广东省中医院
纸质出版:2017
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[1]黎胜,施梅姐,萧焕明,谢玉宝,池晓玲.自身免疫性肝炎中医医案诊治规律数据挖掘[J].中医杂志,2017,58(14):1237-1240.
LI Sheng, SHI Meijie, XIAO Huanming, et al. Data Mining for Diagnosis and Treatment Law of Autoimmune Hepatitis based on Chinese Medical Records[J]. Journal of Traditional Chinese Medicine2017, 58(14): 1237-1240.
[1]黎胜,施梅姐,萧焕明,谢玉宝,池晓玲.自身免疫性肝炎中医医案诊治规律数据挖掘[J].中医杂志,2017,58(14):1237-1240. DOI: 10.13288/j.11-2166/r.2017.14.017.
LI Sheng, SHI Meijie, XIAO Huanming, et al. Data Mining for Diagnosis and Treatment Law of Autoimmune Hepatitis based on Chinese Medical Records[J]. Journal of Traditional Chinese Medicine2017, 58(14): 1237-1240. DOI: 10.13288/j.11-2166/r.2017.14.017.
目的通过分析当代中医诊治自身免疫性肝炎的医案初步探讨其临床诊治规律。方法分别检索中国知网、中国生物医学数据库、维普期刊数据库、万方数据库、广州中医药大学名医数据库1990年1月至2016年2月期间的中医或中西医结合诊治自身免疫性肝炎的医案
提取医案详细信息包括中医证型、中医病位证素、中医病性证素、使用药物
采用描述性统计分析、频数分析、聚类分析对数据进行统计分析
同时运用复杂网络分析绘制核心药物网络图。结果共纳入医案80则
涉及中医证型13个
出现频次前3位的证型分别为瘀血阻络(29)、湿热内蕴(24)、肝郁脾虚(17);涉及中医病性证素13种
出现频次前3位的证素分别为血瘀(33)、湿(32)、热(31)。医案中涉及中药方剂28种
出现频次前3位的方剂分别为茵陈蒿汤(22)、柴胡疏肝散(7)、逍遥散(5)、小柴胡汤(5)、一贯煎(5);共使用中药169味
平均每则医案使用药物14.6味
出现频次前5位的药物分别为茵陈(45)、甘草(42)、赤芍(37)、柴胡(34)、白术(31)。使用频次>3的药味有84味
聚类分析可分为9类;复杂网络分析得到不伴有黄疸的自身免疫性肝炎的治疗核心药物为柴胡、白术、白芍、茯苓、甘草、当归、黄芪
伴有黄疸的自身免疫性肝炎的治疗核心药物为茵陈、大黄、赤芍、黄芩。结论自身免疫性肝炎常见瘀血阻络证、湿热内蕴证
其病性以血瘀、湿、热多见
治疗药物以补虚、清热、利水渗湿、活血化瘀药为主。
Objective To explore the clinical diagnosis and treatment law of autoimmune hepatitis( AIH) by analyzing the medical records of contemporary Chinese medicine physicians. Methods The medical records of Chinese medicine or integrative traditional and western medicine in diagnosing and treating AIH from January of 1990 to February of 2016 were searched from China National Knowledge Infrastructure
Chinese Biological Medical Literature Database
VIP Database
Wanfang Database and Famous Doctor Database of Guangzhou University of Chinese Medicine. Detailed information in the medical records
including Chinese medicine syndrome type
Chinese medicine syndrome elements of disease location
Chinese medicine syndrome elements of disease nature
and used herbs
was extracted. Data was analyzed with descriptive statistics
frequency analysis and cluster analysis. Meanwhile
core herb network map was drawn with complex network analysis. Results Totally
80 medical records were included.There were thirteen Chinese medicine syndrome types were involved in
and the top 3 syndrome types with the highest frequency of occurrence were static blood blocking collaterals( 29)
internal retention of damp-heat( 24) and stagnation of liver Qi and spleen deficiency( 17). There were thirteen Chinese medicine syndrome elements of disease nature were included
and the top 3 syndrome elements with the highest frequency of occurrence were blood stasis( 33)
dampness( 32) and heat( 31). There were twenty-eight prescriptions were involved in the records
and the top 3 prescriptions with the highest frequency of occurrence were Yinchenhao Decoction( 茵陈蒿汤)( 22)
selfdesigned prescriptions( 20) and Chaihu Shugan San( 柴胡疏肝散)( 7). Totally
169 herbs were used. The average herbs used in each record were 14. 6. The top 5 herbs with the highest frequency of occurrence were Yinchen [Herba Artemisiae Scopariae
茵陈]( 45)
Gancao [Radix Glycyrrhizae
甘草]( 42)
Chishao [Radix Paeoniae Rubra
赤芍]( 37)
Chaihu [Radix Bupleuri
柴胡]( 34) and Baizhu [Rhizoma Atractylodis Macrocephalae
白术]( 31).There were 84 herbs with the used frequency > 3
which could be classified into 9 categories by cluster analysis. By complex network analysis
the core herbs in treating AIH without jaundice were Chaihu
Baizhu
Baishao [Radix Paeoniae Alba
白 芍]
Fuling [Poria
茯 苓]
Gancao
Danggui [Radix Angelicae Sinensis
当 归] and Huangqi[Radix Astragali seu Hedysari
黄芪]; the core herbs in treating AIH with jaundice were Yinchen
Dahuang [Radix et Rhizoma Rhei
大黄]
Chishao and Huangqin [Radix Scutellariae
黄芩]. Conclusion In AIH
the common Chinese medicine syndromes include syndrome of static blood blocking collaterals and syndrome of internal retention of damp-heat
and the common Chinese medicine disease natures are blood stasis
dampness and heat. For the treatment
herbs that replenishing deficiency
clearing heat
diuresis
diffusing dampness
promoting blood circulation and removing blood stasis are mostly applied.
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