胆胀证型-证素分布及用药规律的病例回顾研究  

Retrospective Study on the Distribution of Gallbladder Distention Syndrome-Syndrome Elements and Medication Rule

作　　者：张伟健 李海文 梁艺钟 黄彦子 陈新博 刘禹翔[2] 姜小艳 康建媛[2] 李京伟[2] 郭绍举[2] Zhang Weijian;Li Haiwen;Liang Yizhong;Huang Yanzi;Chen Xinbo;Liu Yuxiang;Jiang Xiaoyan;Kang Jianyuan;Li Jingwei;Guo Shaoju(Guangzhou University of Chinese Medicine,Guangdong,Shershen 518033,China)

机构地区：[1]广州中医药大学,广东深圳518033 [2]广东省深圳市中医院,广东深圳518033

出　　处：《中国中医急症》2021年第4期633-637,共5页Journal of Emergency in Traditional Chinese Medicine

基　　金：广东省自然科学基金项目(2017A030310601);广东省中医药局面上科研项目(20191272);深圳市卫生系统科研项目资助(201606023);深圳市科技计划项目(JCYJ20160428175010774)。

摘　　要：目的分析胆胀患者性别年龄、中医证型、证候要素的分布特点及用药规律,为胆胀临床诊疗规范的制定提供参考。方法对深圳市中医院2011年至2019年门诊治疗胆胀病例中的性别年龄、证型、证素和用药频次进行统计并导出;结合系统聚类、关联规则等数据挖掘方法分析其用药规律,并对结果进行网络可视化展示。结果共纳入病例1 374例,40~59岁(657)年龄段患者最多。中医证型34种,频次最高的3种证型为肝胆湿热(370)、肝郁脾虚(262)、湿热蕴脾(156)。病位证素8个,前3位为肝(978)、脾(554)、胆(370)。病性证素10个,前3位为气滞(570)、湿(538)、热(533)。涉及中药325味,频次较高的依次为金钱草(1 274)、郁金(1 192)、瓜蒌皮(938)等;核心药对有郁金-金钱草、瓜蒌皮-丝瓜络等。结论气郁为胆胀的核心病机贯穿始终,湿热为其发生发展过程的驱动要素,中后期易夹杂血瘀、痰结、阳亢等复杂证候表现。治疗上以调气、制湿、治心为基本原则,祛邪顾本,痰湿并治,气血同调,常配伍平肝息风药、消食药和清热药等。Objective:To analyze the distribution characteristics and medication rules of sex,age,TCM syndrome types,syndrome elements of patients with gallbladder distention,so as to provide reference for the formulation of clinical diagnosis and treatment of gallbladder distention.Methods:The sex,age,syndrome types,syndrome elements and medication frequency of gallbladder distension cases treated in the outpatient department of Shenzhen Traditional Chinese Medicine Hospital in 2011-2019 were counted and exported;the medication rules were analyzed with data mining methods such as system clustering and association rules,and the results were displayed visually on the network.Results:A total of 1374 cases were included,with the largest number of patients in the age group of 40~59 years old(657 cases).There were 34 TCM syndrome types,and the top three syndrome types with the highest frequency were damp-heat of liver and gallbladder(370),liver depression and spleen deficiency(262),and damp-heat accumulation of spleen(156).There were 8 syndrome elements in the disease location,and the top three were liver(978),spleen(554)and gallbladder(370).There were 10 syndrome elements of disease,and the top three were qi depression(570),dampness(538)and heat(533).A total of 325 kinds of traditional Chinese medicine were involved,and the ones with the highest frequency were Artemisia mandshurica(1274),Turmeric(1192),Trichosanthes bark(938).The core medicine combinations were Turmeric-Artemisia angustifolia,Gourd peel-towel gourd,etc.Conclusion:Qi depression is the core pathogenesis of gallbladder distention,dampness and heat are the driving factor of its occurrence and development.The disease is easy to be mixed with blood stasis,phlegm,yang hyperactivity and other complex syndromes in the middle and later stage.The treatment should be based on the basic principles of regulating qi,regulating dampness and treating heart,dispelling evil qi and supporting vital qi,treating phlegm and dampness simultaneously,harmonizing qi and blood.Compatibilit

关 键 词：胆胀 中医证型 证候要素 用药规律 

分 类 号：R256.4[医药卫生—中医内科学]