚证,气阴两虚证;根据患者的临床特点,选取4例具有代表性的患者,根据患者的不同证型分别运用不同的方剂进行治疗,3到4个疗程后患者的临床症状消失,尿常规等指标明显改善,证明临床疗效显著。结论:通过对导师处方的统计和总结,导师马鸿斌主任医师治疗慢性肾盂肾炎的经验分为4种证型和4种不同的方剂,符合临床诊治的需要,辨证与方药相结合,方证对应,病证结合,提高了临床疗效,且根据导师用药选方的相关规则,为临床用药及选方提供了新的依据。
[Abstract]:Objective: to summarize the clinical experience of treating chronic pyelonephritis by chief physician Ma Hongbin according to differentiation of symptoms and signs, and to collect the typical cases of chronic pyelonephritis treated by tutor, and summarize the experience of tutor in treating chronic pyelonephritis. And inherit and carry forward the academic thought of the tutor. Methods: (1) collect out-patient prescriptions for the treatment of chronic pyelonephritis by chief physician Ma Hongbin. The data mining technique was used to explore the regularity of drug use in the treatment of chronic pyelonephritis by mentor Ma Hongbin. (2) according to the clinical cases and the characteristics of the tutor's medication, it was mainly studied by following the tutor in clinical practice. (3) the experience in treating chronic pyelonephritis was summarized. (3) this experience summarized a total of 4 typical clinical cases collected, according to the characteristics of Dr. Ma Hongbin's classification and treatment of chronic pyelonephritis, To evaluate the therapeutic effect of tutors' classification theory on chronic pyelonephritis. Results: (1) according to the characteristics of medication and prescription selection of chief physician Ma Hongbin in treating chronic pyelonephritis, a detailed summary and data statistics were made from 95 prescriptions, and the rule of prescription based on association rule analysis was studied. Based on entropy clustering and complex system entropy clustering, the first three drugs were selected as Poria cocos, continuous break, licorice, and the core combination analysis of drugs based on complex system entropy clustering. The first three drug combinations were "Phellodendron cedar", "Glycyrrhiza uralensis", "Poria cocos", "Achyranthes bidentata", and evolved a core drug combination of 3 and 4 taste, and got four new prescriptions. Finally, according to the characteristics of four qi and five flavours, the use of drugs was more frequent. (2) Chief physician Ma Hongbin, mentor, divided chronic pyelonephritis into four syndrome types according to the clinical characteristics of the disease, and the clinical characteristics of chronic pyelonephritis were divided into four types, according to the clinical characteristics of the disease. Namely kidney deficiency damp-heat syndrome (heat heavy), kidney deficiency damp-heat syndrome (damp heavy), kidney yang deficiency syndrome, qi-yin deficiency syndrome; According to the clinical characteristics of the patients, 4 representative patients were selected and treated with different prescriptions according to the different syndrome types of the patients. After 3 to 4 courses of treatment, the clinical symptoms of the patients disappeared, urine routine and other indexes were obviously improved, and the clinical symptoms of the patients disappeared after 3 to 4 courses of treatment, and the urine routine was improved obviously. It is proved that the clinical curative effect is remarkable. Conclusion: according to the statistics and summary of the prescription of the tutor, the experience of chief physician Ma Hongbin in treating chronic pyelonephritis is divided into four types of syndromes and four different prescriptions, which accord with the needs of clinical diagnosis and treatment, the combination of syndrome differentiation and prescription, and the correspondence of prescription and syndrome. The combination of disease and syndrome improves the clinical efficacy and provides a new basis for clinical use and selection of drugs according to the relevant rules of prescription selection by mentors.
【学位授予单位】：甘肃中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R249;R277.5

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