發(fā)布時間：2018-06-14 22:39

  本文選題：2型糖尿病 + 西醫(yī)��； 參考：《北京中醫(yī)藥大學(xué)》2014年博士論文

【摘要】：1.研究背景 據(jù)統(tǒng)計2型糖尿病約占糖尿病的95%,目前我國已取代印度,成為全球糖尿病第一大國,有超過9200萬的糖尿病患者�！吨腥A人民共和國國民經(jīng)濟(jì)和社會發(fā)展規(guī)劃》已將糖尿病作為重大疾病研究,而中醫(yī)藥防治糖尿病已有幾千年的歷史,積累了豐富經(jīng)驗,取得了顯著的效果。在中醫(yī)藥治療2型糖尿病領(lǐng)域,從古至今醫(yī)者們撰寫了大量的書籍、文獻(xiàn),記載了他們的心得體會、臨床及科研成果。面對這些迅速海量增長的醫(yī)學(xué)文獻(xiàn),通過傳統(tǒng)手工檢索的方法已經(jīng)無法準(zhǔn)確及時的捕捉到學(xué)科發(fā)展的脈動,客觀上要求產(chǎn)生一種新型、高效、科學(xué)、準(zhǔn)確且直觀的方法,以此來揭示學(xué)科的知識結(jié)構(gòu)和演進(jìn)過程。以往傳統(tǒng)的文獻(xiàn)計量學(xué)方法多解決的是“極值”和“排序”類問題,卻難以解決文獻(xiàn)數(shù)據(jù)中存在的“結(jié)構(gòu)”類問題,如大規(guī)模文獻(xiàn)數(shù)據(jù)中復(fù)雜的作者、機(jī)構(gòu)合作關(guān)系、研究主題的結(jié)構(gòu)及演化、研究領(lǐng)域潛在的發(fā)展趨勢等問題；而且其統(tǒng)計數(shù)據(jù)圖形不能基于內(nèi)在統(tǒng)計數(shù)據(jù)表現(xiàn)機(jī)理,無法滿足多維統(tǒng)計數(shù)據(jù)表現(xiàn)和分析的要求。我們?nèi)绾螐募姺钡那叭撕Ａ垦芯繑?shù)據(jù)中找到科研思路、總結(jié)出規(guī)律、預(yù)測該領(lǐng)域的發(fā)展前景并以直觀的形式展示出來等問題急待每一個科研工作者去解決�？茖W(xué)知識圖譜的出現(xiàn),正是迎合了科學(xué)和時代發(fā)展的需要。它以準(zhǔn)確的圖像視覺表達(dá)為我們直觀的呈現(xiàn)了科學(xué)的框架結(jié)構(gòu)和發(fā)展脈絡(luò),特別是研究熱點和前沿領(lǐng)域。 2.研究目的及意義 2.1系統(tǒng)梳理國內(nèi)中醫(yī)藥及國外西醫(yī)治療2型糖尿病領(lǐng)域的文獻(xiàn),揭示該領(lǐng)域發(fā)展脈絡(luò),找到核心的學(xué)科領(lǐng)軍人物及研究單位,力圖清晰、準(zhǔn)確地揭示其知識領(lǐng)域結(jié)構(gòu),發(fā)現(xiàn)該領(lǐng)域研究熱點、研究前沿及發(fā)展趨勢。這對我們追蹤和選擇國際科技研究前沿、探索和制定科技發(fā)展戰(zhàn)略及政策具有重大而深遠(yuǎn)的實際意義。 2.2在繪制2型糖尿病治療領(lǐng)域知識圖譜的基礎(chǔ)上將國內(nèi)外該領(lǐng)域的研究進(jìn)行對比,找到各自的特點。特別是挖掘出中醫(yī)藥在治療2型糖尿病方面的優(yōu)勢及不足,借鑒國外先進(jìn)的科研方法和科學(xué)技術(shù),促進(jìn)中醫(yī)藥更好地為人類健康服務(wù)。 2.3本研究以輔助科研人員把握目前國內(nèi)外、中西醫(yī)治療2型糖尿病領(lǐng)域研究的現(xiàn)狀,為科研工作者提供研究方向信息；為科學(xué)管理者決策提供數(shù)據(jù)參考；為國內(nèi)外學(xué)術(shù)合作、交流提供新的方向與途徑。 3.研究方法 3.1應(yīng)用共現(xiàn)分析及詞頻分析法,對國內(nèi)外中西醫(yī)治療2型糖尿病領(lǐng)域文獻(xiàn)就作者、年代、來源機(jī)構(gòu)等文獻(xiàn)的外部特征做系統(tǒng)的文獻(xiàn)計量分析,找到合作關(guān)系及主要研究陣地。 3.2本研究運(yùn)用文獻(xiàn)共被引聚類分析、關(guān)鍵節(jié)點文獻(xiàn)分析、關(guān)鍵詞共現(xiàn)聚類分析、突變詞監(jiān)測分析、引用突現(xiàn)分析等,繪制了中西醫(yī)治療2型糖尿病的知識圖譜。 3.3借助信息可視化技術(shù),識別出2型糖尿病治療領(lǐng)域的研究熱點、演進(jìn)的關(guān)鍵節(jié)點及研究前沿新趨勢等,為中醫(yī)治療2型糖尿病提供參考。 3.4運(yùn)用比較分析法,基于所做的知識圖譜并結(jié)合經(jīng)典文獻(xiàn)的閱讀,本文試圖對中西醫(yī)治療2型糖尿病的異同點進(jìn)行梳理說明,并做出原因分析。 4.