摘要
目的采用数据挖掘分析中医药专家治疗慢性胃炎的经验。方法计算机检索万方数据库、中国知网期刊全文数据库及学位论文全文数据库中所有关于慢性胃炎专家经验报道的文献,并人工查阅《临证治验》《张泽生医案医话集》筛选慢性胃炎的有效医案。提取医案中四诊信息、中医证素诊断、治法及方药信息并进行标准化处理,采用科研病例采集系统制定结构化电子病历采集模板,采集医案资料建立数据库,并根据系统数据挖掘平台对慢性胃炎症状、证素、治法及用药频次进行描述性统计,对症状-证候-治法-药物之间的关系、药物配伍规律进行关联规则分析。结果共筛选了108位中医药专家的278则有效医案。慢性胃炎症状出现频次前5位为胃脘痛(200)、胃脘胀满(176)、纳呆(139)、嗳气(101)、反酸(87);证素出现频次前5位为脾气虚(128)、肝郁(92)、气滞(82)、胃热(53)、湿热(50);治法出现频次前5位为健脾(141)、清热(109)、理气(95)、疏肝(93)、化湿(58)。278则医案共使用中药239味,其中出现频次≥10次的有80味,出现频率≥10%的有甘草、半夏、白芍、陈皮、白术等40味。白芍、茯苓、陈皮、白术分别与甘草,党参、白术、陈皮分别与茯苓,茯苓、白术、陈皮、甘草分别与砂仁两者之间,麦芽、山楂、神曲,白术、陈皮、茯苓三者之间为慢性胃炎最常见药物配伍。结论慢性胃炎以脾虚、肝郁为本,以气滞、湿热、血瘀为标,治疗以健脾益气、疏肝解郁为基本大法,根据兼挟的不同分别佐以行气、清热、化湿、活血、养阴和温阳之法。
Objective To analyze treatment experience of Traditional Chinese Medicine（TCM） experts on chronic gastritis using data analysis. Methods All literature about experts＇ experience in treating chronic gastritis was searched from Wan Fang Data,Journal Full-Text Database and Dissertation Full-Text Database of China National Knowledge Infrastructure. Effective medical records of chronic gastritis were collected by browsing books Clinical Experience and Zhang Zesheng Medical Records. Information on TCM four diagnostic methods,TCM syndrome diagnosis,therapy and prescription was extracted and standardized. Data from medical records was collected with template of structured electronic patient record designed with case collecting system for research,and a database was established.Descriptive statistics of chronic gastritis symptoms,syndrome elements,therapies and medication frequency,and association rule analysis on the relationships among symptom,syndrome,therapy,and herbal medicines,as well as between Chinese herbs and regularity of compatible herbs were conducted on the data mining platform. Results Totally 278 effective medical records from 108 TCM experts were collected. Top five frequent symptoms of chronic gastritis were stomachache（200）,Gastric distention（176）,anorexia（139）,eructation（101）,and acid regurgitation（87）. Top five frequent syndromes were spleen Qi deficiency（ 128）,liver depression（ 92）,Qi stagnation（82）,stomach-heat（53）,and damp-heat（50）. Top five frequent therapies were invigorating spleen（141）,clearing heat（109）,regulating Qi（95）,soothing live r（93）,and dissipating dampness（58）. 239 herbs were applied in 278 records,with 80 herbs recorded more than 10 times. 40 kinds of Chinese herbs were with recorded frequency over 10%,including Gancao（ Liquorice,甘草）,Banxia（ Pinellia,半夏）,Baishao（ White Peony Root,白芍）,Chenpi（ Tangerine Peel,陈皮）,Baizhu（ Atractylodes,白术）,etc. Common compatibility herbs for chronic gastritis were： Baishao（ White Peony Root,白芍）,Fuling（ Poria,茯苓）,Chenpi（ Tangerine Peel,陈皮）,and Baizhu（Atractylodes,白术） respectively with Gancao（ Liquorice,甘草）; Dangshen（ Codonopsis pilosula,党参）,Baizhu（Atractylodes,白术） and Chenpi（Tangerine Peel,陈皮） respectively with Fuling（Poria,茯苓）; Fuling（Poria,茯苓）,Baizhu（Atractylodes,白术）,Chenpi（Tangerine Peel,陈皮） and Gancao（Liquorice,甘草） respectively with Sharen（ Amomum,砂仁）; and Maiya（ malt,麦芽）,Shanzha（ hawthorn,山楂） and Shenqu（ medicated leaven,神曲） with Baizhu（Atractylodes,白术）,Chenpi（Tangerine Peel,陈皮） and Fuling（Poria,茯苓）. Conclusion Original cause of chronic gastritis was spleen deficiency and liver depression; while superficial cause was Qi stagnation,dampheat and blood stasis. Strengthening spleen,replenishing Qi and relieving depressed liver were basic treatment principles. According to different concurrent syndromes,other kinds herbs were also used,in order to promote Qi,clear heat,dissipate dampness,activate blood,nourish Yin or warm Yang.
出处
《中医杂志》
CSCD
北大核心
2015年第8期704-708,共5页
Journal of Traditional Chinese Medicine
基金
国家中医药管理局中医药行业科研专项(201207001-02
201007006)
国家中医药管理局中医药标准化项目(ZYYS-2014[21])
关键词
慢性胃炎
专家经验
中医药疗法
数据挖掘
chronic gastritis
experience of Chinese experts
Chinese medicine therapy
data mining
