發(fā)布時(shí)間：2018-05-15 01:38

  本文選題：老年功能性便秘 + 名老中醫(yī)經(jīng)驗(yàn)�。� 參考：《湖北中醫(yī)藥大學(xué)》2017年碩士論文

【摘要】：目的:中醫(yī)藥學(xué)的發(fā)展離不開對名老中醫(yī)的診療經(jīng)驗(yàn)和學(xué)術(shù)思想進(jìn)行總結(jié),由于大數(shù)據(jù)時(shí)代的到來,運(yùn)用數(shù)據(jù)挖掘的方法對名老中醫(yī)的臨床經(jīng)驗(yàn)及學(xué)術(shù)思想進(jìn)行研究成為當(dāng)前的熱點(diǎn)。數(shù)據(jù)挖掘是運(yùn)用計(jì)算技術(shù)與統(tǒng)計(jì)的方法,從大量診療數(shù)據(jù)中提取有用信息,用以揭示名醫(yī)的組方及用藥規(guī)律。中醫(yī)傳承輔助平臺軟件集醫(yī)案整理、證候及方藥統(tǒng)計(jì)、組方用藥規(guī)律分析等強(qiáng)大功能于一身,可實(shí)現(xiàn)“數(shù)據(jù)的錄入-管理-查詢-分析”的完整的功能。因此開展以中醫(yī)傳承輔助平臺軟件為手段,對導(dǎo)師甘愛萍教授診治老年功能性便秘經(jīng)驗(yàn)進(jìn)行系統(tǒng)研究,具有十分重要的臨床意義。方法:收集湖北省中醫(yī)院甘愛萍教授門診老年功能性便秘患者308例,填寫患者姓名、性別、年齡、癥狀、舌苔脈象、證型、處方,填寫便秘患者生活質(zhì)量量表(PAC-QOL)、Wexner便秘評分系統(tǒng),將患者全部信息錄入中醫(yī)傳承輔助平臺“臨床采集系統(tǒng)”中。通過該軟件中的“統(tǒng)計(jì)報(bào)表系統(tǒng)”中“醫(yī)案統(tǒng)計(jì)”進(jìn)行“體重統(tǒng)計(jì)”、“性別統(tǒng)計(jì)”、“癥狀統(tǒng)計(jì)”、“證候統(tǒng)計(jì)”、“治則治法統(tǒng)計(jì)”、“藥物頻次統(tǒng)計(jì)”、“性味歸經(jīng)統(tǒng)計(jì)”、“藥物用量統(tǒng)計(jì)”;通過“數(shù)據(jù)分析系統(tǒng)”進(jìn)行“癥狀排序”、“癥狀規(guī)律”、“癥狀聚類”分析;通過“方證分析”進(jìn)行“網(wǎng)絡(luò)展示”、“關(guān)鍵藥物”、“關(guān)鍵癥狀”的統(tǒng)計(jì)分析。結(jié)果:1、癥狀統(tǒng)計(jì)顯示,老年功能性便秘出現(xiàn)頻率最高的前10位癥狀依次為:大便干、大便次數(shù)少、口干、大便艱難、腹脹、脘痞、呃逆、泛酸、入睡困難、大便量少。2、中醫(yī)證候統(tǒng)計(jì)顯示,甘愛萍教授辨證老年功能性便秘的常見證型為:氣陰兩虛證(126次)、脾氣虧虛證(111次)、胃腸熱結(jié)證(98次)、肝脾不和證(92次)、腸道氣滯證(75次)、津虧血少證(73次)、胃熱津傷證(64次)。3、治則治法統(tǒng)計(jì)顯示,甘愛萍教授治療老年功能性便秘的主要治法為:養(yǎng)陰潤燥(112次)、補(bǔ)脾益氣(109次)、滋陰清熱(98次)、益氣養(yǎng)陰(93次)、疏肝理脾(87次)、調(diào)氣寬腸(66次)。4、藥物統(tǒng)計(jì)顯示,甘愛萍教授治療老年功能性便秘的主要藥物為:生白術(shù)、枳實(shí)、玉竹、浙貝母、茜草、虎杖、杏仁、蒲公英、郁李仁、生地黃、百合、瓜蔞、石斛、玫瑰花、麥冬、紫蘇子、佛手、合歡花、砂仁、玄參。5、藥物四氣歸類顯示,甘愛萍教授治療老年功能性便秘物四氣信息依次是:寒性(2555次)、溫性(1356次)、平性(533次)、涼性(140次)。6、藥物五味歸類顯示,甘愛萍教授治療老年功能性便秘五味信息分別是“五味統(tǒng)計(jì)”顯示藥物五味排序依次為:苦味(3234次)、甘味(2737次)、辛味(1098次)、酸味(329次)、咸味(166次)、澀味(38次)。7、藥物歸經(jīng)顯示,甘愛萍教授治療功能性消化不良藥物歸經(jīng)信息分別是:胃經(jīng)(2423次)、肺經(jīng)(2200次)、肝經(jīng)(1589次)、脾經(jīng)(1345次)、心經(jīng)(1165次)、大腸經(jīng)(1129次)、腎經(jīng)(918次)、膽經(jīng)(304次)、小腸經(jīng)(259次)、膀胱經(jīng)(10次)。結(jié)論:1、甘愛萍教授認(rèn)為老年功能性便秘病因病機(jī)當(dāng)以氣陰兩虛為本,內(nèi)生火熱、氣機(jī)失調(diào)是關(guān)鍵。2、甘愛萍教授治療老年功能性便秘以益氣養(yǎng)陰為根本治法,清熱存陰、理氣通腑也是重要治療方法。3、甘愛萍教授治療老年功能性便秘用藥特點(diǎn)有治以苦寒,佐以甘溫辛,并且善用對藥。
[Abstract]:Objective: the development of traditional Chinese medicine can not be separated from the diagnosis and treatment experience and academic thought of famous old Chinese medicine. Due to the arrival of the big data age, the research on the clinical experience and academic thought of the famous old Chinese medicine has become a hot spot. Data mining is a method of computing and statistics, from a large number of diagnosis and treatment. The useful information is extracted from the data to reveal the prescription of the famous doctors and the law of drug use. The software of traditional Chinese Medicine Inheritance assistant platform is set up, the syndromes, the statistics of prescription and medicine, the analysis of the rule of drug use in the group and other powerful functions, and the complete function of "data entry management inquiry analysis" can be realized. Therefore, the auxiliary platform of traditional Chinese medicine is carried out. A systematic study of Professor Gan Aiping's experience in the diagnosis and treatment of functional constipation in the elderly is of great clinical significance. Methods: 308 cases of elderly functional constipation in the outpatient department of Gan Aiping, Hubei Provincial Traditional Chinese Medical Hospital, were collected, and the patient's name, sex, age, symptoms, tongue coating pulse, syndrome type, prescription, and constipation patients were filled in. The quality of life scale (PAC-QOL) and the Wexner constipation scoring system