本文選題：CAG并癌前病變 + 脾胃氣滯　； 參考：《山西中醫(yī)學(xué)院》2016年碩士論文

【摘要】：目的1.整理和繼承我國名老中醫(yī)白兆芝教授治療慢性萎縮性胃炎并癌前病變的臨床經(jīng)驗(yàn)。2.運(yùn)用數(shù)據(jù)挖掘方法對白兆芝教授的治療經(jīng)驗(yàn)進(jìn)行有效的總結(jié)和傳承。方法選取符合納入標(biāo)準(zhǔn)的慢性萎縮性胃炎并癌前病變患者110例;將病歷資料規(guī)范化,并將其基本信息、主訴、癥狀、體征、舌脈、診斷、治法、藥物進(jìn)行錄入,形成病歷資料數(shù)據(jù)庫;運(yùn)用EXCEL軟件制作頻數(shù)分布表,對患者性別、年齡構(gòu)成,證候分布、藥物等進(jìn)行描述,運(yùn)用Statistica8.0軟件(Data Mining)模塊為挖掘工具,運(yùn)用weka3.4數(shù)據(jù)挖掘軟件對臨床常見癥狀與常用藥物以及藥物對應(yīng)配伍關(guān)系進(jìn)行關(guān)聯(lián)規(guī)則分析;初步總結(jié)白兆芝教授治療慢性萎縮性胃炎并癌前病變的臨證經(jīng)驗(yàn);形成可直接分析的多維臨床數(shù)據(jù)。結(jié)果慢性萎縮性胃炎并癌前病變可為肝胃氣滯、肝胃郁熱、脾胃濕熱、脾胃氣虛、脾胃虛寒、胃陰不足、胃絡(luò)瘀血七個證型[1],研究結(jié)果表明,本病臨床以脾胃氣虛為主,臨床癥狀以脘痞、納呆、乏力、畏冷,大便溏薄,舌暗淡邊齒痕苔薄白,脈沉弦為主,治則以“益氣健脾、活血解毒”為基礎(chǔ),常用黃芪、太子參、白術(shù)、茯苓加丹參、莪術(shù)、白屈菜等;病程日久可見胃陰不足,臨床癥狀主要表現(xiàn)為脘中灼熱、嘈雜或隱痛,舌紅少津或有裂紋,脈沉細(xì)或數(shù),治則為“益氣養(yǎng)陰、活血解毒”,用太子參、麥冬、百合、烏藥加丹參、莪術(shù)、白屈菜等;因“木克土”,故在臨床中肝胃不和的證型也較常見,可見胃脹、可牽及脅肋不適,噯氣,心煩易怒,情緒不佳時表現(xiàn)益甚,舌暗苔白,脈沉弦,多采用疏肝和胃、化瘀解毒法,常用柴胡、白芍、枳實(shí)、陳皮加丹參、莪術(shù)、白花蛇舌草等,此外,因個人體質(zhì)及飲食習(xí)慣等差異,疾病早期也可見濕熱內(nèi)蘊(yùn)證型,臨床常見脘痞、納呆、口干苦,惡心,舌紅苔厚膩,脈沉弦或弦滑,常用清化濕熱、化瘀解毒法,用黃芩、生薏仁、白蔻仁加丹參、莪術(shù)、白屈菜等。結(jié)論白兆芝教授治療CAG并癌前病變的臨床經(jīng)驗(yàn)突出了中醫(yī)整體觀念,注重把握病機(jī)轉(zhuǎn)化規(guī)律,認(rèn)為脾胃虛弱是CAG發(fā)病的基礎(chǔ),其關(guān)鍵因素是胃氣阻滯,胃絡(luò)瘀阻則貫穿疾病發(fā)展始終;辯證以虛實(shí)、寒熱、氣血、陰陽為主,但更注重虛實(shí)夾雜、寒熱失調(diào)、氣血同病的復(fù)合證候;治療主張緩調(diào),以和為要,以“益氣健脾,化瘀通絡(luò)”為基本原則,根據(jù)臨床癥狀靈活變化,做到局部和整體綜合調(diào)治[2];用藥配伍注重剛?cè)嵯酀?jì)、升降相宜、氣血相合等多方面,開辟了治療本病的新領(lǐng)域。以“人機(jī)結(jié)合,以人為主”的數(shù)據(jù)挖掘方式進(jìn)行整理名老中醫(yī)臨床經(jīng)驗(yàn),探討診療規(guī)律是切實(shí)可行的,跟師出診學(xué)習(xí),收集足量有價值的臨床資料為基礎(chǔ),運(yùn)用數(shù)據(jù)挖掘方法,在大量而復(fù)雜的個體化病例資料中總結(jié)出科學(xué)有效的經(jīng)驗(yàn)[3],將之歸納成可隨時參考、進(jìn)行實(shí)踐的有價值的知識,是對中醫(yī)最好的繼承和發(fā)揚(yáng)。
[Abstract]:Objective 1. Collate and inherit the clinical experience of Professor Bai Zhaozhi in the treatment of chronic atrophic gastritis with precancerous lesion. The data mining method is used to summarize and inherit Professor Bai Zhaozhi's treatment experience. Methods 110 patients with chronic atrophic gastritis complicated with precancerous lesion were selected and their basic information, complaints, symptoms, signs, tongue veins, diagnosis, treatment methods and drugs were recorded. Form the database of medical record data, use EXCEL software to make frequency distribution table, describe patient's sex, age composition, syndrome distribution, drug, etc., use Statistica8.0 software / data mining module as mining tool, Weka3.4 data mining software was used to analyze the association rules between common clinical symptoms and common drugs and their corresponding compatibility, and the clinical experience of Professor Bai Zhaozhi in treating chronic atrophic gastritis with precancerous lesions was summarized preliminarily. To form multidimensional clinical data that can be directly analyzed. Results chronic atrophic gastritis combined with precancerous lesion could be divided into seven types: liver and stomach qi stagnation, liver and stomach stagnation heat, spleen and stomach dampness and heat, spleen and stomach qi deficiency, spleen and stomach deficiency cold, stomach yin deficiency and gastric collateral blood stasis. The results showed that the main clinical pattern of the disease was spleen and stomach qi deficiency. The clinical symptoms were epigastric distension, incapacity, fatigue, dread of cold, thin stool, thin fur of