研究結(jié)果 4.1西醫(yī)治療2型糖尿病知識圖譜分析結(jié)果 4.1.1西醫(yī)治療2型糖尿病領(lǐng)域文獻(xiàn)逐年穩(wěn)步上升,PARVING HH是該領(lǐng)域最高產(chǎn)的作者,美國高居發(fā)文量榜首國家,哈佛大學(xué)是發(fā)文最多的機(jī)構(gòu),928篇文獻(xiàn)載于《DIABETES CARE》雜志,該雜志成為該領(lǐng)域的核心期刊,研究方向以內(nèi)分泌方向為主,諾和諾德公司(丹麥著名的制藥公司)資助的研究最多。 4.1.2通過對納入的23558篇文獻(xiàn)及其參考文獻(xiàn)進(jìn)行共被引及聚類分析,結(jié)果顯示,共引網(wǎng)絡(luò)由307個節(jié)點、717條連線組成,被分成11個共引聚類,Cluster3是規(guī)模最大的一個聚類,從中可以看出該研究領(lǐng)域的基礎(chǔ)知識結(jié)構(gòu)。關(guān)鍵節(jié)點文獻(xiàn)視圖、關(guān)鍵詞共現(xiàn)聚類圖譜、引用突現(xiàn)視圖及枚舉高被引文獻(xiàn)、關(guān)鍵節(jié)點文獻(xiàn)及引用突現(xiàn)文獻(xiàn)、突現(xiàn)詞列表,勾勒出西醫(yī)治療2型糖尿病領(lǐng)域的關(guān)鍵節(jié)點、熱點及前沿。 4.2中醫(yī)治療2型糖尿病知識圖譜分析結(jié)果 4.2.1中醫(yī)藥治療2型糖尿病的文獻(xiàn)逐年增長趨勢明顯,該領(lǐng)域已成為中醫(yī)藥研究的熱點�？蒲袌F(tuán)隊合作明顯,各中醫(yī)藥大學(xué)成為該領(lǐng)域的主要研究陣地。 4.2.2中醫(yī)藥治療2型糖尿病的6724篇文獻(xiàn),其關(guān)鍵詞共現(xiàn)網(wǎng)絡(luò)共形成20個聚類,將這20個聚類詳細(xì)列表顯示,標(biāo)識了該研究領(lǐng)域的基礎(chǔ)知識結(jié)構(gòu)及其動態(tài)演進(jìn)的過程。關(guān)鍵詞共現(xiàn)網(wǎng)絡(luò)視圖、關(guān)鍵詞聚類的時序圖、高頻關(guān)鍵詞列表及結(jié)合經(jīng)典文獻(xiàn),呈現(xiàn)了中醫(yī)藥治療2型糖尿病領(lǐng)域的熱點及研究新趨勢。 5.結(jié)論 5.1西醫(yī)治療2型糖尿病知識圖譜分析結(jié)論 5.1.1西醫(yī)治療2型糖尿病領(lǐng)域主要知識結(jié)構(gòu)：包括2型糖尿病基于腸促胰島素治療；噻唑烷二酮類降糖藥物的應(yīng)用；代謝手術(shù)、減肥手術(shù)、糖尿病手術(shù)治療2型糖尿��；高血壓和糖尿病的關(guān)系；糖尿病與血脂障礙的關(guān)系；(強(qiáng)化)控制血糖與并發(fā)癥(心血管并發(fā)癥)的臨床試驗研究及2型糖尿病的基因治療、炎癥通路、胰島素治療、胰島素抵抗、鈉依賴性葡萄糖轉(zhuǎn)運(yùn)蛋白的研究等諸多方面。 5.1.2研究熱點：2型糖尿病的各類口服降糖藥的藥物治療(主要為二甲雙胍)；強(qiáng)化血糖控制對并發(fā)癥的影響(特別是大血管并發(fā)癥及其嚴(yán)重后果)；對2型糖尿病患者進(jìn)行血糖、血壓、血脂的綜合管理等主題成為該領(lǐng)域的研究熱點。 5.1.3重要知識演進(jìn)路徑：英國前瞻性糖尿病研究(UKPDS)、噻唑烷二酮類降糖藥物及胰高血糖素樣肽-1(GLP-1)的降糖作用三大主題的研究在整個西醫(yī)治療2型糖尿病領(lǐng)域的發(fā)展過程中起到了關(guān)鍵節(jié)點作用,反映了該領(lǐng)域的重要知識演進(jìn)路徑。 5.1.4研究前沿和新趨勢：基于腸胰島素治療的新藥物及鈉-葡萄糖協(xié)同轉(zhuǎn)運(yùn)蛋白2(SGLT2)抑制劑(格列凈類藥物)的研發(fā)與應(yīng)用；強(qiáng)化降糖問題；手術(shù)治療2型糖尿病等成為該領(lǐng)域的研究前沿和新趨勢。 5.2中醫(yī)藥治療2型糖尿病知識圖譜分析結(jié)論 5.2.1研究熱點：糖尿病腎病、糖尿病(周圍)神經(jīng)病變及糖尿病足等并發(fā)癥的治療是中醫(yī)藥治療2型糖尿病的熱點問題。 5.2.2中醫(yī)藥治療2型糖尿病的主要手段、治法、方劑及藥物：其主要治療手段為中草藥治療、中西醫(yī)結(jié)合治療及針刺療法,主要治法為活血祛瘀、益氣養(yǎng)陰,最常用方劑為六味地黃丸、補(bǔ)陽還五湯、消渴丸,常用中藥為黃芪、黃連、天花粉。天麥消渴片、芪明顆粒、降糖合劑、益氣養(yǎng)陰丸、消渴飲、糖尿康方、益氣養(yǎng)陰合劑、糖腎康、丹蛭降糖膠囊、消渴(無糖)沖劑、消渴膠囊等中成藥成為中醫(yī)藥治療2型糖尿病的特色,取得了良好的治療效果。 5.2.3研究新趨勢：有關(guān)中醫(yī)藥治療2型糖尿病的系統(tǒng)評價問題將成為該領(lǐng)域未來發(fā)展的新趨勢。 本研究依托于國家自然基金面上項目：基于系統(tǒng)復(fù)雜性的中醫(yī)診療信息集成可視化建模研究(項目號：81273876)。本文利用知識圖譜的方法,探求國內(nèi)中醫(yī)藥及國際上西醫(yī)治療2型糖尿病領(lǐng)域的演進(jìn)關(guān)鍵節(jié)點、知識結(jié)構(gòu)和前沿?zé)狳c。2型糖尿病治療領(lǐng)域的知識圖譜,為科研人員清晰呈現(xiàn)了該領(lǐng)域的“知識地圖”,也使我們能以一個更宏觀的文獻(xiàn)視角來梳理發(fā)現(xiàn)該領(lǐng)域的基本面貌和發(fā)展?fàn)顩r。在此基礎(chǔ)上,通過分析、對比中西醫(yī)在治療2型糖尿病方面各自的特點、優(yōu)勢和不足,客觀上也為中醫(yī)治療2型糖尿病提供了新的思路、方向和參考。
