發(fā)布時(shí)間：2018-01-21 22:11

  本文關(guān)鍵詞： 慢性萎縮性胃炎 數(shù)據(jù)挖掘 名老中醫(yī)經(jīng)驗(yàn) 徐景藩　出處：《南京中醫(yī)藥大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:以徐景藩教授治療慢性萎縮性胃炎(CAG)的臨床醫(yī)案為研究對(duì)象,運(yùn)用數(shù)據(jù)挖掘的方法,分析總結(jié)徐景藩教授對(duì)CAG的辨治經(jīng)驗(yàn),冀提高中醫(yī)藥治療CAG的臨床療效。方法:整理收集徐景藩教授診治CAG患者的醫(yī)案,嚴(yán)格依據(jù)診斷標(biāo)準(zhǔn)、排除標(biāo)準(zhǔn)進(jìn)行篩選,將符合納入標(biāo)準(zhǔn)的244診次醫(yī)案資料建立數(shù)據(jù)庫,對(duì)數(shù)據(jù)庫中的醫(yī)案進(jìn)行規(guī)范與清洗,運(yùn)用頻數(shù)分析、關(guān)聯(lián)規(guī)則和相關(guān)性分析等數(shù)據(jù)挖掘方法,重點(diǎn)研究醫(yī)案中癥狀、舌象、脈象、病機(jī)、方藥及相互間的規(guī)律,并結(jié)合徐景藩教授的論著思想,進(jìn)一步總結(jié)徐景藩教授辨治CAG的臨床經(jīng)驗(yàn)。結(jié)果:1.一般情況:本研究共選取CAG患者醫(yī)案244診次,其中男性87診次,女性157診次;平均年齡54歲,主要分布在40-69歲之間。2.頻數(shù)分析:所有診次中癥狀出現(xiàn)頻率較高的有痞脹、胃脘痛、噯氣、便溏;舌質(zhì)出現(xiàn)頻率較高的有舌淡紅、舌紅、舌微紅;舌苔出現(xiàn)頻率較高的有苔薄白、苔薄膩、苔薄黃;脈象出現(xiàn)頻率較高的有細(xì)、弦、沉、濡;病機(jī)出現(xiàn)頻率較高的有脾胃氣虛、肝胃不和、胃陰不足、瘀血阻滯、氣滯郁熱、脾胃濕熱;藥物分類頻率較高的有理氣藥、消食藥、補(bǔ)氣藥、補(bǔ)血藥。3.關(guān)聯(lián)規(guī)則:分析244診次醫(yī)案中癥狀-病機(jī)、病機(jī)-藥物的內(nèi)在聯(lián)系,總結(jié)徐景藩教授對(duì)CAG的辨治經(jīng)驗(yàn)。4.相關(guān)性分析:分析244診次醫(yī)案中常用藥物配伍規(guī)律,得出徐景藩教授治療CAG的常用藥物組合,包括炒白術(shù)和茯苓、炒白術(shù)和山藥、麥冬和石斛、紫蘇梗和香附、合歡花和合歡皮、黃連和藿香、法半夏和陳皮、陳皮和橘絡(luò)、佛手和炙雞內(nèi)金、炒麥芽和炒谷芽、白芍和炙甘草。結(jié)論:通過研究發(fā)現(xiàn),證候方面:CAG癥狀以痞脹、胃脘痛為主;舌質(zhì)以舌淡紅、舌紅、舌微紅為主;舌苔以苔薄白、苔薄膩、苔薄黃為主;脈象以細(xì)、弦為主。病機(jī)方面:CAG主要病機(jī)分為三類,包括脾胃氣虛、胃陰不足、肝胃不和,常伴有瘀血阻滯、脾胃濕熱、氣滯郁熱等兼證。用藥方面:徐景藩教授以辨證論治為基礎(chǔ),同時(shí)重視CAG氣機(jī)失調(diào)、運(yùn)化無力的病理特點(diǎn),并且善用藥對(duì)、靈活選藥。
[Abstract]:Objective: to study the clinical records of Professor Xu Jingfan in the treatment of chronic atrophic gastritis (CAG), and to analyze and summarize the experience of professor Xu Jingfan in the diagnosis and treatment of CAG by using the method of data mining. Methods: collect the medical records of Professor Xu Jingfan in the treatment of CAG patients, strictly according to the diagnostic criteria, exclude the criteria for screening. The data of 244 medical cases according to the standard were established, the medical records in the database were standardized and cleaned, and the methods of data mining such as frequency analysis, association rules and correlation analysis were used. Focus on the study of symptoms, tongue, pulse, pathogenesis, prescription and the law between each other, and combined with Professor Xu Jingfan's thoughts. Results: 1. General situation: in this study, we selected 244 medical cases of CAG patients, of which 87 were male and 157 were female; The average age was 54 years old, mainly distributed between 40-69 years old. Frequency analysis: the frequency of symptoms in all the visits was higher, such as distension, epigastric pain, belching, loose stools; The higher frequency of tongue appearance are light red tongue, red tongue, slightly red tongue; The high frequency of tongue coating has thin white fur, thin greasy fur, thin yellow fur; The higher frequency of pulse appearance is thin, chord, sink, acculturation; The higher frequency of pathogenesis are spleen and stomach qi deficiency, liver and stomach disharmony, stomach yin deficiency, blood stasis, stagnation of qi and heat, spleen and stomach dampness and heat; Drug classification frequency of rational qi drugs, drugs, tonifying qi drugs, blood tonic drugs .3.Association rules: analysis of 244 medical records of symptoms-pathogenesis, pathogenesis-drug internal relations. Summary of Professor Xu Jingfan's experience in differentiation and treatment of CAG. 4. Correlation analysis: analysis of 244-times of medical cases of commonly used drug compatibility law, draw the common combination of drugs for the treatment of CAG by Professor Xu Jingfan. These include stir-fried Atractylodes macrocephala and Poria, stir-fried Atractylodes macrocephala and yam, Ophiopogon and Dendrobium, Perilla pedunculus and Cortex Albizae, Albiziae and Albizae, Coptidis and Pogostemon, Fructus ternata and Pericarp, Pericarp and Orange, Buddha's hand and. Conclusion: according to the study, the symptoms of the symptoms of the symptom of "10% CAG" are bulging, epigastric pain, and epigastric pain. Tongue is light red, tongue red, tongue slightly red; Tongue coating to thin white, thin greasy fur, thin yellow coating mainly; The main pathogenesis of the disease is divided into three categories, including deficiency of spleen and stomach qi, deficiency of stomach yin, disharmony of liver and stomach, often accompanied by blood stasis, dampness and heat of spleen and stomach. On the basis of syndrome differentiation and treatment, Professor Xu Jingfan also attached importance to the pathological characteristics of CAG Qi Qi maladjustment, weak transport and utilization of drugs, as well as making good use of drug pairs and selecting drugs flexibly.
【學(xué)位授予單位】：南京中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R249;R259

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