tongue, thin white tongue, weak vein, and the treatment was based on "invigorating qi and strengthening spleen, promoting blood circulation and detoxification". Astragalus membranaceus, Radix princeliae, Atractylodes macrocephala, Poria cocos plus Salvia miltiorrhiza, Curcuma were commonly used. The main clinical symptoms were burning heat, noise or pain, red tongue or crack, fine or number of veins, treatment for "nourishing qi and yin, promoting blood circulation and detoxification", using Radix Pseudostellariae, Radix Ophiopogonis, Lilium, etc. Wuyao plus Salvia miltiorrhiza, Curcuma curcumae, etc., because of "Mu Ke Tu", the syndrome type of disharmony between liver and stomach is also more common in clinical practice. It can be seen that stomach distension, discomfort of pulling and hypochondria, belching, irritability, bad mood and white tongue coating. The blood vessel sinks the string, uses the soothing liver and the stomach, detoxifies the blood stasis method, commonly used chaihu, white peony, Aurantii, Chen Pei + Danshen, Curcuma, the white flower snake tongue grass and so on. In addition, because of the individual physique and the diet habit and so on difference, the disease early may also see the damp heat internal accumulation syndrome type, Clinical common epigastric bullies, dry bitter mouth, nausea, tongue red fur thick and greasy, pulse sink string or string smooth, commonly used to remove dampness and heat, detoxification method, with Scutellaria baicalin, Shengyi, Baikourenjia Danshen, Curcuma, Baiqu dish, etc. Conclusion Professor Bai Zhaozhi's clinical experience in the treatment of CAG with precancerous lesions highlights the whole concept of traditional Chinese medicine, pays attention to the law of pathogenesis and transformation, and holds that the deficiency of spleen and stomach is the basis of the pathogenesis of CAG, and the key factor is gastric qi block. The stagnation of stomach collaterals runs through the development of the disease all the time; dialectical is based on deficiency and reality, cold and heat, qi and blood, yin and yang, but pays more attention to the complex syndromes of deficiency and deficiency, imbalance of cold and heat, Qi and blood with disease; treatment advocates slow adjustment, takes harmony as the main purpose, and "invigorates qi and invigorates spleen", Huayu Tongluo "is the basic principle, according to the clinical symptom nimble change, achieves the partial and the whole synthesis adjusts the treatment [2]; the medicine compatibility pays attention to the rigid and soft to be mixed, rises and falls suitable, and so on many aspects and so on unifies, opens up the new domain which treats this disease. Based on the data mining method of "man-machine combination, people-oriented", to sort out the clinical experience of famous Chinese medicine, to discuss the rule of diagnosis and treatment, to study with the teacher, to collect enough valuable clinical data, and to use the method of data mining. It is the best inheritance and development of traditional Chinese medicine to sum up scientific and effective experience in a large number of complicated individual case data and to generalize it into valuable knowledge which can be referred to and practiced at any time.
【學(xué)位授予單位】：山西中醫(yī)學(xué)院
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2016
【分類號】：R249;R259