[Abstract]:1. background of research
According to statistics, type 2 diabetes accounts for about 95% of diabetes. At present, China has replaced India and has become the world's first country with diabetes. There are more than 92 million diabetic patients. < People's Republic of China national economic and social development planning > has studied diabetes as a major disease, and the prevention and treatment of diabetes by Chinese medicine has been accumulated for thousands of years. In the field of traditional Chinese medicine for the treatment of type 2 diabetes, doctors have written a large number of books, documents, and records of their experience, clinical and scientific research. The pulsation of discipline development objectively requires a new, efficient, scientific, accurate and intuitive method to reveal the knowledge structure and evolution process of the subject. The traditional bibliometric methods used to solve the problems of "extreme value" and "sort", but it is difficult to solve the "structural" problems in the literature data, such as the problems of "structure". The complex author, the cooperative relationship, the structure and evolution of the research topic, the potential development trend in the field of research, and the statistical data graphics can not be based on the internal statistical data representation mechanism, and can not meet the requirements of the multi-dimensional statistical data representation and analysis. Finding out the idea of scientific research, summing up the law, predicting the future of the field and displaying it in the form of intuition are urgent to be solved by every researcher. The emergence of the map of scientific knowledge is just to meet the needs of science and the development of the times. The framework and development of the framework, especially the research hotspots and frontiers.
