發(fā)布時(shí)間：2018-03-20 20:20

  本文選題：郭立中　切入點(diǎn)：解表法　出處：《南京中醫(yī)藥大學(xué)》2017年碩士論文　論文類(lèi)型：學(xué)位論文

【摘要】：[目的]以導(dǎo)師近三年來(lái)運(yùn)用解表法診治的社區(qū)慢性病病案為研究對(duì)象,應(yīng)用計(jì)算機(jī)數(shù)據(jù)挖掘技術(shù),結(jié)合人工統(tǒng)計(jì)分析,探討導(dǎo)師從表論治慢性病的臨床經(jīng)驗(yàn)及學(xué)術(shù)思想,以進(jìn)一步深化對(duì)中醫(yī)解表法的理論認(rèn)識(shí),并提高對(duì)慢性病辨治的臨床療效。[方法]在跟師抄方學(xué)習(xí)的三年時(shí)間里,對(duì)導(dǎo)師在南京華飛衛(wèi)生所、寧西門(mén)診部及鐵心橋社區(qū)衛(wèi)生服務(wù)中心從表論治慢性病的病案進(jìn)行全面收集、整理,并按照統(tǒng)一的納入標(biāo)準(zhǔn)、排除標(biāo)準(zhǔn)進(jìn)行篩選,將符合條件的829例病案資料全部利用Medcase V3.2倉(cāng)公診籍國(guó)醫(yī)脈案數(shù)據(jù)記錄挖掘系統(tǒng)建立病案采集、存貯數(shù)據(jù)庫(kù);運(yùn)用R語(yǔ)言數(shù)據(jù)挖掘及WPS數(shù)據(jù)處理系統(tǒng),以治法研究為切入點(diǎn),運(yùn)用頻次頻率對(duì)比分析方法重點(diǎn)探討各種解表法相應(yīng)的臨床表現(xiàn)、舌脈、處方用藥之間的關(guān)系,并對(duì)數(shù)據(jù)結(jié)果進(jìn)行分析、歸納、提煉、總結(jié)。[結(jié)果]829例患者中,其中男性309例,占37.27%;女性520例,占62.73%。年齡分布:兒童(0-9歲)1例,占0.12%,青少年(10-19歲)32例,占3.86%,青中年(20-39歲)324例,占 39.09%,中老年(40-59 歲)330 例,占 39.81%,老年(60-89 歲)142 例,占 17.13%。導(dǎo)師運(yùn)用解表法的主要癥狀中頻率大于5%的依次有:怕冷(9.26%),汗少(9.22%),腰酸痛(5.54%),寐差(5.32%),口干(5.04%),頸項(xiàng)僵硬(4.74%);主要舌象中頻率大于6%的依次有:質(zhì)淡紅(19.26%),苔薄白(15.01%),邊有齒印(10.86%),體胖大(6.17%);主要脈象中頻率大于10%的依次有:緊脈(31.35%),浮脈(23.52%),滑脈(10.50%);主要病機(jī)中頻率大于8%的依次有;風(fēng)寒束表(27.79%),太少兩感(16.90%),寒濕凝滯(14.63%)和氣血不暢(8.42%);主要藥物中頻率大于2%的主要有:生姜(9.47%),桂枝(8.00%),朱茯神(7.41%),蒼術(shù)(6.52%),石菖蒲(4.83%),法半夏(4.52%),白芷(4.04%),陳皮(3.45%),藿香(2.88%),細(xì)辛(2.63%),制附片(2.30%),麻黃(2.30%)。[結(jié)論]1、導(dǎo)師從表論治的社區(qū)慢性病以中老年女性患者為主;2、導(dǎo)師從表論治的社區(qū)慢性病主要臨床癥狀:怕冷、汗少、腰酸痛、頸項(xiàng)僵硬及寐差、口干;主要舌脈:質(zhì)淡紅,苔薄白,邊有齒印,脈(浮、緊、滑等);主要病機(jī):風(fēng)寒束表,太少兩感,寒濕凝滯和氣血不暢;主要藥物:生姜、桂枝、朱茯神、蒼術(shù)、石菖蒲、法半夏、白芷、陳皮、藿香、細(xì)辛、制附片和麻黃等。
[Abstract]:[objective] to explore the clinical experience and academic thought of the tutor in treating chronic diseases from the surface by using computer data mining technology and artificial statistical analysis, taking the history of chronic diseases diagnosed and treated by the tutor in the past three years as the research object. In order to further deepen the theoretical understanding of traditional Chinese medicine (TCM) method of releasing tables, and to improve the clinical efficacy of treating chronic diseases. [methods] during the three years of studying with the teacher, the tutor was in Nanjing Huafe Health Center. The Ningxi outpatient department and the Tiexinqiao Community Health Service Center collected and sorted out the medical records of chronic diseases according to the table, and screened them according to the unified inclusion criteria and exclusion criteria. The data of 829 medical records were collected and stored by Medcase V3.2 medical record data mining system, and the R language data mining and WPS data processing system were used as the breakthrough point of medical treatment research, and the data mining system of R language and WPS data processing