1.北京中医药大学中医学院,北京市朝阳区北三环东路11号,100029
2.北京中医药大学中药学院
3.北京中医药大学北京中医药研究院
4.北京中医药大学生命科学学院
5.北京中医药大学东方医院
suzeqi@aliyun.com
收稿:2023-02-13,
修回:2023-08-20,
纸质出版:2023-11-02
移动端阅览
吴宇杰,王停,朱佩轩等.基于数据挖掘的名医名家治疗溃疡性结肠炎辨证治疗规律研究[J].中医杂志,2023,64(21):2241-2247.
WU Yujie,WANG Ting,ZHU Peixuan,et al.Research on Syndrome and Treatment Rules of Famous Doctors in Treating Ulcerative Colitis Based on Data Mining[J].Journal of Traditional Chinese Medicine,2023,64(21):2241-2247.
吴宇杰,王停,朱佩轩等.基于数据挖掘的名医名家治疗溃疡性结肠炎辨证治疗规律研究[J].中医杂志,2023,64(21):2241-2247. DOI: 10.13288/j.11-2166/r.2023.21.013.
WU Yujie,WANG Ting,ZHU Peixuan,et al.Research on Syndrome and Treatment Rules of Famous Doctors in Treating Ulcerative Colitis Based on Data Mining[J].Journal of Traditional Chinese Medicine,2023,64(21):2241-2247. DOI: 10.13288/j.11-2166/r.2023.21.013.
目的
2
系统梳理我国四届国医大师和两届全国名中医治疗溃疡性结肠炎(UC)临证经验,对其进行数据挖掘分析,明确名医名家治疗UC的诊治思路和组方用药特色。
方法
2
检索自系统建库至2023年3月31日收录于中国知网、万方数据知识服务平台、中文科技期刊数据库、中国生物医学文献数据库中的名医名家治疗UC相关文献,筛选临证医案,建立数据库,并借助古今医案云平台V2.3.5,运用频次分析、关联规则、聚类分析法等进行数据挖掘。
结果
2
共纳入文献157篇,包含临证医案数据115条。UC可归为大肠湿热证(频次75,频率65.22%)、脾虚湿困证(23,20.00%)、脾肾阳虚证(21,18.26%)等14种证候类型论治;病位主要在脾(85,73.91%)与大肠(75,65.22%),且与肝(24,20.87%)、肾(21,18.26%)等密切相关,病性以湿(83,72.17%)、热(80,69.57%)、气虚(65,56.52%)尤为突出;治疗涉及清热利湿法(75,65.22%)、补脾益气法(25,21.74%)、健脾化湿法(23,20.00%)等30种治法,与证候分布相对应,用药涉及187味,以清热药(37,19.79%)和补虚药(27,14.44%)使用最多,药味甘(85,45.45%)、苦(80,42.78%)、辛(71,37.97%)居多,关联规则展示了以黄连、白芍、甘草为主,与白术、茯苓、木香、当归共同形成的16个高频组合。
结论
2
名医名家善从脏腑和气血辨治UC,其中“脾虚为本、大肠湿热为标”为其病机关键,在治疗时以“清热、健脾、利湿”为核心,寓“调气和血、平调寒热”于其中。
Objective
2
To systematically review the clinical experience of four sessions of Masters of Traditional Chinese Medicine and two sessions of National Famous Chinese Medicine Practitioners in treating ulcerative colitis (UC). Data mining and analysis were conducted to clarify the diagnosis and treatment ideas and characteristics of prescription used by these famous doctors in treating UC.
Methods
2
Relevant literature on the treatment of UC by renowned doctors was retrieved from the establishment of the database until March 31, 2023. The literature was collected from databases such as China National Knowledge Infrastructure (CNKI), Wanfang Data Knowledge Service Platform, Chinese Science and Technology Periodicals Database, and China Biomedical Literature Database. The data mining techniques including frequency analysis, association rules, and cluster analysis were conducted using the Ancient and Modern Medical Case Cloud Platform V2.3.5.
Results
2
A total of 157 literatures were included in this study, including 115 clinical case data. The study found that UC can be categorized into 14 types of syndrome patterns for treatment, including large intestine dampness-heat syndrome (75,65.22%), syndrome of dampness stagnancy due to spleen deficiency (23, 20.00%), spleen-kidney
yang
deficiency syndrome (21, 18.26%). The main affected organs were the spleen (85, 73.91%) and large intestine (75, 65.22%), and they were closely related to liver (24, 20.87%) and the kidney (21, 18.26%). The predominant pathogenic factors were dampness (83, 72.17%) , heat (80, 69.57%) and
qi
deficiency (65, 56.52%). The treatment involved 30 kinds of treatment methods, including heat-clearing and dampness-draining method (75, 65.22%), pleen-tonifying and
qi
-boosting method (25,21.74%) and spleen-invigorating and dampness-transforming method (23, 20.00%). The medication involved 187 ingredients, with the most commonly used being heat-clearing herbs (37, 19.79%) and tonifying herbs (27, 14.44%). The tastes of the herbs were mostly sweet (85, 45.45%) , bitter (80, 42.78%) , and pungent (71, 37.97%). The association rules revealed 16 high-frequency combinations mainly composed of Huanglian (黄连), Baishao (白芍) and Gancao (甘草) along with Baizhu (白术), Fuling (茯苓), Muxiang (木香) and Danggui (当归).
Conclusion
2
Famous doctors are skilled in diagnosing and treating UC based on the differentiation of the
zang
-
fu
organs and
qi
-blood. The key pathological mechanism is “spleen deficiency as the root, and large intestine damp-heat as the manifestation”. The core treatment approach is “heat-clearing, spleen-tonifying, and dampness-draining”, with the inclusion of “regulating
qi
and blood, and balancing cold and heat”.
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