基于医案挖掘痉病的证素研究
发布时间：2019-05-24 11:26
【摘要】：目的:本研究通过古今医案研究结合现代数理统计分析方法,挖掘并分析痉病的核心症状,总结探讨痉病的主要证素特点,阐明痉病病因病机。以期为中医痉病的辨证论治提供借鉴与新思路,为痉病指南修订提供参考。方法:以大型电子丛书《中华医典》作为古代痉病医案主要来源,选取古代医籍中具有代表性医家的医案、医话及医论等,挑选出痉病医案部分的内容;以各大中文数据库作为现代痉病医案来源,从中国生物医学文献服务系统(CBM)、维普中文期刊数据库(VIP)、中国知识资源总库(CNKI)、万方学术期刊全文数据库、中国中医药期刊文献数据库检索系统、读秀数据库等大型中文数据库,以及中国优秀博硕士学位论文、会议文献中检索2015年1月之前的所有关于痉病的文献,提取出痉病医案的部分;制定纳入标准与排除标准,严格按照纳入排除标准筛选及规范化处理所搜集医案,建立古今痉病医案数据库。以《中华医典》及现代文献中有关痉病医案的内容为研究对象,对症状进行频数分析、关联规则分析,得出核心症状,依据“以主症为中心进行辨证”的中医基础理论,参考朱文锋教授所著《证素辨证学》提取痉病证素。结果:本研究共收集263则痉病医案,其中古代内科医案153例,现代文献内科医案110例。得出203个症状,全身症状共有145条,累计频数有1537次,出现频次在10次以上的症状有61个,百分比在10%以上的有19个症状,包括四肢抽搐、神昏、牙关紧闭、发热、便秘、项背强急、手足挛急、心烦、汗出、角弓反张、头痛及口渴等12个全身症状,舌象34条,脉象20条,其中百分比在10%以上包括脉弦、脉数、脉细、舌红、苔白、脉滑及脉沉等7个舌脉症状。初步统计数据经关联规则分析,有22条关联涉及症状和6条舌象脉象,推出痉病核心症状为:四肢抽搐、牙关紧闭、发热、神昏、项背强急。最终推测出痉病的主要病位证素有:心神(脑)、肝、经络;病性证素有:暑、动风、火(热)、津亏、阴虚。结论:本研究通过数据挖掘技术对痉病医案进行数理统计分析,整理、归纳、总结痉病常见症状,得出痉病核心症状为四肢抽搐、牙关紧闭、发热、神昏、项背强急,依据“以主症为中心进行辨证”的中医基础理论,参考朱文锋·《证素辨证学》中证素提取标准,得出痉病主要病位证素:心神(脑)、肝、经络,病性证素:暑、动风、火(热)、津亏、阴虚。这些痉病核心要素为中医痉病的辨证论治提供了借鉴与新思路,并为痉病指南修订提供参考。
[Abstract]:Objective: through the study of ancient and modern medical records combined with modern mathematical statistical analysis methods, this study excavates and analyzes the core symptoms of spasm, summarizes and discusses the main syndrome elements of spasm, and expounds the etiology and pathogenesis of spasm. In order to provide reference and new ideas for the syndrome differentiation and treatment of spasm in traditional Chinese medicine, and to provide reference for the revision of spasmodic guidelines. Methods: taking the large electronic series Chinese Medical Code as the main source of ancient spasmodic medical records, the medical records, medical words and medical theories of representative doctors in ancient medical books were selected to select the contents of spasmodic medical records. Taking each major Chinese database as the source of modern spasmodic medical records, from the Chinese Biomedical Literature Service system (CBM), Weipu Chinese Journal Database (VIP), China knowledge Resources General Library (CNKI), Wanfang academic Journal full-text Database, Chinese traditional Chinese medicine periodical literature database retrieval system, read show database and other large Chinese databases, as well as Chinese excellent master's degree thesis, the conference literature to retrieve all the literature on spasmodic before January 2015. Extract the part of spasmodic medical record; To establish the inclusion standard and exclusion standard, to screen and standardize the collected medical cases according to the inclusion exclusion criteria, and to establish the database of ancient and modern spasmodic medical records. Taking the contents of spasmodic medical records in Chinese Medical Code and modern literature as the research object, the frequency analysis of symptoms and the analysis of association rules were carried out, and the core symptoms were obtained, according to the basic theory of TCM differentiation of symptoms and signs centered on the main symptoms. With reference to Professor Zhu Wenfeng's syndrome differentiation, spasmodic syndrome elements were extracted. Results: a total of 263 spasmodic medical records were collected, including 153 cases of ancient internal medicine and 110 cases of modern literature. 