本文選題：痤瘡 + 醫(yī)案　； 參考：《南京中醫(yī)藥大學(xué)》2016年博士論文

【摘要】：[目的]病證結(jié)合乃當(dāng)代中醫(yī)臨床的主要模式,“審證求機(jī)”在辨證論治過(guò)程中最為關(guān)鍵。探究痤瘡的病證特點(diǎn)并其理、法、方、藥,不單能有效指導(dǎo)臨床,更能提高療效。文獻(xiàn)研究發(fā)現(xiàn),古今醫(yī)家對(duì)痤瘡的病位認(rèn)識(shí)大體一致,歸為肺脾腎三臟,涉及心肝。但對(duì)其癥狀、治法及處方用藥的認(rèn)識(shí)各家觀點(diǎn)龐雜而欠系統(tǒng)。有見(jiàn)及此,本研究選擇當(dāng)代中醫(yī)名家治療痤瘡的有效醫(yī)案,通過(guò)強(qiáng)化FP-Growth算法的關(guān)聯(lián)分析,索出其組方配伍規(guī)律,并發(fā)掘出一些新的認(rèn)識(shí),為中醫(yī)臨床與中醫(yī)科研提供參考及線索。[方法]檢索發(fā)表于1988年2月～2014年11月于中國(guó)知網(wǎng)有關(guān)中醫(yī)痤瘡的醫(yī)案,并依據(jù)納入排除標(biāo)準(zhǔn),構(gòu)建中醫(yī)痤瘡醫(yī)案數(shù)據(jù)庫(kù)；在進(jìn)行數(shù)據(jù)挖掘、統(tǒng)計(jì)分析前,事先對(duì)原始醫(yī)案數(shù)據(jù)進(jìn)行原始資料查證、醫(yī)學(xué)術(shù)語(yǔ)規(guī)范、藥名規(guī)范、錯(cuò)字糾正等預(yù)處理方法；再將符合標(biāo)準(zhǔn)入選共448診次的中醫(yī)痤瘡醫(yī)案,采用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),建立醫(yī)案訊息采集、儲(chǔ)存數(shù)據(jù)庫(kù),并對(duì)數(shù)據(jù)庫(kù)納入的醫(yī)案訊息進(jìn)行錄入規(guī)范及多次的數(shù)據(jù)清洗。在規(guī)范癥狀術(shù)語(yǔ)詞匯共361條、累計(jì)規(guī)范2699頻次的前提下,建立集采集、儲(chǔ)存、梳理、分析、挖掘于一體的、非單一的模塊和數(shù)據(jù)挖掘方法組成的醫(yī)案數(shù)據(jù)挖掘平臺(tái)；運(yùn)用Medcase V3.2系統(tǒng),透過(guò)加強(qiáng)關(guān)聯(lián)規(guī)則數(shù)據(jù)挖掘運(yùn)算模型、Medcase Record Mining系統(tǒng)、Association Rule Analysis平臺(tái)、Xminer Operation Tool運(yùn)算工具及強(qiáng)化FP-Growth算法,就著統(tǒng)計(jì)分析結(jié)果,從舌象、脈象、治法、用藥等各方面作中醫(yī)痤瘡醫(yī)案經(jīng)驗(yàn)的總結(jié)。[結(jié)果]頻數(shù)分析方面,當(dāng)代醫(yī)家的痤瘡醫(yī)案依次以口干、面部油膩、煩躁、大便干和瘙癢為高頻臨床癥狀；.皮損依次有丘疹、膿皰、結(jié)節(jié)、瘢痕和色素沉著；病變部位依次為面部、頰部、額部、頸項(xiàng)、胸部、背部；皮損顏色依次為紅、淡紅、暗紅；舌象依次為舌質(zhì)紅、舌尖紅、舌淡紅、舌淡、舌暗紅、舌暗、舌邊紅、舌邊有齒痕；脈象方面依次為弦、滑、細(xì)、數(shù)、沉、緩、小、浮、濡、弱、澀、大、實(shí)、虛、促、洪。當(dāng)代醫(yī)家治療痤瘡的醫(yī)案中出現(xiàn)的首十五種高頻治法依次為清熱、解毒、活血、散結(jié)、化瘀、涼血、清肺、健脾、疏肝、化痰、利濕、祛濕、滋陰、清胃、通腑。