本文選題：咳嗽變異性哮喘 + 風痰�。� 參考：《南京中醫(yī)藥大學》2017年碩士論文

【摘要】：目的:以朱佳教授多年來治療咳嗽變異性哮喘的臨床實踐為基礎(chǔ),以數(shù)據(jù)挖掘技術(shù)為手段,重點探討朱佳教授辨治咳嗽變異性哮喘的臨證經(jīng)驗及學術(shù)思想,同時為咳嗽變異性哮喘的中醫(yī)診療提供新的思路與方法。方法:收集并整理朱佳教授2014年10月～2016年12月共116例、224診次咳嗽變異性哮喘病例,建立數(shù)據(jù)庫,通過數(shù)據(jù)挖掘技術(shù)(如頻數(shù)、關(guān)聯(lián)及聚類分析等方法)對符合納入標準的醫(yī)案信息進行數(shù)據(jù)的挖掘處理和邏輯分析。根據(jù)統(tǒng)計分析結(jié)果,從癥狀、舌苔、脈象、病機以及具體方藥等角度,多方面對數(shù)據(jù)的結(jié)果進行分析、歸納和總結(jié)。結(jié)果:224診次中女性患者82例159診次,男性患者34例65診次,平均年齡44.50歲。出現(xiàn)頻率較高的癥狀有咳嗽、夜間咳甚、晝夜均咳、痰白、咽喉癢則咳、痰少、陣咳,在所有診次中分別占 87.50%、38.84%、37.95%、36.61%、36.61%、26.34%、24.55%。病機主要是風痰阻肺證,在所有診次中占69.20%。病理因素方面,痰的頻率最高,為89.73%,其次為風、虛、熱,其頻率依次為80.36%、37.95%、14.29%。朱佳教授治療咳嗽變異性哮喘用藥廣泛,共涉及中藥171味,高頻藥物主要有12種,分別為:炙麻黃、射干、苦杏仁、紫菀、蟬蛻、地龍、紫蘇子、炙甘草、陳皮、防風、荊芥、紫蘇葉,在所有診次中分別占 85.27%、83.04%、74.55%、74.11%、72.32%、64.73%、62.95%、62.95%、54.91%、54.46%、49.55%、44.64%。結(jié)論:通過研究發(fā)現(xiàn),病機方面:風痰阻肺證為朱老師辨治咳嗽變異性哮喘的基礎(chǔ)病機。病理因素方面:主要為風、痰、虛、熱,其中風與痰貫穿本病始末,亦為始動病理因素。治療上朱老師辨病與辨證相結(jié)合,尤為重視"風邪"在本病中的作用,祛風同時不忘理痰,病久則不忘顧護正氣。結(jié)合現(xiàn)代統(tǒng)計方法,挖掘出1組核心處方、4組常用藥對。
[Abstract]:Objective: based on the clinical practice of Professor Zhu Jia in treating cough variant asthma for many years, and with data mining technology as the means, the clinical experience and academic thought of professor Zhu Jia in treating cough variant asthma were discussed. At the same time, it provides new ideas and methods for TCM diagnosis and treatment of cough variant asthma. Methods: from October 2014 to December 2016, 116 cases of cough variant asthma were collected and sorted out by Professor Zhu Jia, and a database was established. The data mining and logical analysis of the medical case information in accordance with the inclusion criteria are carried out by the methods of association and cluster analysis. According to the results of statistical analysis, the results of data are analyzed, summarized and summarized from the aspects of symptoms, tongue coating, pulse, pathogenesis and specific prescriptions. Results 82 female patients (159 visits) and 34 male patients 65 visits (mean age 44.50 years). The symptoms with higher frequency included cough, severe cough at night, both day and night cough, white phlegm, cough with itching throat, less phlegm and cough, which accounted for 87.50% of the total number of diagnoses. The main pathogenesis is wind-phlegm obstruction of lung syndrome, 69.20 in all visits. The frequency of phlegm was the highest (89.73), followed by wind, deficiency and heat. The frequency of phlegm was 80.36, 37.95 and 14.29 respectively. Professor Zhu Jia has used a wide range of drugs to treat cough variant asthma, involving 171 kinds of Chinese medicine. There are 12 kinds of high-frequency drugs, namely: grilled ephedra, shoot dry, bitter almond, Aster, cicada slough, Dilong, purple perilla, grilled licorice, old peel, Fangfeng, thornmustard, etc. The perilla leaves, which account for 85.27% of the total number of visits, are 83.04 and 74.55, and they are 74.11, 72.32, 64.73, 62.95, 62.95, 54.46, 49.5545 and 44.64, respectively, in the area of 62.95, 54.91, 54.46 and 44.64. Conclusion: it is found that the syndrome of wind and phlegm blocking lung is the basic pathogenesis of cough variant asthma. Pathological factors: wind, phlegm, asthenia, heat, wind and phlegm through the beginning and end of the disease, but also for the initial pathological factors. On the treatment, teacher Zhu combined disease differentiation with syndrome differentiation, especially attached importance to the role of "wind evil" in this disease, dispelling wind and not forgetting to manage phlegm, and not forgetting to protect qi for a long time. Combined with modern statistical methods, the core prescriptions of 1 group and 4 groups of common drug pairs were excavated.
【學位授予單位】：南京中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R249;R256.12

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