system were used to set up the medical records data collection and storage database, and the R language data mining system and the WPS data processing system. Frequency frequency contrast analysis method was used to discuss the relationship among clinical manifestations, tongue pulse and prescription medication of various methods of dissolving table, and the data were analyzed, summarized, refined and summarized. [results] among 829 patients, 309 cases were male. 37.27%; 520 women, 62.73.The age distribution is as follows: one child aged 0-9 years, one child aged 0.12a, 32 adolescents aged 10-19 years, accounting for 3.86um, 324 young and middle-aged persons aged 20-39 years, 39.09.The middle and old people aged 40-59 years have 330 cases, accounting for 39.81s.142 cases are aged 60-89 years. Account for 17.13. among the main symptoms of using the chart method, the frequency of which is greater than 5%: afraid of cold, 9.26m, less sweat, 5.54g, 5.32, 5.04, and 4.74; the frequency of the main tongue is more than 6%; the frequency of the main tongue is more than 6%; the main tongue is more than 19.26261.The tongue is thin and white and 15.01T, and the main tongue is more than 6% in the order of the frequency of the major symptoms: 9.26, 9.22, 5.54, 5.32, 5.04, 4.74, respectively; the frequency of the main tongue images is more than 6%. The frequency of the main pulse was greater than 10%; the frequency of the main pulse was greater than 10%; the frequency of the main pulse was greater than 31.35%, the floating vein was 23.52%, the slippery vein was 10.50%, and the frequency of the main pathogenesis was more than 8%. The frequency of the main drugs is more than 2%: Ginger 9.4770, Guizhi 8.00, Zhu Fu Shen 7.41, Rhizoma Atractylodes 6.522, Rhizoma Atractylodes 6.522am, Rhizoma Atractylodes 4.833, Rhizoma Atractylodes 6.522am, Rhizoma Atractylodes 4.833, Rhizoma Atractylodes 6.52am, Angelica angelicae 4.04m, Radix angelicae dahurica 4.04m, Chen Pei 3.4545, patchouli 2.88. The main clinical symptoms of the community chronic diseases treated by mentors were middle-aged and elderly female patients, and the main clinical symptoms of community chronic diseases treated by mentors were: fear of cold. Less sweat, sore waist, stiff neck and poor sleep, dry mouth; main tongue vein: light red, thin fur white, edge with teeth marks, veins (floating, tight, slippery, etc.); main pathogenesis: wind and cold bundle table, too little two senses, cold and wet stagnation and unobstructed qi and blood; Main drugs: ginger, Guizhi, Zhu Fu Shen, Atractylodes Atractylodes, Acorus calamus, Atractylodes ternata, Radix angelicae dahurica, Pericarp, Pogostemon, Asarum, Atractylodes and Ephedra et al.
【學(xué)位授予單位】：南京中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類(lèi)號(hào)】：R249

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