203 symptoms were obtained, with a total of 145 systemic symptoms, with a cumulative frequency of 1537 times, 61 symptoms with a frequency of more than 10 times, and 19 symptoms with a percentage of more than 10 per cent, including twitching of limbs, dizziness, closed teeth, fever and constipation. There are 12 systemic symptoms, such as strong back, clonic hand and foot, upset, sweating, angular arch reflexive, headache and thirst, etc., there are 34 tongue images and 20 pulse images, of which more than 10% include pulse string, pulse number, pulse fineness, tongue red, moss white, There are 7 symptoms of tongue and vein, such as pulse slippage and pulse sedimentation. According to the analysis of association rules, 22 related symptoms and 6 tongue pulse images were found. The core symptoms of spasmodic were as follows: twitching of limbs, closure of teeth, fever, dizziness and urgency of item back. Finally, it is inferred that the main symptoms of spasm are heart (brain), liver, meridians and collaterals, and the pathological syndromes are heat, wind, fire (heat), Jin deficiency and yin deficiency. Conclusion: through data mining technology, this study makes mathematical statistical analysis, collates, sums up and summarizes the common symptoms of spasm. It is concluded that the core symptoms of spasm are twitching of limbs, closed teeth, fever, dizziness and urgency of the back of the item. According to the basic theory of TCM syndrome differentiation centered on the main symptoms, and referring to Zhu Wenfeng's syndrome differentiation standard of syndrome differentiation, it is concluded that the main syndrome elements of spasmodic disease are heart and mind (brain), liver, meridians and collaterals, disease syndrome elements: heat and wind. Fire (heat), Jin deficiency, yin deficiency. These core elements of spasm provide a reference and new idea for the syndrome differentiation and treatment of spasm in traditional Chinese medicine, and provide a reference for the revision of spasmodic guidelines.
【学位授予单位】：湖北中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R249;R256.44
本文编号：2484822
[Abstract]:Objective: through the study of ancient and modern medical records combined with modern mathematical statistical analysis methods, this study excavates and analyzes the core symptoms of spasm, summarizes and discusses the main syndrome elements of spasm, and expounds the etiology and pathogenesis of spasm. In order to provide reference and new ideas for the syndrome differentiation and treatment of spasm in traditional Chinese medicine, and to provide reference for the revision of spasmodic guidelines. Methods: taking the large electronic series Chinese Medical Code as the main source of ancient spasmodic medical records, the medical records, medical words and medical theories of representative doctors in ancient medical books were selected to select the contents of spasmodic medical records. Taking each major Chinese database as the source of modern spasmodic medical records, from the Chinese Biomedical Literature Service system (CBM), Weipu Chinese Journal Database (VIP), China knowledge Resources General Library (CNKI), Wanfang academic Journal full-text Database, Chinese traditional Chinese medicine periodical literature database retrieval system, read show database and other large Chinese databases, as well as Chinese excellent master's degree thesis, the conference literature to retrieve all the literature on spasmodic before January 2015. Extract the part of spasmodic medical record; To establish the inclusion standard and exclusion standard, to screen and standardize the collected medical cases according to the inclusion exclusion