本文關(guān)鍵詞： 糖尿病 數(shù)據(jù)挖掘 復法 王旭 經(jīng)驗總結(jié)　出處：《南京中醫(yī)藥大學》2017年碩士論文　論文類型：學位論文

【摘要】：目的:以收集的導師門診治療糖尿病的醫(yī)案為基礎,采用數(shù)據(jù)挖掘技術(shù)對導師臨證病案進行分析,結(jié)合導師臨證典型醫(yī)案方劑解構(gòu),總結(jié)導師臨床辨治糖尿病的經(jīng)驗及復法組方結(jié)構(gòu),使其源于臨床,高于臨床,以冀回歸指導臨床。方法:本次研究主要分為兩大部分。第一部分通過跟隨導師門診學習,對導師治療糖尿病的醫(yī)案進行全面收集、整理,嚴格按照納入標準、排除標準篩選數(shù)據(jù),將符合條件的193例病例共計340診次的臨床資料利用Medcase V3.2數(shù)據(jù)記錄挖掘系統(tǒng)建立病案采集、存貯數(shù)據(jù)庫,運用頻數(shù)分布、關(guān)聯(lián)規(guī)則分析等方法挖掘分析其臨床表現(xiàn)、舌苔、脈象、處方用藥的特點和各自之間的聯(lián)系,并對挖掘結(jié)果進行分析、歸納、總結(jié)。第二部分通過篩選導師臨床診治糖尿病及其并發(fā)癥的典型醫(yī)案,對其進行方劑解構(gòu)分析,總結(jié)導師復法治療糖尿病的組方結(jié)構(gòu)。結(jié)果:通過數(shù)據(jù)挖掘研究得出:193例患者中男性86例,女性107例,年齡最大91歲,最小21歲。臨床癥狀頻次超過60次的有:口干、視物模糊、尿沫、寐差、乏力、神疲、肢麻,分別占 34.71%、32.94%、29.71%、29.41%、27.35%、22.35%、20.29%。舌質(zhì)主要為質(zhì)紅65.88%、質(zhì)淡紅23.53%,舌苔頻次大于80次的有苔薄白、苔薄,頻率分別為27.94%、25.88%。脈象頻次大于100次的有細脈、滑脈、弦脈,頻率分別為51.18%、38.82%、30.88%。本次研究共涉及中藥251味,累計用藥頻次5328次,診次頻率大于50%的高頻藥物有地骨皮、枸杞子、葛根、山藥四味。共涉及藥物種類14種,主要為清熱藥、補氣藥、活血化瘀藥、補陰藥、補血藥、補陽藥,其中清熱藥占首重。通過典型醫(yī)案解構(gòu)分析,總結(jié)導師的組方特點有陰陽雙補、氣血互調(diào)、多臟兼顧、清滋并用等。結(jié)論:通過研究發(fā)現(xiàn),糖尿病發(fā)病人群多為中、老年人群,在青年人群中的發(fā)病率亦較高。王旭教授辨治糖尿病多從虛損、熱郁、瘀阻立論,基本治法為清熱活血,養(yǎng)陰益氣。復法組方特點有陰陽雙補、氣血互調(diào)、多臟兼顧、清滋并用等。
[Abstract]:Objective: based on the medical records of tutor outpatient treatment of diabetes mellitus, data mining technology was used to analyze the clinical medical records of mentors, and to deconstruct the typical prescriptions of mentors' clinical cases. Summing up the experience of clinical differentiation and treatment of diabetes mellitus and the compound prescription structure, so that it originated from the clinical, higher than the clinical. Methods: this study is divided into two parts. The first part is to collect and organize the medical records of diabetes treated by mentors through out-patient study with mentors, and strictly follow the inclusion criteria. Excluding the standard screening data, the clinical data of 193 cases were collected and stored by Medcase V3.2 data mining system. Using frequency distribution, association rules analysis and other methods mining analysis of its clinical manifestations, tongue coating, pulse, prescription drug use characteristics and the relationship between each other, and mining results are analyzed and summarized. Summary. The second part through screening mentors clinical diagnosis and treatment of diabetes and its complications of typical medical records, the prescription deconstruction analysis. Results: according to data mining, 86 cases of male and 107 cases of female were found to be male, 107 cases were female, the oldest age was 91 years old. The youngest 21 years, the frequency of clinical symptoms more than 60 times: dry mouth, blurred vision, urine foam, insomnia, fatigue, fatigue, limb anaesthesia, 34.71%, 32.94%. 29.41: 27.35B 22.35B 20.29.The tongue quality is mainly qualitative red 65.88, light red 23.53, tongue coating frequency more than 80 times with thin white fur and thin fur. The frequencies of pulse frequency were 27.94 and 25.88.The frequency of pulse frequency more than 100 times was 51.1838.82%, and the frequency of smooth vein and chord vein were 51.18% and 38.82%, respectively. 30.88. this study involved 251kinds of traditional Chinese medicine, the cumulative frequency of drug use 5328 times, the frequency of diagnosis more than 50% times of high-frequency drugs have the bone skin, wolfberry, Pueraria root. There are 14 kinds of drugs involved in yam. They are mainly heat-clearing medicine, tonifying qi medicine, activating blood circulation medicine, tonifying yin medicine, blood tonifying medicine, reinforcing yang medicine, among which heat-clearing medicine is the most important one, which is analyzed by deconstruction of typical medical records. Summing up the teacher's prescription characteristics are Yin and Yang double tonifying, qi and blood mutual regulation, both dirty and clean, and so on. Conclusion: through the study, the diabetes incidence population is mostly middle, elderly people. The incidence of diabetes in young people is also high. Professor Wang Xu differentiation and treatment of diabetes from deficiency, heat depression, stasis theory, the basic treatment method for clearing heat and activating blood, nourishing Yin and Qi. The compound method has the characteristics of Yin and Yang, Qi-blood intermodulation. How dirty, how dirty, and so on.
【學位授予單位】：南京中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R249;R259

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