基于中医传承辅助平台探讨丁学屏名中医诊治糖尿病肾病的用药规律  

Discussing Medicine Law of Famous Chinese Medicine Physician DING Xueping Diagnosing and Treating Diabetic Nephropathy Based on Chinese Medicine Inheritance Support System

作　　者：陆施婷 陈清光[1,2] 徐佩英[1,2] 陶枫[1,2] 姚政[1,2] 陆灏[1,2] 丁学屏 

机构地区：[1]全国名中医丁学屏学术传承工作室,上海201203 [2]上海中医药大学附属曙光医院内分泌科,上海201203

出　　处：《新中医》2017年第4期203-207,共5页New Chinese Medicine

基　　金：国家自然科学基金(81503552);上海市中医临床重点实验室(14DZ2273200);上海市中医药事业发展三年行动计划项目(ZYSNXD-CC-YJXYY);上海市中医药事业发展三年行动计划项目(ZY3-CCCX-3-3041);上海市中医药事业发展三年行动计划项目(ZY3-CCCX-2-1003);上海市科委科研计划项目(13401903200);上海市教委预算内项目(2014YSN43);慢性非传染性疾病防控领域中医预防保健(治未病)服务技术应用示范(2012BAI41B05)

摘　　要：目的:运用中医传承辅助平台管理系统(V2.5),分析"疾病-证候-治法-中药"之间的关系,探讨丁学屏教授诊治水瘀交互证糖尿病肾病的临证经验及用药规律。方法:通过临床医案采集,结合软件的分析系统,采用频次统计法,分析医案症状、证候、治法出现频次及中药性味归经频次;采用关联规则分析法、聚类分析法、改进的互信息法、复杂系统熵聚类、无监督的熵层次聚类等高级数据挖掘方法,分析处方中药物组合使用频次及药物之间的关联规则。结果:共纳入糖尿病肾病水瘀交互证患者17例进行分析,高频药物有土茯苓、茯苓、牛膝、防己、黑大豆等,药物组合有黑大豆与白扁豆,牛膝与茯苓,牛膝与土茯苓,白扁豆与茯苓等。结论:辨治糖尿病肾病,首先辨缓急,急者治其标,缓者治其本,治疗重视肺脾肾三脏,多用芳淡化湿,上下分利之品,祛邪而不伤正。Objective：By using Chinese Medicine Inheritance Support System（V2.5）,to analyze the relationship among disease-syndrome-treatment-Chinese medicine,and to discuss Professor DING Xueping＇s clinical experience and medicine law on diagnosing and treating diabetic nephropathy with water stasis syndrome.Methods：By collecting clinical medical cases and combining analytic system of the software,the statistical method of frequency was applied to analyze the appearance frequency of symptoms,syndromes and treatments of the medical cases as well as the frequency of channel tropism of Chinese medicine＇s nature and flavor.Some advanced data mining methods,such as association rule analysis,clustering analysis,improved mutual information,complex system entropy clustering,unsupervised entropy hierarchical clustering,etc.were adopted to analyze the frequency of combined use of Chinese medicine in prescriptions as well as the associated rules among medicine.Results：Seventeen cases of patients with diabetic nephropathy with water stasis syndrome were brought into the analysis.High-frequency medicines were smilax glabra,poria cocos,achyranthes root,radix and black soybean,etc.Medical combinations were black soybean and semen dolichoris,achyranthes root and poria cocos,achyranthes root and smilax glabra,semen dolichoris and poria cocos and so on.Conclusion：To differentiate and treat diabetic nephropathy,the degrees of seriousness should be firstly differentiate.The acute cases should be treated with temporary solution,and the less acute cases should be treated with permanent treatment.The emphasis of the treatment is put on three organs：lung,spleen and kidney.Aromatic medicine and medicine of tasteless flavor are preferable to be used to dispel dampness from upward and downward,so as to eliminate pathogenic factors without health energy being hurt.

关 键 词：糖尿病肾病 数据挖掘 学术经验传承 中医传承辅助平台管理系统 用药规律 丁学屏 

分 类 号：R587.2[医药卫生—内分泌]