中国中医科学院西苑医院
纸质出版:2015
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[1]张北华,高蕊,李振华,李保双,王凤云,唐旭东.中医药治疗慢性胃炎的专家经验数据挖掘分析[J].中医杂志,2015,56(08):704-708.
ZHANG Beihua, GAO Rui, LI Zhenhua, et al. Data Mining Analysis of Chinese Medicine Experts’ Experiences in Treating Chronic Gastritis[J]. Journal of Traditional Chinese Medicine2015, 56(8): 704-708.
[1]张北华,高蕊,李振华,李保双,王凤云,唐旭东.中医药治疗慢性胃炎的专家经验数据挖掘分析[J].中医杂志,2015,56(08):704-708. DOI: 10.13288/j.11-2166/r.2015.08.019.
ZHANG Beihua, GAO Rui, LI Zhenhua, et al. Data Mining Analysis of Chinese Medicine Experts’ Experiences in Treating Chronic Gastritis[J]. Journal of Traditional Chinese Medicine2015, 56(8): 704-708. DOI: 10.13288/j.11-2166/r.2015.08.019.
目的采用数据挖掘分析中医药专家治疗慢性胃炎的经验。方法计算机检索万方数据库、中国知网期刊全文数据库及学位论文全文数据库中所有关于慢性胃炎专家经验报道的文献
并人工查阅《临证治验》《张泽生医案医话集》筛选慢性胃炎的有效医案。提取医案中四诊信息、中医证素诊断、治法及方药信息并进行标准化处理
采用科研病例采集系统制定结构化电子病历采集模板
采集医案资料建立数据库
并根据系统数据挖掘平台对慢性胃炎症状、证素、治法及用药频次进行描述性统计
对症状-证候-治法-药物之间的关系、药物配伍规律进行关联规则分析。结果共筛选了108位中医药专家的278则有效医案。慢性胃炎症状出现频次前5位为胃脘痛(200)、胃脘胀满(176)、纳呆(139)、嗳气(101)、反酸(87);证素出现频次前5位为脾气虚(128)、肝郁(92)、气滞(82)、胃热(53)、湿热(50);治法出现频次前5位为健脾(141)、清热(109)、理气(95)、疏肝(93)、化湿(58)。278则医案共使用中药239味
其中出现频次≥10次的有80味
出现频率≥10%的有甘草、半夏、白芍、陈皮、白术等40味。白芍、茯苓、陈皮、白术分别与甘草
党参、白术、陈皮分别与茯苓
茯苓、白术、陈皮、甘草分别与砂仁两者之间
麦芽、山楂、神曲
白术、陈皮、茯苓三者之间为慢性胃炎最常见药物配伍。结论慢性胃炎以脾虚、肝郁为本
以气滞、湿热、血瘀为标
治疗以健脾益气、疏肝解郁为基本大法
根据兼挟的不同分别佐以行气、清热、化湿、活血、养阴和温阳之法。
Objective To analyze treatment experience of Traditional Chinese Medicine(TCM) experts on chronic gastritis using data analysis. Methods All literature about experts’ experience in treating chronic gastritis was searched from Wan Fang Data
Journal Full-Text Database and Dissertation Full-Text Database of China National Knowledge Infrastructure. Effective medical records of chronic gastritis were collected by browsing books Clinical Experience and Zhang Zesheng Medical Records. Information on TCM four diagnostic methods
TCM syndrome diagnosis
therapy and prescription was extracted and standardized. Data from medical records was collected with template of structured electronic patient record designed with case collecting system for research
and a database was established.Descriptive statistics of chronic gastritis symptoms
syndrome elements
therapies and medication frequency
and association rule analysis on the relationships among symptom
syndrome
therapy
and herbal medicines
as well as between Chinese herbs and regularity of compatible herbs were conducted on the data mining platform. Results Totally 278 effective medical records from 108 TCM experts were collected. Top five frequent symptoms of chronic gastritis were stomachache(200)
Gastric distention(176)
anorexia(139)
eructation(101)
and acid regurgitation(87). Top five frequent syndromes were spleen Qi deficiency( 128)
liver depression( 92)
Qi stagnation(82)
stomach-heat(53)
and damp-heat(50). Top five frequent therapies were invigorating spleen(141)
clearing heat(109)
regulating Qi(95)
soothing live r(93)
and dissipating dampness(58). 239 herbs were applied in 278 records
with 80 herbs recorded more than 10 times. 40 kinds of Chinese herbs were with recorded frequency over 10%
including Gancao( Liquorice
甘草)
Banxia( Pinellia
半夏)
Baishao( White Peony Root
白芍)
Chenpi( Tangerine Peel
陈皮)
Baizhu( Atractylodes
白术)
etc. Common compatibility herbs for chronic gastritis were: Baishao( White Peony Root
白芍)
Fuling( Poria
茯苓)
Chenpi( Tangerine Peel
陈皮)
and Baizhu(Atractylodes
白术) respectively with Gancao( Liquorice
甘草); Dangshen( Codonopsis pilosula
党参)
Baizhu(Atractylodes
白术) and Chenpi(Tangerine Peel
陈皮) respectively with Fuling(Poria
茯苓); Fuling(Poria
茯苓)
Baizhu(Atractylodes
白术)
Chenpi(Tangerine Peel
陈皮) and Gancao(Liquorice
甘草) respectively with Sharen( Amomum
砂仁); and Maiya( malt
麦芽)
Shanzha( hawthorn
山楂) and Shenqu( medicated leaven
神曲) with Baizhu(Atractylodes
白术)
Chenpi(Tangerine Peel
陈皮) and Fuling(Poria
茯苓). Conclusion Original cause of chronic gastritis was spleen deficiency and liver depression; while superficial cause was Qi stagnation
dampheat and blood stasis. Strengthening spleen
replenishing Qi and relieving depressed liver were basic treatment principles. According to different concurrent syndromes
other kinds herbs were also used
in order to promote Qi
clear heat
dissipate dampness
activate blood
nourish Yin or warm Yang.
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