基于中医传承辅助平台探讨丁学屏名中医诊治糖尿病合并高血压的临证经验及用药规律研究  

Analysis on Professor Ding Xueping's Herbal Administration Experiences for Diabetes combined with Hypertension by Using Traditional Chinese Medicine Inheritance Support System

作　　者：陆施婷 陈清光[2,1] 徐佩英[2,1] 陶枫[2,1] 姚政[2,1] 陆灏[2,1] 丁学屏[2,1] Lu Shiting Chen Qingguang Xu Peiying Tao Feng Yao Zheng Lu Hao Ding Xueping(Chinese Traditional Heritage Laboratory of Ding Xueping Academic Results, Shanghai 201203, China Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China)

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

出　　处：《世界科学技术-中医药现代化》2017年第4期644-652,共9页Modernization of Traditional Chinese Medicine and Materia Medica-World Science and Technology

基　　金：国家自然科学基金委青年科学基金项目(81503552):基于NF-κB通路介导的微循环障碍探讨糖尿病大鼠舌色的生物学基础研究;负责人:陈清光;上海市中医临床重点实验室(14DZ2273200);负责人:刘成海;上海市卫计委中医药事业发展三年行动计划项目(ZY3-CCCX-3-3041):糖尿病周围神经病变中医防治优化方案的评价研究;负责人:陆灏;上海市卫计委中医药事业发展三年行动计划项目(ZY3-CCCX-2-1003):中医药传承和创新发展;负责人:周华;上海市科委科研计划项目(13401903200):糖尿病周围神经病变中医防治优化方案的评价研究;负责人:陆灏;科学技术部国家科技支撑计划中医预防保健(治未病)服务技术研究与示范项目(2012BAI41B05):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;负责人:上海中医药大学附属曙光医院

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糖尿病合并高血压的临证经验及用药规律,总结丁学屏教授学术经验。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,统计得出医案症状、证候、治法出现频次,使用中药性味归经频次;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,统计得出处方中药物组合使用频次及药物之间的关联规则。结果:本研究对28例糖尿病合并高血压阴亏阳亢证进行分析,平肝熄风药出现频次前三位的分别为石决明、珍珠母、天麻;药物组合有"生地黄,山药"、"桑叶,桑白皮"、"菟丝子,山药,生地黄"等;对27例糖尿病合并高血压风火相煽证进行分析,平肝熄风药出现频次前两位的分别为石决明,珍珠母;药物组合除糖尿病常用组合外有"黄连,夏枯草"、"夏枯草,桑叶"、"黄连,生地黄,地骨皮"、"夏枯草,桑叶,黄连"等。结论:辨治糖尿病合并高血压,注重"厥阴风木"、"少阳相火"中"风""火"两大病因病机,以"平肝熄风,滋阴潜阳"为主要治则。This study was aimed to analyze the ＂disease - syndrome - treatment - medicine＂ experiences of professor Ding for diabetes combined with hypertension by using ＂traditional Chinese medicine （TCM） inheritance support system （V2.5）＇. By analyzing the data, we summarized Professor Ding＇ s academic experiences. Through collecting the standard clinical cases, combined with the software analysis system, the composing principles were analyzed by using data mining methods such as frequency statistics, revised mutual information, association rules analysis, cluster analysis, improvement of mutual information, complex system entropy clustering, unsupervised hierarchical clustering entropy and so on. The analysis results showed that 28 patients with diabetes combined with hypertension of yin-deficiency and yang- hyperactivity syndrome, the characteristics were discovered that the highest-frequency used drugs of Ping Gan Xi Feng were concha haliotidis, concha margaritifera, rhizoma gastrodiae; the highest-frequency used drug combinations were ＂radices rehmanniae, rhizoma dioscoreae＂, ＂folium mori, cortex mori＂, ＂semen cuscutae, rhizoma dioscoreae, radices rehmanniae＂ and so on. Analyzing the 27 patients with diabetes combined with hypertension ＂wind and fire evils stir up syndrome, the characteristics were discovered that the highest-frequency used drugs of Ping Gan Xi Feng were concha haliotidis, concha margaritifera. In addition to the most common combinations used in diabetes, there were ＂rhizoma coptidis, spica prunellae＇, ＂spica prunellae, folium mori＇, ＂rhizoma coptidis, radices rehmanniae, cortex lycii＂, ＂spica prunellae, folium mori, rhizoma coptidis＂ and so on. It was concluded that the syndrome differentiation and treatment of diabetes combined with hypertension was focused on the etiology and pathogenesis of wind and fire. The main treatment principle was to calm the liver to stop the wind, nourish yin and suppress hyperactive yang.

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

分 类 号：R286.0[医药卫生—中药学]