were used to enter the whole information of the patients into the "clinical collection system" of the auxiliary platform of traditional Chinese medicine. The "statistical report system" of the software was used to carry out "weight statistics", "sex statistics", "symptom statistics", "syndrome statistics", "governance rule" "Statistics", "drug frequency statistics", "sex taste after statistics", "drug dosage statistics"; through the "data analysis system" to carry out "symptoms sort", "symptoms law", "symptom clustering" analysis; through the "syndrome analysis" to carry out "network display", "key drugs", "key symptoms" statistical analysis. Results: 1, symptoms Statistics show that the first 10 symptoms of the highest frequency of functional constipation in the elderly are: stool, less stool, dry mouth, difficult stool, abdominal distention, epigastric and epigastric, hiccup, pantothenic acid, difficulty in falling asleep, and less stool.2. The common syndromes of TCM syndrome differentiation are: Qi Yin two deficiency syndrome (126 times), spleen qi syndrome (126 times), temper tantrums Deficiency syndrome (111 times), gastrointestinal heat syndrome (98), liver and spleen disharmony (92 times), intestinal qi stagnation syndrome (75 times), deficiency of Tianjin blood deficiency syndrome (73 times) and stomach heat and Tianjin syndrome (64 times).3, the main treatment method of treating senile functional constipation was: Nourishing Yin and moistening dryness (112), supplementing spleen and replenishing qi (109), nourishing yin and clearing heat (98 times), Yiqi nourishing yin (93 (87 times), liver and spleen (87 times), Qi regulating qi (66 times), statistics show that the main medicine for the treatment of Senile Functional Constipation: Sheng Bai Shu, Fructus aurantii, Fructus aurantii, Fritillaria, Polygonum cuspidatum, almond, dandelion, Yu Li Ren, dandelion, rehmannia, Fructus Trichosanthes, Dendrobium, rose, Ophiopogon, purple sodas, acacia, Amomum,.5. The four gas classification showed that the four Qi information in the treatment of Senile Functional constipation was in turn: cold (2555 times), temperature (1356 times), flatness (533 times), cool sex (140 times).6, five flavors of drugs, and Gan Aiping's five flavor information on Senile Functional constipation were "five statistics", respectively, indicating that the order of five flavours was the order of bitter taste (32). 34 times), sweet (2737), bitter (1098), acid (329 times), saltiness (166 times), astringency (38).7, the drug was treated to the meridian, Gan Aiping was treated for functional dyspepsia, the meridian (2423 times), the lung (2200), the liver (1589 times), the spleen meridian (1345), the meridian (1165), the intestine meridian (1129), the kidney meridian (918 times), the bile meridian (304) 259 times, small intestine meridian (259 times) and bladder meridian (10 times). Conclusion: 1, Professor Gan Aiping believes that the etiology and pathogenesis of functional constipation in the elderly should be based on Qi and yin deficiency, internal heat, Qi machine maladjustment is the key.2, Professor Gan Aiping's treatment of senile functional constipation is the basic treatment of Treating Senile Functional Constipation with Qi and Yin nourishing, clearing heat and preserving Yin, Qi Qi and Fu Fu is also an important treatment method.3, Gan Aiping Professor treatment of Senile Functional Constipation medication characteristics are treated with bitter cold, with Gwen Xin, and good use of drugs.

【學(xué)位授予單位】：湖北中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R249;R256.35

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