本文選題：慢性結(jié)腸炎 + 治腸六法　； 參考：《湖北中醫(yī)藥大學》2017年碩士論文

【摘要】：目的本次臨床研究是以中醫(yī)基礎理論為指導,運用“中醫(yī)醫(yī)案知識服務與共享系統(tǒng)”對導師嚴光俊教授治療慢性結(jié)腸炎的臨床醫(yī)案進行病案采集和數(shù)據(jù)挖掘分析,分析疾病、證型、治法和用藥之間的關系,總結(jié)和探討嚴師應用“三降五法學說”中的“治腸六法”治療“慢性結(jié)腸炎”的臨床應用規(guī)律,對豐富慢性結(jié)腸炎的中醫(yī)分型、治法及用藥具有積極的推動作用。方法收集嚴光俊教授2015年01月至2017年01月間在荊州市中醫(yī)醫(yī)院門診及住院病房處方診治的部分慢性結(jié)腸炎的病歷資料,嚴格按照納入與排除標準進行篩選,將符合研究標準的509例醫(yī)案資料(主要包括患者基本信息、四診資料、證型、藥物)錄入“中醫(yī)醫(yī)案知識服務與共享系統(tǒng)”并應用系統(tǒng)的數(shù)據(jù)處理標準化模塊對數(shù)據(jù)進行標準化處理。運用系統(tǒng)設置的關聯(lián)規(guī)則及置信度等數(shù)據(jù)處理方法,對醫(yī)案信息進行挖掘處理,分析嚴光俊教授運用“治腸六法”治療慢性結(jié)腸炎的用藥特色,總結(jié)其運用規(guī)律和經(jīng)驗。結(jié)果(1)嚴師臨床運用“治腸六法”治療慢性結(jié)腸炎—便秘頻次分別為:理氣通降法(26.9%)潤腸通降法(24.6%)益氣通降法(19.7%)清化通降法(14.2%)清熱通降法(7.4%)溫陽通降法(7.1%);慢性結(jié)腸炎—泄瀉頻次為:清化通降法(53.5%)益氣通降法(31.5%)溫陽通降法(15%)。(2)嚴光俊教授在診治慢性結(jié)腸炎時常用藥物有:茯苓、白術(shù)、山藥、陳皮、香附、當歸、白扁豆、紫蘇梗、大腹皮、黃連、枳殼、法半夏、柴胡、太子參、桔梗、木香、芡實、豆蔻、玉竹、澤瀉、火麻仁、麥冬、川芎、黃芩、補骨脂、蒼術(shù)、六神曲、薏苡仁、柏子仁、肉桂等。(3)總結(jié)出慢性結(jié)腸炎歸屬不同范疇的不同證型中各治法中的用藥頻率、核心處方、用藥特色及藥對應用。結(jié)論(1)通過不斷總結(jié)、綜合、分析,嚴師將慢性結(jié)腸炎癥狀特點總結(jié)為“結(jié)”、“泄”、“墜”、“脹”、“痛”。(2)嚴師認為胃腸道疾病主在一“通”字,通則結(jié)解,通則脹消,通則墜除,通則泄止,通則痛除,以“通”為治腸病的核心。(3)嚴師在應用“治腸六法”治療慢性結(jié)腸炎時多從中焦脾胃著手,其藥精效宏,用藥也多中正平和,較少使用孟浪之品,恐攻伐之用壞腸道通降之機。并且臨證時也會因時、因地、因人、因病加減用藥及劑量,常常以常規(guī)劑量取得較好療效。中醫(yī)醫(yī)案知識與服務共享平臺對于挖掘中醫(yī)臨床經(jīng)驗、發(fā)現(xiàn)隱性規(guī)律為臨床診療疾病提供支撐具有重要意義。
[Abstract]:Objective this clinical study is based on the basic theory of traditional Chinese medicine, using the "knowledge Service and sharing system of TCM Medical record" to collect and analyze the medical records of Professor Yan Guangjun's treatment of chronic colitis, and to analyze the disease. The relationship among syndromes, treatment methods and drug use is summarized and discussed. The clinical application law of "treating intestinal six methods" in "three descending and five legal theories" in Yan Shi's treatment of "chronic colitis" is summarized and discussed, so as to enrich the TCM classification of chronic colitis. Treatment and drug use have a positive role in promoting. Methods from January 2015 to January 2017, Professor Yan Guangjun collected the medical records of some chronic colitis cases that were prescribed in the outpatient and inpatient wards of Jingzhou traditional Chinese Medicine Hospital, and screened them strictly according to the criteria of inclusion and exclusion. The data of 509 medical records (including the basic information of patients, the data of four diagnoses, the types of syndromes), which meet the research criteria, will be collected. Medicine) is entered into the "knowledge Service and sharing system of TCM Medical record" and the data processing standardization module is used to standardize the data processing. By using the data processing methods such as association rules and confidence degree set up by the system, the information of medical records is excavated and processed, and the characteristics of the drug used by Professor Yan Guangjun in the treatment of chronic colitis with "six methods of treating intestines" are analyzed, and the application law and experience are summarized. Results 1) the frequency of treating chronic colitis and constipation by treating chronic colitis with "six methods of treating intestines" by strict teachers were as follows: regulating qi and clearing up and lowering methods: 26.9) moistening the intestines and clearing up and descending methods (24.6cm) supplementing qi and clearing up and descending methods (19.775) clearing away heat and clearing up and lowering methods (7.4) warming Yang and lowering methods (7.1m); The frequency of enteritis and diarrhea is as follows: Qinghua Tongshang (53.5) Yiqi and descending (31.5) warming Yang and decreasing (15).) Professor Yan Guangjun's commonly used drugs in the diagnosis and treatment of chronic colitis are: Poria cocos. Atractylodes macrocephala, yam, pericarp, angelica sinensis, white lentils, perilla pedicel, abdominal skin, Coptis chinensis, Fructus Aurantii, Radix Pinelliae, Radix Bupleurum, Radix Pseudostellariae, Platycodon grandiflorum, Radix Euryale, Cardamom Cardamom, Phyllostachys edulis, Rhizoma Alismatis, Magnoliae, Rhizoma Ophiopogonis, Rhizoma Chuanxiong, Scutellaria Fructus psoralen, Atractylodes, Liu-Shen qu, Coix seed, Burberry seed, Cinnamon, etc.) summarized the frequency, the core prescription, the characteristics and the application of drugs in different syndromes of chronic colitis. Conclusion 1) through continuous summing up, synthesizing and analyzing, Yan Shi summed up the symptoms of chronic colitis as "knot", "catharsis", "fall", "distension", "pain". The general principles of expansion and elimination, the general rule of falling, the general principle of relief, the general principle of pain, "Tong" as the core of the treatment of bowel disease. 3) Yan Shi in the application of "treatment of the intestinal six methods" treatment of chronic colitis from the spleen and stomach, its drug essence effect is great, medication is also more moderate and peaceful, Less use of Menglang products, fear of cutting with bad intestinal access to the opportunity. And clinical symptoms will also be due to, because of, because of people, because of diseases, drugs and dosage, often with conventional dose to obtain better curative effect. The knowledge and service sharing platform of TCM medical records is of great significance to excavate the clinical experience of TCM and find the hidden law to provide support for clinical diagnosis and treatment of diseases.
【學位授予單位】：湖北中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R249;R259

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