国医大师治疗慢性萎缩性胃炎证型证素分布及用药规律研究  

Study on the Types of Syndromes and Medication Rules of Master of Traditional Chinese Medicine in the Treatment of Chronic Atrophic Gastritis

作　　者：张伟健 梁艺钟 黄彦子 陈新博 徐思思 陈洁娜 李海文 康建媛[2] 刘禹翔[2] 郭绍举[2] ZHANG Weijian;LIANG Yizhong;HUANG Yanzi;CHEN Xinbo;XU Sisi;CHEN Jiena;LI Haiwen;KANG Jianyuan;LIU Yuxiang;GUO Shaoju(The Fourth Clinical Medical College of Guangzhou University of Chinese Medicine,Shenzhen 518033,Guangdong,China;Shenzhen Hospital of Traditional Chinese Medicine,Shenzhen 518033,Guangdong,China;Beijing University of Chinese Medicine,Beijing 102400,China)

机构地区：[1]广州中医药大学第四临床医学院,广东深圳518033 [2]深圳市中医院,广东深圳518033 [3]北京中医药大学,北京102400

出　　处：《辽宁中医药大学学报》2022年第3期37-41,共5页Journal of Liaoning University of Traditional Chinese Medicine

基　　金：国家自然科学基金(82104747);广东省基础与应用基础研究基金(2020A1515110947)。

摘　　要：目的分析国医大师治疗慢性萎缩性胃炎病案处方中的药物使用情况、证候要素、常用及潜在的核心药物组合及组方规律,以为慢性萎缩性胃炎的中医辨治提供有价值的指导方针,更好地传承与发展国医大师用药经验及学术思想。方法以医案处方为切入点,提取国医大师病案中涉及的证候要素,并运用关联规则、系统熵聚类等一系列高级的数据挖掘方法分析国医大师治疗慢性萎缩性胃炎病案处方中的用药组方规律。结果收集到历届共16位国医大师验案处方327首,涉及中医证型70种,中药219味。其中核心药物组合198对,潜在常用药对163对,新处方4首。结论国医大师认为脾胃气虚证、肝胃不和证及气滞血瘀证是慢性萎缩性胃炎的核心证候,贯穿于慢性萎缩性胃炎整个过程,尤以脾胃气虚为主,治疗应以健脾和胃为核心,根据气滞、血瘀、湿阻等标实的不同,佐以调气活血、化湿祛浊之法,辨证施治,标本兼治,虚实同调,恰中慢性萎缩性胃炎病机,才能屡获良效。Objective To analyze the basic drug information,syndrome elements,core drug combination and prescription rules in the prescription of chronic atrophic gastritis by masters of traditional Chinese medicine,in order to more fully grasp his academic thoughts and provide a TCM differentiation for chronic atrophic gastritis.Methods Taking the prescription of medical records as the starting point,extract the syndrome elements involved in the medical records of masters of traditional Chinese medicine,and use advanced data mining methods such as Apriori association rule algorithm,complex system entropy clustering and improved mutual information method to analyze the treatment of chronic atrophy by masters of traditional Chinese medicine.Results A total of 327 prescriptions verified by 16 masters of traditional Chinese medicine were collected,involving 70 types of Chinese medicine syndromes and 219 Chinese medicines.Among them,198 pairs of core drug combinations,163 pairs of potential common drugs and 4 new prescriptions.Conclusion Masters of traditional Chinese medicine believe that spleen-stomach Qi deficiency syndrome,liver-stomach discordance syndrome,and Qi stagnation and blood stasis syndrome are the core syndromes of chronic atrophic gastritis,which run through the entire process of chronic atrophic gastritis,especially spleen-stomach Qi deficiency syndrome,The treatment should take invigorating the spleen and harmonizing stomach as the core,according to the differences of Qi stagnation,blood stasis,dampness resistance and other standards and facts,supplemented by the methods of regulating Qi and activating blood circulation,removing dampness and removing turbidity,treat syndrome differentiation,treat both symptoms and root causes,harmonize deficiency and reality,and just hit the pathogenesis of chronic atrophic gastritis..

关 键 词：慢性萎缩性胃炎 国医大师 验案 组方规律 健脾和胃 

分 类 号：R573.32[医药卫生—消化系统]