基于数据挖掘探析石氏伤科颅脑损伤恢复期辨证分型规律  

An Analysis of Syndrome Differentiation Classification Rules of Shi′s Traumatology in Convalescence of Traumatic Brain Injury Based on Data Mining

作　　者：张国梁 韩扬 石瑛[3] 顾航睿 熊轶喆 王永谦[4] 周承扬 刘宇翔 徐丹丘 李辉 ZHANG Guo-liang;HAN Yang;SHI Ying;GU Hang-rui;XIONG Yi-zhe;WANG Yong-qian;ZHOU Cheng-yang;LIU Yu-xiang;XU Dan-qiu;LI Hui(Zhabei Central Hospital of Jing'an District of Shanghai,Shanghai,China,200070;Jing'an Sub-Base of Shi's Traumatology of Shanghai School of Traditional Chinese Medicine,Shanghai,China,20007;Shi's Center of Orthopedics and Traumatology of Shuguang Hospital Affiliated to Shanghai University of Chinese Medicine,Shanghai,China,200021;Longhua Hospital Affiliated to Shanghai University of Chinese Medicine,Shanghai,China,200032)

机构地区：[1]上海市静安区闸北中心医院,上海200070 [2]海派中医流派石氏伤科静安分基地,上海200070 [3]上海中医药大学附属曙光医院石氏伤科医学中心,上海200021 [4]上海中医药大学附属龙华医院,上海200032

出　　处：《河南中医》2021年第3期401-405,共5页Henan Traditional Chinese Medicine

基　　金：上海市进一步加快中医药事业发展三年行动计划(2014—2016)中医、中西医结合重点扶持项目(ZY3-JSFC-1-1025);上海市卫生健康委员会2018中医药健康文化素养促进项目(Ⅳ-2-35);上海市卫生健康委员会中医药科研基金课题青年项目(2012QL002A)。

摘　　要：目的:总结石氏伤科对颅脑损伤的辨证分型规律,优化石氏伤科流派颅脑损伤特色病种的诊疗体系。方法:选择上海市静安区闸北中心医院2009年9月至2014年8月收治的170例颅脑损伤患者为研究对象,制定中医四诊信息表,对所选病例中符合纳入标准的症状体征运用Excel表进行收录,然后用SPSS 16.0统计软件进行聚类分析。结果:170例病例全部纳入研究,以初诊辨证信息为主,对四诊信息进行频数分析,将其中出现频率小于5%的去除,初步得到主要症状及病史特点作为中医四诊的观察指标,主要有:外伤(或手术)史,偏斜舌、舌下脉络瘀紫、舌质紫暗或有瘀斑,口唇紫暗或暗红,伤后有短暂意识障碍等。再将调查结果中出现频率>14%的中医四诊病症进行系统聚类分析,共得到4类结果。结论:石氏伤科将颅脑损伤初步辨证分四型:瘀浊证、瘀痰证、肝肾不足夹痰瘀证、脾肾不足夹痰瘀证。早期属"瘀",后期属"虚",且"痰瘀"兼邪可交阻于颅脑损伤的全过程。Objective:To summarize syndrome differentiation classification rules of Shi′s traumatology in convalescence of traumatic brain injury,and optimize the diagnosis and treatment system of characteristic diseases of Shi′s traumatology.Methods:A total of 170 patients with traumatic brain injury in Zhabei Central Hospital of Jing′an District of Shanghai(formerly Zhabei Central Hospital of Shanghai)from September 2009 to August 2014 were selected as the research objects.The four diagnostic information table of TCM was drawn.The symptoms and signs of the selected cases were collected by Excel,and then the cluster analysis was carried out by SPSS 16.0 statistical software.Results:The selected 170 cases were all included in the study,mainly based on the first diagnosis of syndrome differentiation information.The frequency of the four diagnosis information was analyzed,and the frequency less than 5%was removed.The main symptoms and medical history characteristics were preliminarily obtained as the observation indicators of the four diagnosis of TCM,which mainly included:trauma(or surgery)history,oblique tongue,sublingual vein blood stasis with purple color,purple dark tongue or ecchymosis,purple dark or dark red lip,and transient disturbance of consciousness after injury,etc.Then,the results of the investigation of the frequency of more than 14%of the four diagnostic diseases of TCM were analyzed by cluster analysis,and a total of four types of results were obtained.Conclusion:According to Shi′s traumatology,traumatic brain injury can be divided into four types:stagnant turbidity syndrome,stagnant phlegm syndrome,liver-kidney deficiency with stagnant phlegm syndrome,and spleen-kidney deficiency with stagnant phlegm syndrome.In the early stage,it belongs to"stagnation"and in the later stage,it belongs to"deficiency",and intermingled"phlegm and stagnation"pathogenic factors can be involved in the whole process of traumatic brain injury.

关 键 词：颅脑损伤 石氏伤科 数据挖掘 聚类分析 瘀浊证 瘀痰证 肝肾不足夹痰瘀证 脾肾不足夹痰瘀证 

分 类 号：R269.511.5[医药卫生—中西医结合]