本文關(guān)鍵詞：基于數(shù)據(jù)挖掘方法的張書信教授治療慢性便秘經(jīng)驗(yàn)研究　出處：《北京中醫(yī)藥大學(xué)》2016年碩士論文　論文類型：學(xué)位論文

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【摘要】：背景：便秘是肛腸科門診常見病種之一,臨床常表現(xiàn)為：排便周期延長；或周期不長,但糞質(zhì)干結(jié),排便艱難；或糞質(zhì)不硬,雖有便意,但便出不暢的病癥。便秘既是可見于其他疾病伴發(fā)的一個(gè)癥狀,又可以是單獨(dú)的一個(gè)病證。病程超過6個(gè)月者為慢性便秘。中醫(yī)內(nèi)治法治療慢性便秘有一定的優(yōu)勢,不同于西方醫(yī)學(xué)之針對癥狀治療。中醫(yī)學(xué)根據(jù)患者體質(zhì)、癥狀等表現(xiàn),四診合參,審證求因,經(jīng)過辨證論治,往往能找到病因根本所在,從而解決便秘問題。導(dǎo)師張書信教授長期從事臨床及科研工作,對慢性便秘的治療積累了豐富的經(jīng)驗(yàn),且臨床療效顯著。目的：應(yīng)用數(shù)據(jù)挖掘技術(shù)對張書信教授門診治療慢性便秘醫(yī)案數(shù)據(jù)資料進(jìn)行探索性研究,挖掘張書信教授治療慢性便秘的辯證、用藥思路,為繼承張書信教授中醫(yī)經(jīng)驗(yàn)提供一種新方法。方法：選取2015年1月至2016年1月期間經(jīng)張書信教授于北京中醫(yī)藥大學(xué)附屬東直門醫(yī)院肛腸科門診,診斷為慢性便秘的患者144例醫(yī)案資料,通過“醫(yī)案數(shù)據(jù)處理系統(tǒng)”進(jìn)行數(shù)據(jù)的預(yù)處理及數(shù)據(jù)存儲,然后將數(shù)據(jù)資料導(dǎo)入“中醫(yī)醫(yī)案數(shù)據(jù)庫”,通過一般描述性分析、頻數(shù)分析、數(shù)據(jù)關(guān)聯(lián)分析等統(tǒng)計(jì)分析方法,進(jìn)行數(shù)據(jù)挖掘,并對得到的結(jié)果進(jìn)行討論分析,獲得結(jié)論。結(jié)果：1.144例研究對象中,男性42人(29.16%),女性102人(70.84%),男女人數(shù)比為1：2.43。按年齡分類：年齡小于40歲者40人(27.78%),年齡在40-59歲之間者45人(31.25%),年齡在60歲以上者59人(40.97%)；2.病因病機(jī)分析：慢性便秘主要病因有：主要有久病正虛、飲食不節(jié)、情志傷、年老體衰、稟賦不足、寒邪侵襲,病機(jī)前10位分別為陰虛津虧、氣陰兩虛、脾虛氣陷、脾胃氣虛、血虛腸燥、氣機(jī)郁滯、氣血兩虛、肺脾氣虛、脾腎兩虛、脾腎陽虛,可以發(fā)現(xiàn),陰虛、氣虛、血虛、氣滯、陽虛是主要病機(jī),通過病因病機(jī)的頻數(shù)分析,反映出臨床便秘患者以正虛為主；3.癥候分析：便秘患者辯證主要為氣虛證、陰虛證、氣陰兩虛證、血虛證、氣機(jī)郁滯證、氣血兩虛證、陽虛證、胃腸濕熱證、腸胃積熱證、寒凝氣滯證；4.癥狀及體征分析：頻次分析結(jié)果取前15位,發(fā)現(xiàn)常見舌脈：紅舌、少苔、淡紅舌、白苔、薄白苔、脈細(xì)數(shù)、薄黃苔,常見癥狀：大便干、排便不暢、食欲減退、倦怠乏力、腹脹、口干、眠差、大便不通,一定程度上反映出臨床便秘患者多陰虛、氣虛表現(xiàn)；5.病位分析：提示慢性便秘病位主要是大腸、脾、胃、肝、腎、肺為主；6.立法分析：結(jié)果顯示主要以為補(bǔ)脾益氣、益氣養(yǎng)陰、養(yǎng)血補(bǔ)血、行氣導(dǎo)滯、氣血雙補(bǔ)為主；7.張書信教授門診治療慢性便秘最常用的藥物是生白術(shù)、當(dāng)歸、枳實(shí)、白芍、酒蓯蓉、虎杖、火麻仁、決明子、生地黃、蜜紫菀、茯苓、熟地黃、升麻、萊菔子、黃芪、何首烏、厚樸、玄參、百合、太子參、麥門冬、桃仁、枳殼、神曲、郁李仁、生甘草、檳榔、澤瀉、瓜蔞、大黃。主要為補(bǔ)虛、行氣、潤腸藥物,醫(yī)案處方中常用的藥物配伍有生白術(shù)、枳實(shí)、當(dāng)歸、芍藥四味藥。結(jié)論：慢性便秘主要病機(jī)以本虛為主,包括氣虛、血虛、陰虛、陽虛四個(gè)方面,主要病位在大腸、脾、胃、肺、腎。治療慢性便秘常以補(bǔ)虛為主,提出治療便秘以補(bǔ)虛為本、從肺論治、從腎論治的思路。治療便秘不拘泥于通便,而善于尋找病因,符合中醫(yī)治病求本之原則,臨床獲得良好的療效。用藥方面,張書信老師善于運(yùn)用生白術(shù)、枳實(shí)、當(dāng)歸、芍藥、火麻仁、肉蓯蓉、虎杖、蜜紫苑、黃芪、升麻、桃仁等藥物治療便秘。
[Abstract]:Background: constipation is one of the common diseases outpatient anorectal diseases, the clinical manifestation is: defecation cycle; or cycle is not long, but the fecal dry, difficult defecation; or fecal matter is not hard, although it is intended, but out of the poor condition. Both constipation found in other diseases with a symptom of hair again, can be a separate course of disease and syndrome. For more than 6 months for chronic constipation. Traditional Chinese medicine treatment of chronic constipation have certain advantages, different from western medicine for the treatment of symptoms of TCM. According to the constitution of the patients, symptoms and other symptoms, four diagnostic methods, for trial, after diagnosis and treatment, can often find the cause of the essence, so as to solve the problem of constipation. Professor Zhang Shuxin has long been engaged in clinical and research work, the treatment of chronic constipation has accumulated rich experience, and has significant clinical effect. Objective: the application of data mining technology to a professor of outpatient letters The treatment of chronic constipation cases data for exploratory research, mining professor Zhang Shuxin in the treatment of chronic constipation dialectical medication ideas, provide a new method for the inheritance of traditional Chinese medicine experience. Professor Zhang letters: During from January 2015 to January 2016 by a letter to Professor anorectal Department of Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine clinic, diagnosed 144 cases of patients with chronic constipation medical information, data preprocessing and data storage through the medical data processing system, and then the data into the database of medical records of Chinese medicine, through descriptive analysis, frequency analysis, correlation analysis and other statistical data analysis, data mining, and discusses the analysis of the results obtained. Results: 1.144 subjects, 42 males, 102 females (29.16%) (70.84%), the number of male to female ratio was 1:2.43. by age. 綾伙細(xì)騫撮緞灝忎簬40宀佽，

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