本文選題：數(shù)據(jù)分析 + 系統(tǒng)性紅斑狼瘡��； 參考：《云南中醫(yī)學(xué)院》2017年碩士論文

【摘要】：目的:通過運(yùn)用數(shù)據(jù)分析的相關(guān)方法,對(duì)國(guó)家級(jí)名老中醫(yī)孟如教授治療系統(tǒng)性紅斑狼瘡的學(xué)術(shù)經(jīng)驗(yàn)進(jìn)行傳承研究,以便探尋其辨治規(guī)律。方法:通過影像采集等方法收集導(dǎo)師保存的孟如教授1997年-2000年,2007年-2010年診治SLE的病歷資料。并將其進(jìn)行規(guī)范化整理,獲得標(biāo)準(zhǔn)化文本,用ACCESS建立孟如教授所治SLE病歷資料的證治方藥數(shù)據(jù)庫;用Excel 2013數(shù)據(jù)透視表統(tǒng)計(jì)出癥狀、體征、證候、證素、方藥等的頻次,運(yùn)用SQL Server 2012MAddin數(shù)據(jù)挖掘軟件及Apriori算法對(duì)孟如教授所治系統(tǒng)性紅斑狼瘡的病歷資料中的主要癥狀、藥物及證-癥-藥-方等進(jìn)行關(guān)聯(lián)規(guī)則分析,設(shè)定最小支持度和最小置信度;同時(shí)運(yùn)用SPSS 21.0對(duì)主要證型和癥狀進(jìn)行決策樹分析,總結(jié)孟如教授治療SLE的辨治規(guī)律。結(jié)果:1.頻數(shù)分析結(jié)果:本課題所納入的病例資料中癥狀頻率出現(xiàn)在10%及以上的依次為:倦怠乏力、鼻唇干燥、唇紅、失眠、腰痛、潮熱、心悸、關(guān)節(jié)痛、咽干、面部紅斑、脫發(fā)、頭暈、口渴、大便干結(jié)、皮膚紅斑、心煩、神疲、面色赤、肢軟、口苦、尿短黃、面瞼浮腫、咳嗽、唇干;舌象以舌苔薄白,舌質(zhì)紅多見,脈象以脈細(xì)、脈滑為主。辨證分型中以氣陰兩虛證最多,頻率30.36%,其次為肝腎陰虛證(26.39%),風(fēng)濕熱痹證(10.91%),熱毒熾盛證(9.72%),脾腎兩虛證(5.56%),其余證候所占比例較少。證素中病位證素以腎(55.95%)、肝(44.64%)為主要病位;病性證素中陰虛(86.11%)、氣虛(53.77%)、濕(27.93%)、熱(26.39%)為四種常見病性。對(duì)260例,504診次的方藥進(jìn)行頻數(shù)分析,其中使用頻數(shù)最高的前15首處方分別是:二至丸、生脈散、六味地黃丸、增液湯、酸棗仁湯、知柏地黃丸、犀角地黃湯、小柴胡湯、當(dāng)歸芍藥散、黃芪生脈二至丸、九味羌活湯、蠲痹湯、青蒿鱉甲湯、杞菊地黃丸、平胃散;使用頻率較高的前40味藥物分別是:甘草、茯苓、生地黃、麥冬、丹皮、淮山藥、澤瀉、山萸肉、芍藥、女貞子、旱蓮草、川芎、五味子、知母、當(dāng)歸、柴胡、半夏、白術(shù)、黃柏、玄參、防風(fēng)、黃芩、連翹、生牡蠣、薏苡仁、生龍骨、蘇條參、陳皮、酸棗仁、枳實(shí)、白茅根、秦艽、黃芪、桑寄生、蒼術(shù)、桔梗、青蒿、菊花、太子參、水牛角,是治療sle的主要藥物。藥類以補(bǔ)虛藥、清熱藥為主,兼活血化瘀藥、解表藥、利水滲濕藥等。2.關(guān)聯(lián)規(guī)則、決策樹分析結(jié)果:本研究主要對(duì)癥狀、中藥及五種常見證型的證-癥-藥-方進(jìn)行關(guān)聯(lián)規(guī)則分析,從癥狀關(guān)聯(lián)規(guī)則分析可知孟如教授所治sle疾病,各癥狀之間聯(lián)系密切,如出現(xiàn)倦怠乏力時(shí)會(huì)出現(xiàn)神疲、肢軟、心悸、潮熱、舌邊齒痕、失眠、脈細(xì)、舌苔薄白、脫發(fā)等癥狀;心煩時(shí)會(huì)出現(xiàn)急躁易怒;咽干時(shí)會(huì)出現(xiàn)口苦、唇紅、口渴、心煩、面部紅斑、鼻唇干燥等癥狀。從藥物關(guān)聯(lián)規(guī)則分析可知孟如教授治療sle常用藥對(duì)有生地黃-茯苓,山萸肉-淮山藥,女貞子-旱蓮草等;常用藥物組合為“生地黃、山萸肉、淮山藥”“茯苓、澤瀉、丹皮”“蘇條參、麥冬、五味子”“神曲、山楂、萊菔子”“桃仁、紅花、川芎、芍藥、姜黃、黃芪、當(dāng)歸”等等;從藥物依賴關(guān)系網(wǎng)絡(luò)圖可歸納總結(jié)孟如教授治療sle的常用處方及核心處方。從“證-癥-藥-方”的關(guān)聯(lián)規(guī)則分析可知五種常見證型各癥狀、藥物之間的相互關(guān)系及各證型所對(duì)應(yīng)的常用核心處方。對(duì)癥狀證型進(jìn)行決策樹分析,初步構(gòu)建孟如教授所治療sle肝腎陰虛證、氣陰兩虛證、脾腎兩虛證、風(fēng)濕熱痹證、熱毒熾盛證等常見證型的診斷模型。結(jié)論:1.運(yùn)用數(shù)據(jù)分析的相關(guān)方法可以提煉出孟如教授治療sle的辨治規(guī)律。如利用頻數(shù)分析,可以歸納出高頻癥狀、證候、方藥,從而得出益氣養(yǎng)陰、滋陰清熱是辨治系統(tǒng)性紅斑狼瘡最常用的法則;利用關(guān)聯(lián)規(guī)則分析可以得出各癥狀的關(guān)聯(lián)、藥物的配伍規(guī)律,以及“證-癥-藥-方”的相互關(guān)系;利用決策樹可以清晰明了的反映癥狀與證型的密切關(guān)系,使其證型診斷客觀化。同時(shí)進(jìn)一步總結(jié)出孟如教授辨治sle的學(xué)術(shù)經(jīng)驗(yàn),即(1)以病為綱,病證結(jié)合,辨證論治;(2)注重整體,把握病機(jī),詳審病勢(shì);(3)善抓主癥,整體審察,執(zhí)簡(jiǎn)馭繁;(4)謹(jǐn)守病機(jī),活用經(jīng)方,精于配伍;(5)擅用藥對(duì),求新增效,增效減毒。2.運(yùn)用現(xiàn)代數(shù)據(jù)分析方法可以從多方面、多角度對(duì)名老中醫(yī)豐富的臨床經(jīng)驗(yàn)進(jìn)行分析,從而總結(jié)其辨治規(guī)律,使名老中醫(yī)經(jīng)驗(yàn)更直觀、易懂,并能夠得到客觀實(shí)用的結(jié)論,對(duì)臨床工作具有指導(dǎo)意義,并對(duì)名老中醫(yī)學(xué)術(shù)經(jīng)驗(yàn)的傳承研究及傳統(tǒng)中醫(yī)藥的發(fā)展、創(chuàng)新均具有重要的現(xiàn)實(shí)意義。