對(duì)高頻治法整合規(guī)范后,發(fā)現(xiàn)痤瘡高頻治法與上�？茖W(xué)技術(shù)出版社陸德銘主編的《中醫(yī)外科學(xué)》中所列痤瘡治法相符,說(shuō)明痤瘡臨床治法仍以清肺、散風(fēng)、清熱、化濕、化痰、健脾、滲濕為主；研究發(fā)現(xiàn)當(dāng)代醫(yī)家的醫(yī)案治法靈活,反映痤瘡病情多復(fù)雜多變。當(dāng)代醫(yī)家治療痤瘡的醫(yī)案中首十五味高頻中藥依次為牡丹皮、連翹、甘草、赤芍、丹參、當(dāng)歸、黃芩、茯苓、生地黃、薏苡仁、蒲公英、白術(shù)、柴胡、白花蛇舌草、陳皮等。參照上�？茖W(xué)技術(shù)出版社雷載權(quán)主編的《中藥學(xué)》將上述高頻中藥分類,高頻藥物種類為：涼血、活血、清熱解毒、清熱燥濕、健脾滲濕、疏肝、化痰、清熱、排膿藥等。藥物內(nèi)關(guān)聯(lián)方面,除了發(fā)現(xiàn)連翹與丹參、金銀花與連翹、牡丹皮與茯苓、白術(shù)與茯苓這些經(jīng)典藥對(duì)外,還發(fā)現(xiàn)了四藥聯(lián)用,如牡丹皮、赤芍、甘草、連翹及牡丹皮、黃芩、連翹、甘草；三藥聯(lián)用則有生地黃、牡丹皮、赤芍及金銀花、連翹、丹參。綜合治則治法與藥物外關(guān)聯(lián)而言,疏肝與柴胡、牡丹皮有較高置信度；清胃與桑白皮、枇杷葉有較高置信度；解毒與生地黃、金銀花、茵陳有較高置信度�；�、活血與桂枝有較高置信度；溫陽(yáng)、潛陽(yáng)與制附子有較高置信度；滋陰、養(yǎng)陰與黃芩有較高置信度；調(diào)和清木、解郁與柴胡有較高置信度。清肺與桑白皮、清熱與黃芩、利濕與茵陳、健脾與黨參、疏風(fēng)與荊芥均有較高置信度。[結(jié)論]通過(guò)對(duì)選取的當(dāng)代醫(yī)家治療痤瘡的醫(yī)案進(jìn)行統(tǒng)計(jì)分析和關(guān)聯(lián)規(guī)則分析后,得出的結(jié)論大部分屬于臨床常用的、現(xiàn)存的、符合傳統(tǒng)理論的認(rèn)識(shí),由此反證應(yīng)用數(shù)據(jù)挖掘進(jìn)行醫(yī)案分析乃有效確當(dāng)�？赏高^(guò)高頻藥物組來(lái)總結(jié)分析痤瘡常用中藥的配伍應(yīng)用關(guān)系。利用關(guān)聯(lián)規(guī)則分析,使治則與中藥、癥狀與中藥之間的組合關(guān)系,透過(guò)定量的數(shù)理關(guān)系來(lái)表示,將“癥法藥”相互連系,令挖掘結(jié)果可作為臨床的參考及應(yīng)用。在比對(duì)挖掘結(jié)果與傳統(tǒng)中醫(yī)藥理論后,發(fā)現(xiàn)了許多新視角、新觀點(diǎn),其實(shí)用性可供臨床參考,說(shuō)明數(shù)據(jù)挖掘及強(qiáng)化FP-Growth算法對(duì)于中醫(yī)醫(yī)案的規(guī)范化處理和再認(rèn)識(shí)是既可取而又值得推廣的一種方法。
[Abstract]:Based on the correlation analysis of FP - Growth algorithm , this study selects the effective medical record of Chinese traditional Chinese medicine for treating acne , and finds out some new knowledge to provide reference and clue for Chinese medicine clinical and traditional Chinese medicine research .