2. purpose and significance of research
2.1 systematically combing the literature of domestic traditional Chinese medicine and Western medicine for the treatment of type 2 diabetes, revealing the development context in this field, finding the core subjects and research units, trying to clear and accurately revealing the structure of their knowledge domain, and finding the hot spots in this field, the research frontiers and the trend of development. It is of great and far-reaching practical significance to explore and formulate strategies and policies for developing science and technology.
2.2 on the basis of drawing knowledge atlas of type 2 diabetes treatment field, the research in this field at home and abroad is compared to find their own characteristics, especially to excavate the advantages and disadvantages of traditional Chinese medicine in the treatment of type 2 diabetes, and to draw on foreign advanced scientific research methods and science and technology to promote the better health service of Chinese medicine to human health.
2.3 this study is to help researchers to grasp the current status of the research on the field of Chinese and Western medicine for the treatment of type 2 diabetes at home and abroad, to provide research direction information for researchers, to provide data reference for scientific managers, and to provide new directions and ways for academic cooperation at home and abroad.
3. research methods
3.1 by means of CO present analysis and word frequency analysis, the literature of Chinese and Western medicine in the field of Chinese and Western medicine in the field of type 2 diabetes was analyzed by bibliometric analysis of the external characteristics of the literature, such as the author, the age, the source organization and other literature, to find the cooperative relationship and the main research positions.
3.2 this study used literature co citation clustering analysis, key node literature analysis, key word CO cluster analysis, mutation word monitoring analysis, citing sudden analysis and so on, drawing the knowledge map of Chinese and Western medicine for the treatment of type 2 diabetes.
3.3 with the help of information visualization technology, the focus of research in the field of treatment of type 2 diabetes, the key nodes of the evolution and the new trends in the research frontier are identified to provide reference for the treatment of type 2 diabetes in traditional Chinese medicine.
3.4 using the method of comparative analysis, based on the knowledge map and reading the classic literature, this paper tries to explain the similarities and differences between Chinese and Western medicine for the treatment of type 2 diabetes and make an analysis of the reasons.
4. research results
Knowledge map analysis of 4.1 western medicine in treatment of type 2 diabetes mellitus
4.1.1 western medicine for the treatment of type 2 diabetes has steadily increased year by year, and PARVING HH is the most prolific author in this field. The highest ranking country in the United States, the Harvard University is the most prolific organization, and the 928 literature is contained in the magazine. This magazine has become a core journal in this field, and the research direction is mainly endocrine direction, Nohe Noor. German company (Denmark's famous pharmaceutical company) funded the most research.
Through the co citation and cluster analysis of the 23558 documents and their references, 4.1.2 shows that the co citation network is composed of 307 nodes and 717 links, which are divided into 11 co citation clusters, and Cluster3 is the largest clustering of the scale. The key node literature view is the key point and the key point is the key point. The clustering Atlas of word concurrence, citing the emergence view and enumerating high cited literature, the key node literature and the cited literature, the list of the breakthrough words, outlined the key nodes, hot spots and frontiers in the field of Western medicine for the treatment of type 2 diabetes.
4.2 knowledge map analysis of type 2 diabetes mellitus treated by TCM
The literature of traditional Chinese medicine for the treatment of type 2 diabetes is increasing year by year. This field has become a hot spot in the research of traditional Chinese medicine. The cooperation of scientific research teams is obvious, and the universities of traditional Chinese medicine have become the main research positions in this field.