[Abstract]:Objective: to carry on the study of the academic experience of Professor Meng Ru in the treatment of systemic lupus erythematosus by means of data analysis, in order to explore the rule of differentiation and treatment of lupus erythematosus. Methods: to collect the medical records of Professor Mencius in 1997 -2000 and -2010 in 2007 by image collection and so on. Standardized text was made, standardized text was obtained, and ACCESS was used to establish the database of prescription and administration of SLE medical records by Professor Mencius. The frequency of symptoms, signs, syndromes, syndromes, prescription, and so on were statistically analyzed with Excel 2013 data pivot table, and the systematicness of Professor Meng Ru was used by SQL Server 2012MAddin data mining software and Apriori algorithm. The main symptoms in the medical records of lupus erythematosus, drug, syndrome, medicine and prescription were analyzed, the minimum support and minimum confidence were set. At the same time, SPSS 21 was used to analyze the major syndromes and symptoms, and the rule of differentiation and treatment of SLE was summed up by Professor Meng Ru. Results: the results of the 1. frequency analysis were included in this subject. Symptoms in the case of 10% or more symptoms were: burnout, dry nasolabial, lip red, sleeplessness, low back pain, hot flashes, palpitations, joint pain, sore throat, facial erythema, hair loss, dizziness, thirst, stool dry knot, skin erythema, irritability, fatigue, face color, soft, bitter, short yellow, eyelid swelling, cough, lip, tongue, tongue, tongue, tongue There were two deficiency syndrome in Qi Yin, 30.36% of Qi Yin deficiency syndrome, second syndrome of liver kidney yin deficiency syndrome (26.39%), rheumatic heat syndrome (10.91%), hot and toxic syndrome (9.72%), two deficiency syndrome of spleen and kidney (5.56%), and the proportion of other syndromes in the syndrome differentiation. The main disease position was kidney (55.95%) and liver (44.64%) as the main disease position. Yin deficiency (86.11%), Qi deficiency (53.77%), wet (27.93%), and heat (26.39%) were four common diseases. 