基于数据挖掘现代医家治疗鼓胀病证治规律研究  

Research on Syndrome and Treatment Rules of Modern Physicians Treating Tympanites Based on Data Mining

作　　者：张爱娟 邝卫红 ZHANG Aijuan;KUANG Weihong

机构地区：[1]青岛市口腔医院,山东青岛266001 [2]广东医科大学附属东莞第一医院,广东东莞523808

出　　处：《新中医》2022年第12期29-33,共5页New Chinese Medicine

基　　金：广东省中医药局资助项目(20213011);青岛市医疗卫生重点学科建设项目(2020-2022)。

摘　　要：目的:基于数据挖掘现代医家治疗鼓胀病的证治规律。方法:以1978~2014年鼓胀病医案为研究对象,采用频数、Logistic回归、Spearman秩相关分析等多元统计方法,对医案中所涉及的证型进行频数分析并归纳其分布情况,通过对高频证型与高频中药进行Logistic回归分析,挖掘与证型关系密切的药物,通过Spearman秩相关分析探讨中药剂量与腹水分级之间是否存在依存关系。结果:共纳入医案591例,涉及医学著作48部,期刊93种。1978~2014年,鼓胀病常见证型有水湿内停、肝脾血虚、湿热蕴结、肝郁脾虚等,且单一证型较少,多数兼见2种或以上证型。证型与药物关系,比如针对水湿内停证的药物依次为大枣、葫芦、桂枝、黄芪、牵牛子、车前子、泽泻等。现代鼓胀病医案涉及中药341味,共计8296药次。其中,药物分类方面,排前3位为补虚药(20.74%)、利水渗湿药(17.01%)、活血化瘀药(11.27%),累积频率达到49.02%。药物归经方面,排前5位为脾(21.48%)、肝(14.79%)、肺(13.24%)、胃(12.24%)、肾(10.55%),入脾胃经累积频率达33.72%;药物药性方面,排前2位为温(28.93%)、平(23.36%),累积频率达52.29%。中药用量与腹水分级呈低度相关的中药是:车前草、红花、牡蛎、川芎;中药用量与腹水分级关系呈微弱或无相关的中药是:黄芪、赤芍和茯苓。研究结果中无中度相关及高度相关的药物。结论:1978~2014年,医家治疗鼓胀病以辨证为要,注重心理因素和患者体质,谨守本虚标实病机,用药首重补虚,脾胃为先,温平调理,标本兼顾。Objective:Based on data mining,this paper discusses syndrome and treatment rules of modern physicians in the treatment of tympanites.Methods:The medical cases of tympanites from 1978 to 2014 were taken as the research object;multiple statistical methods such as frequency,logistic regression and Spearman’s rank correlation analysis were used to analyze the frequency of the syndrome types involved in the medical cases and summarize their distribution.Through the logistic regression analysis of high-frequency syndrome types and high-frequency Chinese medicines,the medicines closely related to the syndrome types were excavated;Spearman’s rank correlation analysis was used to explore whether there was a dependency between the dosage of Chinese medicine and the grade of ascites.Results:A total of 591 medical cases were included,involving 48 medical works and 93 periodicals.From 1978 to 2014,the common syndrome types of tympanites were internal retention of water-dampness,the liver-spleen blood deficiency,dampness-heat accumulation,and liver constraint and spleen deficiency;there were few medical cases with a single syndrome type,and most cases had two or more syndrome types.As for the correlation between syndrome types and Chinese medicines,the Chinese medicines for syndrome of internal retention of water-dampness were Fructus Jujubae,Fructus Lagenariae,Ramulus Cinnamomi,Radix Astragali,Semen Pharbitidis,Semen Plantaginis,and Rhizoma Alismatis successively.Modern medical cases involved 341 Chinese medicines,a total of 8296 times;in terms of classification of Chinese medicine,the top three medicines were deficiency-tonifying medicine(20.74%),dampness-draining diuretic medicine(17.01%),and bloodactivating and stasis-resolving medicine(11.27%),and the cumulative frequency reached 49.02%;as for the meridian entry,the top five entries were the spleen(21.48%),the liver(14.79%),the lung(13.24%),the stomach(12.24%),and the kidney(10.55%),and the cumulative frequency of the spleen and stomach meridians reached 33.72%;as for

关 键 词：鼓胀 腹水 证治规律 数据挖掘 

分 类 号：R256.42[医药卫生—中医内科学]