In 4.2. 2, 6724 documents for the treatment of type 2 diabetes in medicine, the key word sharing network has formed a total of 20 clusters, showing the detailed list of these 20 clusters, identifying the basic knowledge structure of the research field and the process of its dynamic evolution. The key words are network view, time sequence diagram of keyword clustering, high frequency keyword list and classic text Presenting the hot spots and new research trends in the field of traditional Chinese medicine in the treatment of type 2 diabetes.
5. conclusion
5.1 western medicine treatment of type 2 diabetes knowledge map analysis conclusion
5.1.1 western medicine is the main knowledge structure in the field of type 2 diabetes: including type 2 diabetes based on intestinal insulin therapy; the use of thiazolidane two ketone hypoglycemic drugs; metabolic surgery, bariatric surgery, type 2 diabetes; the relationship between hypertension and diabetes; the relationship between diabetes and dyslipidemia; and (intensification) control of blood. Clinical trials of sugar and complications (cardiovascular complications), gene therapy for type 2 diabetes, inflammatory pathways, insulin therapy, insulin resistance, and sodium dependent glucose transporter research.
5.1.2 research hotspot: the drug treatment of various oral hypoglycemic agents of type 2 diabetes (mainly metformin); strengthening the effect of glycemic control on complications (especially large vascular complications and its serious consequences); the topic of combined management of blood sugar, blood pressure and blood lipids in type 2 diabetes mellitus patients has become a hot topic in this field.
5.1.3 important knowledge evolution path: British Prospective Diabetes Study (UKPDS), thiazolidane two ketone hypoglycemic drugs and glucagon like peptide -1 (GLP-1) hypoglycemic effect of the study played a key role in the development of the whole field of Western medicine in the field of type 2 diabetes, reflecting the important evolution of knowledge in this field. Diameter.
5.1.4 research frontiers and new trends: new drugs based on intestinal insulin therapy and the development and application of sodium glucose co transporter 2 (SGLT2) inhibitor (glycide), intensification of hypoglycemic problems and surgical treatment of type 2 diabetes have become the frontiers and new trends in this field.
5. analysis of knowledge map of type 2 diabetes treated by Chinese medicine 2
5.2.1 research focus: diabetic nephropathy, diabetic peripheral neuropathy and diabetic foot complications are the hot topics of traditional Chinese medicine in the treatment of type 2 diabetes.
5.2. 2 is the main means, treatment, prescription and medicine for the treatment of type 2 diabetes. The main treatment means are Chinese herbal medicine, combination of traditional Chinese and Western medicine and acupuncture, the main treatment is activating blood and removing stasis, nourishing qi and nourishing Yin, the most commonly used prescription is six flavored Rehmannia pills, Buyang return five soup, Xiaoke pill, common Chinese medicine as Astragalus, Rhizoma Coptidis, Trichosanthin and Tian Mai Xiaoke tablet, Qi Ming granule, Jiangtang mixture, Yiqi Yangyin pill, Xiaoke Yin, Yiqi Kang Fang, Yiqi Yangyin mixture, sugar kidney Kang, Dan lege Jiangtang Capsule, Xiaoke (sugar free) granule, Xiaoke Capsule and other Chinese traditional medicine have become the characteristics of Chinese medicine for the treatment of type 2 diabetes, and achieved good therapeutic effect.
The new trend of 5.2.3 research: the systematic evaluation of Chinese medicine in the treatment of type 2 diabetes will become a new trend of the future development of this field.
This research is based on the national natural fund project: Research on the visualization modeling of information integration of TCM diagnosis and treatment based on system complexity (project number: 81273876). This paper uses the method of knowledge map to explore the key nodes, the knowledge structure and the frontier hot spot.2 sugar in the field of Chinese medicine and the international medical treatment for type 2 diabetes. The knowledge map of the field of urine disease has clearly presented the "knowledge map" in this field for researchers. It also enables us to sort out the basic features and development status of the field in a more macro literature perspective. On the basis of this, we compare the advantages and disadvantages of Chinese and Western medicine in the treatment of type 2 diabetes. Foot also provides a new direction, direction and reference for Chinese medicine in the treatment of type 2 diabetes.
【學(xué)位授予單位】：北京中醫(yī)藥大學(xué)
【學(xué)位級別】：博士
【學(xué)位授予年份】：2014
【分類號】：R587.1

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