criteria, and to establish the database of ancient and modern spasmodic medical records. Taking the contents of spasmodic medical records in Chinese Medical Code and modern literature as the research object, the frequency analysis of symptoms and the analysis of association rules were carried out, and the core symptoms were obtained, according to the basic theory of TCM differentiation of symptoms and signs centered on the main symptoms. With reference to Professor Zhu Wenfeng's syndrome differentiation, spasmodic syndrome elements were extracted. Results: a total of 263 spasmodic medical records were collected, including 153 cases of ancient internal medicine and 110 cases of modern literature. 203 symptoms were obtained, with a total of 145 systemic symptoms, with a cumulative frequency of 1537 times, 61 symptoms with a frequency of more than 10 times, and 19 symptoms with a percentage of more than 10 per cent, including twitching of limbs, dizziness, closed teeth, fever and constipation. There are 12 systemic symptoms, such as strong back, clonic hand and foot, upset, sweating, angular arch reflexive, headache and thirst, etc., there are 34 tongue images and 20 pulse images, of which more than 10% include pulse string, pulse number, pulse fineness, tongue red, moss white, There are 7 symptoms of tongue and vein, such as pulse slippage and pulse sedimentation. According to the analysis of association rules, 22 related symptoms and 6 tongue pulse images were found. The core symptoms of spasmodic were as follows: twitching of limbs, closure of teeth, fever, dizziness and urgency of item back. Finally, it is inferred that the main symptoms of spasm are heart (brain), liver, meridians and collaterals, and the pathological syndromes are heat, wind, fire (heat), Jin deficiency and yin deficiency. Conclusion: through data mining technology, this study makes mathematical statistical analysis, collates, sums up and summarizes the common symptoms of spasm. It is concluded that the core symptoms of spasm are twitching of limbs, closed teeth, fever, dizziness and urgency of the back of the item. According to the basic theory of TCM syndrome differentiation centered on the main symptoms, and referring to Zhu Wenfeng's syndrome differentiation standard of syndrome differentiation, it is concluded that the main syndrome elements of spasmodic disease are heart and mind (brain), liver, meridians and collaterals, disease syndrome elements: heat and wind. Fire (heat), Jin deficiency, yin deficiency. These core elements of spasm provide a reference and new idea for the syndrome differentiation and treatment of spasm in traditional Chinese medicine, and provide a reference for the revision of spasmodic guidelines.
【学位授予单位】：湖北中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R249;R256.44
【相似文献】
相关期刊论文 前10条
1 张毅之;;金匮“痉病”探讨[J];天津中医学院学报;1984年03期
2 张鹏;痉病[J];浙江中医学院学报;1984年02期
3 薛近芳;;治疗流行性痉病的经验介绍[J];江苏医药(中医分册);1979年01期
4 陈鼎;经方辨治痉病二则[J];河南中医;1995年02期
5 王桐萍;对《金匮》痉病辨治的认识及运用[J];浙江中医杂志;1996年10期
6 杨晓爱;;针刺配合中药治疗痉病26例[J];中国针灸;2009年S1期
7 李致重;;关于《金匮》痉病的几个问题[J];浙江中医学院学报;1982年04期
8 吴生元;;对《金匾要略》“痉病”的讨论[J];云南中医学院学报;1980年01期
9 倪忠根;;五书“论痉”的异同考辨[J];实用中医内科杂志;2008年02期
10 曾勇;;刘裁吾及其《痉病与脑膜炎全书》[J];湖南中医学院学报;1984年01期
相关会议论文 前1条
1 杨晓爱;;针刺配合中药治疗痉病26例[A];第8届全国针灸科研与临床研讨会暨安徽省针灸学会2009年年会论文集[C];2009年
相关重要报纸文章 前1条
1 孟琳升;仲景论痉[N];中国中医药报;2007年
相关硕士学位论文 前2条
1 陈丽珠;基于医案挖掘痉病的证素研究[D];湖北中医药大学;2016年
2 陈乞;基于古今医案数据挖掘的痉病用药特点研究[D];湖北中医药大学;2016年
，本文编号：2484822
本文链接：https://www.wllwen.com/zhongyixuelunwen/2484822.html
