本文關(guān)鍵詞： 劉啟泉 慢性萎縮性胃炎 腸上皮化生 經(jīng)驗 中醫(yī)傳承輔助系統(tǒng) 數(shù)據(jù)挖掘　出處：《河北醫(yī)科大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:總結(jié)并挖掘劉啟泉教授治療慢性萎縮性胃炎(chronic atrophic gastritis,CAG)伴腸上皮化生(intestinal metaplasia,IM)的經(jīng)驗及用藥規(guī)律,以利于名老中醫(yī)治療經(jīng)驗的傳承,并為中醫(yī)治療CAG伴IM的臨床與科研提供思路及參考。方法:收集劉啟泉教授2014年10月至2016年10月在河北省中醫(yī)院脾胃病科門診治療CAG伴IM的有效病案286例,錄入由中國中醫(yī)科學(xué)院研究所開發(fā)的“中醫(yī)傳承輔助平臺(V2.5)”軟件,利用該軟件集成的規(guī)則分析、改進(jìn)互信息法、熵聚類等數(shù)據(jù)挖掘方法,分析劉啟泉教授治療CAG伴IM的用藥規(guī)律及常用處方的藥物特點,探索治療CAG伴IM的新思路、新方法。結(jié)果:1基本情況:286例患者中,男性145例,女性141例;年齡集中在50-69歲之間;臨床癥狀排前3位的是胃脹、胃痛和噯氣;舌脈以舌暗紅、苔黃膩、脈弦滑為主;根據(jù)西醫(yī)疾病分類,CAG伴輕、中度IM者較多,伴有糜爛者有174例;根據(jù)中醫(yī)疾病分類,胃痞者為172例,胃脘痛者為114例;根據(jù)中醫(yī)證型分類,胃絡(luò)瘀阻證最多,其次為脾胃濕熱證。2處方分析:中藥“四氣”統(tǒng)計結(jié)果顯示,溫性和寒性藥所占比例較高,分別為48.02%、35.56%;中藥“五味”統(tǒng)計結(jié)果顯示,苦味藥和辛味藥使用比例較高,分別為36.19%、33.40%;藥物歸經(jīng)統(tǒng)計結(jié)果顯示,以脾、胃、肝三經(jīng)頻次最高;處方中使用頻次在40次以上的藥物有44味,按功效分類,共計使用14類藥,其中清熱藥和理氣藥使用頻次最高,其次是活血化瘀藥、養(yǎng)陰藥和安神藥;關(guān)聯(lián)規(guī)則分析中,通過支持度的不斷上升,得到8味核心藥物,包括石菖蒲、郁金、百合、白芍、延胡索、茯苓、當(dāng)歸、蒲公英;在關(guān)聯(lián)度分析的基礎(chǔ)上,通過復(fù)雜系統(tǒng)熵聚類算法,得到3-5味新方聚類核心組合,通過無監(jiān)督熵層次聚類,得到治療CAG伴IM的9首新處方。結(jié)論:1基于數(shù)據(jù)挖掘技術(shù),分析出劉啟泉教授治療CAG伴IM臨證用藥多辛開苦降,寒溫并用,認(rèn)為熱毒血瘀是病機(jī)關(guān)鍵,以“清熱解毒,行氣活血”貫穿始終,同時不忘顧護(hù)陰液及情志的調(diào)護(hù)。并開發(fā)出9首治療CAG伴IM的新處方,推動了劉啟泉教授學(xué)術(shù)思想和臨床經(jīng)驗的傳承與創(chuàng)新。2中醫(yī)傳承輔助平臺軟件通過數(shù)據(jù)挖掘技術(shù),對患者的基本情況、用藥情況及組方規(guī)律進(jìn)行統(tǒng)計,為深入分析和挖掘劉啟泉教授治療CAG伴IM經(jīng)驗提供了良好的平臺,有助于名老中醫(yī)治療經(jīng)驗的總結(jié)與傳承,值得進(jìn)一步推廣和應(yīng)用。
[Abstract]:Objective: To summarize and mining of Professor Liu Qiquan in treating chronic atrophic gastritis (chronic atrophic, gastritis, CAG) with intestinal metaplasia (intestinal metaplasia IM) experience and drug laws, in order to experience the old Chinese medicine treatment of inheritance, and Chinese medicine for the treatment of CAG with IM in the clinical and scientific research to provide ideas and reference methods. Collection of Professor Liu Qiquan in October 2014 to October 2016 in the medical record department of outpatient treatment of spleen and stomach effectively CAG traditional Chinese Medicine Hospital of Hebei province with IM in 286 cases, TCM inheritance auxiliary input platform developed by the research Chinese Academy of traditional Chinese medicine "(V2.5)" software analysis using the software integration rules, the improved mutual information method, entropy clustering method professor Liu Qiquan analysis, drug law for the treatment of CAG with IM and commonly used prescription drugs, a new method to explore new ideas, for the treatment of CAG with IM. Results: 1 basic conditions: in the 286 cases, male In 145 cases, 141 cases were female; the age concentrated in 50-69 years old; the clinical symptoms of the top 3 is bloating, stomach pain and belching; tongue to dark red tongue, yellow greasy moss, pulse string slide; according to the classification of diseases of Western medicine, CAG with mild to moderate IM, more, accompanied by erosion in 174 cases; according to the the classification of diseases in TCM, Weipi were 172 cases of epigastric pain in 114 cases; classified according to TCM syndromes, gastric stasis syndrome is the highest, followed by the spleen and stomach damp heat syndrome.2 prescription analysis: the statistical results of traditional Chinese medicine "four" shows that the warm and cold medicine accounted for a higher proportion, respectively 48.02%, 35.56% traditional Chinese medicine; the "Five" statistics showed that bitter and pungent drugs with a higher proportion, respectively 36.19%, 33.40%; drug owned by the statistics showed that in the spleen, stomach, liver and three with the highest frequency in the use of prescription drugs; frequency of 40 times more than 44 flavor, according to the classification of functions, the use of a total of 14 the drugs, antipyretic and Gas use the highest frequency, followed by blood stasis, nourishing yin and tranquilizing drugs; association rules analysis, through the support of the rising, get 8 kinds of core drugs, including Shichangpu, lily, turmeric, Radix Paeoniae Alba, Rhizoma Corydalis, angelica, Poria, dandelion; based on correlation analysis, through the the complex system entropy clustering algorithm, obtained 3-5 kinds of new clustering core portfolio through unsupervised hierarchical clustering entropy, get 9 new prescriptions for the treatment of CAG with IM. Conclusion: 1 based on the data mining technology, analysis of Professor Liu Qiquan for the treatment of CAG with IM clinical medicine multisymplectic open and bitter down, cold and warm, that heat blood stasis is the key pathogenesis, to detoxify, invigorate the circulation of Qi and blood throughout, while not forgetting to protecting Yin fluid and emotional nursing. And the development of a new prescription for the treatment of CAG with 9 pieces of IM, promote the inheritance of academic thought and clinical experience of Professor Liu Qiquan and the innovation of traditional Chinese medicine.2 The auxiliary platform software through the data mining technology, the basic situation of patients, medication and prescription rule statistics, provides a good platform for in-depth analysis and mining professor Liu Qiquan for the treatment of CAG with IM experience, summed up the experience and inheritance of help old Chinese medicine treatment, worthy of further promotion and application.

【學(xué)位授予單位】：河北醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R249;R259

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