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 黃虹;邵建華;鄒玉蓉;;基于臨床數(shù)據(jù)中心的單病種質(zhì)量管理系統(tǒng)設(shè)計(jì)與實(shí)現(xiàn)[J];中國數(shù)字醫(yī)學(xué);2016年02期

2 田同德;楊峰;唐靜雯;牛虹;范伊?xí)?;慢性炎性反應(yīng)與胃癌前病變關(guān)系及中醫(yī)對策探討[J];中華中醫(yī)藥雜志;2016年02期

3 劉旭光;;慢性萎縮性胃炎內(nèi)科規(guī)范治療臨床分析[J];醫(yī)學(xué)理論與實(shí)踐;2016年02期

4 康耿華;趙旭;許君望;;中西醫(yī)結(jié)合治療慢性萎縮性胃炎癌前病變臨床療效觀察[J];現(xiàn)代中西醫(yī)結(jié)合雜志;2016年03期

5 張德英;侯卓成;李衛(wèi)強(qiáng);;中醫(yī)藥治療胃癌前病變研究進(jìn)展[J];遼寧中醫(yī)雜志;2016年01期

6 陳建偉;李麗坤;;數(shù)據(jù)挖掘技術(shù)研究[J];數(shù)字技術(shù)與應(yīng)用;2016年01期

7 曹菊英;;中醫(yī)藥辨證治療慢性萎縮性胃炎52例療效研究[J];中國醫(yī)藥指南;2015年36期

8 王海萍;白震寧;;白兆芝從毒論治疑難病經(jīng)驗(yàn)選介[J];山西中醫(yī);2015年12期

9 楊印智;王繼栓;王曉琴;聶利民;刁紅杰;;慢性萎縮性胃炎的診斷與中醫(yī)藥治療[J];現(xiàn)代中西醫(yī)結(jié)合雜志;2014年24期

10 吳嘉瑞;唐仕歡;郭位先;張曉朦;張冰;;基于數(shù)據(jù)挖掘的名老中醫(yī)經(jīng)驗(yàn)傳承研究述評[J];中國中藥雜志;2014年04期

相關(guān)碩士學(xué)位論文 前3條

1 隋曉艷;慢性胃炎內(nèi)鏡和病理診斷的臨床分析[D];大連醫(yī)科大學(xué);2012年

2 劉珊;慢性萎縮性胃炎辯證治療的療效評價和基于數(shù)據(jù)挖掘的導(dǎo)師經(jīng)驗(yàn)總結(jié)[D];中國中醫(yī)科學(xué)院;2011年

3 武颯;基于數(shù)據(jù)挖掘技術(shù)的名老中醫(yī)臨床診療經(jīng)驗(yàn)的探索研究[D];成都中醫(yī)藥大學(xué);2009年

，

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