Prior to the data mining and statistical analysis , the original data of medical records were verified , and the methods of pre - treatment , such as original data verification , medical terminology specification , drug name specification and error correction , were carried out in advance ;
A medical record data mining platform consisting of collection , storage , carding , analysis , mining and integration , non - single module and data mining method is established on the premise of standardizing symptom terms and vocabulary of 361 and cumulative specification of 2699 frequency .
Using Medcase V3.2 system , through strengthening association rules data mining operation model , Medcase Record Mining system , Association Rule Analysis platform , Xishan Operation Tool operation tool and enhanced FP - Growth algorithm , the authors summarize the experience of Chinese traditional Chinese medicine acne medical records from aspects of tongue image , pulse image , treatment method and medication .
and the like . The lesions in turn have papules , pustules , nodules , scars and pigmentation ;
The lesion site is in turn the face , cheek , forehead , neck , chest , back ;
the color of the skin loss is in turn red , light red and dark red ;
The tongue image is in turn the tongue is red , the tongue is red , the tongue is reddish , the tongue is pale , the tongue is dark red , the tongue is dark , the tongue is red , and the tongue edge has a tooth mark ;
The first fifteen kinds of high - frequency treatment methods in the medical record of acne include clearing away heat , removing toxic substance , promoting blood circulation , dispersing pathogenic accumulation , dispersing blood stasis , cooling blood , clearing away lung , strengthening spleen , dispersing stagnated liver qi , eliminating phlegm , clearing away heat , eliminating dampness , nourishing yin , clearing stomach and dredging viscera .
In this paper , the relationship between traditional Chinese medicine and traditional Chinese medicine is analyzed by means of correlation rule analysis , and the results can be used as reference for clinical reference . The results of comparison show that the data mining and the enhanced FP - Growth algorithm are both desirable and worthy of popularization .
the combination of three medicines is prepared from Radix Rehmanniae , Cortex Moutan , Radix Paeoniae Rubra , Flos Lonicerae , Fructus Forsythiae , and Saviae Miltiorrhizae Radix .
Qingwei had higher confidence level with mulberry bark and loquat leaf .
The detoxification and Sheng Di Huang , Flos Lonicerae and Herba Artemisiae Scopariae have high confidence level , and have high confidence in removing blood stasis , promoting blood circulation and Ramulus Cinnamomi ;
There is a high degree of confidence in warming yang , latent yang and Radix Aconiti Lateralis Preparata ;
has high confidence in nourishing yin , nourishing yin and radix scutellariae ;
A Chinese medicinal composition for treating acne is prepared from Cortex Moutan , Fructus Forsythiae , Radix Glycyrrhizae , Radix Paeoniae Rubra , Radix Salviae Miltiorrhizae , Radix Angelicae Sinensis , Scutellariae Radix , Poria , Radix Rehmanniae , Radix Angelicae Sinensis , Scutellariae Radix , Poria , Radix Rehmanniae , Radix Angelicae Sinensis , Scutellariae Radix , Poria , Radix Rehmanniae , Radix Angelicae Sinensis , Herba Taraxaci , Rhizoma Atractylodis Macrocephalae , Radix Bupleuri , Rhizoma Atractylodis Macrocephalae , and Poria .

【學(xué)位授予單位】：南京中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：博士
【學(xué)位授予年份】：2016
【分類號(hào)】：R249;R275.9

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