陈民教授治疗肝脾不调型老年慢性疾病的用药规律分析

发布时间：2019-07-09 20:38

【摘要】：目的:探寻陈民教授治疗肝脾不调型老年慢性疾病的用药规律,挖掘其辨证论治中的理、法、方、药,以总结吾师治疗老年慢性疾病的辨证思维和处方规律,发挥中医在诊治老年慢性疾病中的优势。材料与方法:本研究通过收集2015年7月至2017年1月就诊于辽宁中医药大学附属医院专家门诊,由陈民教授诊治的符合纳入标准和排除标准的186例老年慢性疾病患者的初、复诊信息,并将药味录入WPS-Excel2016,建立处方数据表格,进行频数、频率、性味归经及功效分类分析,将使用频率在30%以上的药味导入IBM SPSS Statistics 22.0,采用相关性分析及聚类分析等数据挖掘技术进行分析。结果:1.根据纳排标准共筛选出186首方,一共总结出136味中药,使用总频次为3482次。其中频率大于30%的共22味,依频次从高到低分别为白术,柴胡,陈皮,白芍,茯苓,合欢花,砂仁,黄芩,甘草,半夏,炙甘草,当归,川芎,菊花,酸枣仁,黄芪,白扁豆,龙骨,桔梗,桂枝,枳壳,薏苡仁。2.136味药中以温性药物居多,占36.24%,寒性、平性次之,分别占29.98%、26.45%;药味以甘、苦、辛居多,分别占34.19%、26.49%、26.19%;归经以脾、胃、肺、心、肝居多,分别占20.77%、15.26%、15.08%、13.58%、13.24%。3.136味药中共涉及17类药,其中补虚药最多,占26.39%,解表药次之,占12.89%,安神药、清热药、理气药、活血化瘀药、利水渗湿药、化痰药亦均为治疗老年慢性疾病的常用药。4.将使用频率大于30%的22味中药用IBM SPSS Statistics 22.0进行相关性分析和聚类分析,得出常用药对及聚类后组成的3个聚类方。结论:吾师治疗肝脾不调型老年慢性疾病坚持以“和”为本,异病同治,注重肝脾两脏发病之主从、内在之联系,并结合老年人的病理生理特点,在调和肝脾的同时不忘以补虚为治疗的基础,并结合兼证转化,灵活运用药物及药物间配伍,辨证论治。
文内图片：

图片说明：补虚药高频次药物（2）解表药高频次分析
[Abstract]:Objective: to explore the law of medicine used by Professor Chen Min in the treatment of chronic diseases of liver and spleen in the elderly, and to excavate the reason, method, prescription and medicine in syndrome differentiation and treatment, so as to summarize the dialectical thinking and prescription law of our teacher in the treatment of chronic diseases in the elderly, and to give full play to the advantages of traditional Chinese medicine in the diagnosis and treatment of chronic diseases in the elderly. Materials and methods: from July 2015 to January 2017, this study collected the initial and revisit information of 186 elderly patients with chronic diseases diagnosed and treated by Professor Chen Min in the affiliated Hospital of Liaoning University of traditional Chinese Medicine from July 2015 to January 2017. The drug flavor was input into WPS-Excel2016, to establish prescription data table, and the frequency, sexual taste return and efficacy classification analysis were carried out. The drug flavor with frequency of more than 30% was introduced into IBM SPSS Statistics 22.0, and the data mining techniques such as correlation analysis and cluster analysis were used for analysis. Result: 1. According to the standard of Naxai, a total of 136 kinds of traditional Chinese medicine were screened out, and the total frequency of use was 3482 times. Among them, the frequency was more than 30%, the frequency was Atractylodes macrocephala, Bupleurum chinense, Radix Paeoniae Alba, Paeonia lactiflora, Poria, Acacia flower, Amomum villosum, Radix Scutellariae, Glycyrrhiza uralensis, Pinellia ternata, Angelica sinensis, Ligusticum chuanxiong, chrysanthemum, jujube kernel, Astragalus, lentil, keel, Platycodon grandiflorum, Cinnamomum cassia, Fructus Aurantii, Coix seed. Among the 2.136 herbs, warm drugs accounted for 36.24%, cold, flatness, 29.98%, respectively. 26.45%; The taste of medicine was sweet, bitter and bitter, accounting for 34.19%, 26.49% and 26.19%, respectively. Spleen, stomach, lung, heart and liver accounted for 20.77%, 15.26%, 15.08%, 13.58%, 13.24%, 13.24%, 13.24%, 13.24%, 13.24%, 13.24%, 13.24%, 13.24%, 13.24%, 13.24%, 13.24%, 13.24%, 13.24%, 13.24%, 13.24%, 13.24%, 13.24%, 26.39%, 12.89%, 12.89%, 12.89%, 12.89%, 12.89%, 12.89%, 12.89%, 12.89%, 12.89%, 12.89%, 12.89%, 20.77%, 15.08%, 13.58% and 13.24%, respectively. The correlation analysis and cluster analysis of 22 kinds of traditional Chinese medicine with frequency more than 30% were carried out with IBM SPSS Statistics 22.0, and the common drug pairs and three cluster prescriptions formed after clustering were obtained. Conclusion: our teacher insists on "harmony" as the basis for the treatment of chronic diseases of liver and spleen disorder, pays attention to the main cause and internal relationship of the incidence of liver and spleen, and combines the pathophysiological characteristics of the elderly, while regulating the liver and spleen, not forgetting to supplement deficiency as the basis of treatment, combined with the transformation of both syndromes, flexible use of drugs and compatibility of drugs, syndrome differentiation and treatment.
【学位授予单位】：辽宁中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R249;R259

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