摘要
目的通过古今医案云平台软件,整理平台上所有与胃食管反流病(GERD)相关医案,总结中医对GERD的辨证治疗规律。方法根据GRED的诊断标准以及临床症状,人工检索并筛选出古今医案云平台中相关医案,将筛选后的处方统一录入Excel数据库,导入古今医案云平台辅助平台,利用软件集成的频数分析、支持度分析、聚类分析法、社团分析法等多种数据挖掘方法分析胃食管反流病相关医案中医辨治规律。结果通过对407个医案的分析发现,中医疾病中,胃痛45次、胃脘痛32次、胃痞14次;中医症状中,反酸64次、烧心62次、苔薄白60次;中医证候中,肝胃不和出现21次;中医治法中,和胃37次、降逆28次、健脾12次、清热12次。GERD当以疏肝化郁、健脾清热为本,和胃降逆为标。以“咳嗽”为例,通过云平台中的社团分析,可得中医诊断为“咳嗽”与“泛酸”之间有交叉症状。GERD所得关于脉象的症状有“脉细、脉沉、脉弦”,关于舌象的有“舌淡、苔白、苔薄”,关于消化系统的有“腹胀、呃逆、嗳气”。除此之外,患者还会出现“畏寒、咳痰”等症状。结论GERD病位主要在胃、肝、脾,辩证多以肝郁脾虚,胃气上逆为主。因此临床上治疗GERD时可以疏肝化郁、健脾清热为本,和胃降逆为辅。
Objective To analyze all the medical cases related to gastroesophageal reflux disease(GERD)from the TCM Medical Cases Cloud Platform software,summarize the TCM diagnosis and treatment rules of gastroesophageal reflux disease and provide certain scientific basis for further clinical treatment of GERD.Methods According to the diagnostic criteria and clinical symptoms of GRED,the relevant medical records in the cloud platform of ancient and modern medical records were manually retrieved and screened.The screened prescriptions were uniformly entered into Excel database and imported into the auxiliary platform of ancient and modern medical records cloud platform.Various data mining methods such as frequency analysis,support analysis,cluster analysis and community analysis were used.ResultsThrough the analysis of 407 medical records,it was found that 45 times of stomachache,32 times of epigastric pain and 14 times of gastric distension were found in TCM diseases.In TCM symptoms,acid regurgitation 64 times,heartburn 62 times,coating thin white 60 times.In TCM syndrome,disharmony of liver and stomach appeared 21 times.In the treatment of TCM,37 times of harmonizing stomach,28 times of descending adverse reaction,12 times of strengthening spleen and 12 times of clearing heat.GERD should be based on soothing the liver and resolving depression,strengthening the spleen and clearing heat,and the stomach should be the standard.In this 407 medical cases,TCM diagnosis of"stomachache","epigastric pain","stomach swelling","cough"and"acid vomiting"symptoms were analyzed respectively.Here,take"cough"as an example for discussion.Through the community analysis in cloud platform,it can be concluded that there are cross symptoms between"cough"and"pantothenic acid".The symptoms of pulse are"thin pulse,deep pulse,and stringy pulse";the symptoms of tongue are"light tongue,white fur,thin fur";and the digestive system is"abdominal distension,hiccup,belching".In addition,patients will also appear"chills,expectoration"and other symptoms.Conclusion GERD disease is mainly located in stomach,liver and spleen.The syndrome differentiation is mainly liver depression and spleen deficiency,and stomach qi is up and down.Therefore,the clinical treatment of GERD can be based on soothing the liver and resolving depression,strengthening the spleen and clearing heat,supplemented by stomach descending.
作者
杨寻止
王俊文
窦智丽
李敬华
于琦
田野
王一萌
YANG Xunzhi;WANG Junwen;DOU Zhili;LI Jinghua;YU Qi;TIAN Ye;WANG Yimeng(School of Humanities, Beijing University of Traditional Chinese Medicine, Beijing 100102, China;Institute of Traditional Chinese Medicine Information, Chinese Academy of Traditional Chinese Medicine, Beijing 100700, China;Institute of Basic Theories of Troditional Chinese Medicine, China Academy of Chinese Medical Sciences, Beijing 100700, China)
出处
《西部医学》
2020年第11期1616-1619,共4页
Medical Journal of West China
基金
国家自然科学基金(81503501)
北京市自然科学基金(7192140)
中国中医科学院基本科研业务费自主选题项目(ZZ120302)。
关键词
胃食管反流病
医案
中医辨治
中医传承辅助平台
Gastroesophageal reflux disease
Medical cases
TCM diagnosis and treatment
Traditional Chinese medicine inheritance support system