260 cases, 504 times of the prescription of the frequency analysis, of which the highest frequency of the first 15 prescriptions were: two to the pill, Shengmai Powder, six flavour Rehmannia pills, Zeng liquid soup, zizzizijen soup, Zhi Bai Dihuang pill, rhino Rehmannia soup, small Bupleurum soup, angelica Peony Scattered, Astragalus raw pulse two pills, nine flavors of Qiang Qi Decoction, Juanbi soup, Artemisia arygwort soup, Qi chrysanthemum pills, flat stomach powder; the use of high frequency of the top 40 drugs are: licorice, Poria cocos, radix rehmanniae, Radix Ophiopogon, Huai yam, Rhizoma Alisma, Fructus Ligustrum, Rhizoma Anemarrhenae, Rhizoma Chuanxiong, Schisandra, Radix Angelicae, Radix Bupleuri, Pinelliae, pachyrhizae, cypress, Radix sabroniae, Wind proof, Scutellaria, forsythia, raw oysters, coix seed, raw dragon bone, soothing bone, citrus peel, sour jujube kernel, Fructus aurantii trifoliate, rhizome root, Radix Gentiana, Radix Astragali, Artemisia rhizome, Artemisia Artemisia, Artemisia Artemisia, chrysanthemum, Radix Astragalus, water ox horn, are the main drugs for the treatment of SLE, and the.2. association rules, such as tonifying deficiency drugs, clearing heat drugs, and activating blood and removing stasis medicine, dissolving the surface medicine and leuewater and humidifying drugs The result of tree analysis: This study mainly analyzes the association rules of symptoms, Chinese medicine and five common syndromes, syndrome, medicine and prescription. From the analysis of symptoms association rules, Professor Meng Ru has a close relationship between the symptoms and symptoms, such as fatigue, soft limbs, palpitations, hot flashes, tongue edges, insomnia, vein fine and tongue thin. White, alopecia and other symptoms; irritability and irritability when irritated; symptoms of pain, lip redness, thirst, irritability, facial erythema, dry nose and lip when dry throat. From the analysis of drug association rules, Professor Meng Ru is used to treat SLE commonly used medications for Rehmannia - Poria, Hillwood meat - Huai yam, Ligustrum lucidum - lotus, and so on; the commonly used drug combination is "rehmannia, mountain, mountain, and so on. "Tuckahoe, HuaiYam" "Poria cocos, Alisma Alisi, Danskin" "sustriae ginseng, Ophiopogon japonicus, Schisandra" "divine comedy, hawthorn, semen Raphani" "peach kernel" "peach kernel", "saffron, Ligusticum chuanxiong, peony, Jiang Huang, Huangqi, angelica" and so on; from the drug dependence network diagram can summarize and summarize the common prescriptions and core prescriptions of Professor Meng Ru treatment SLE. From the association of "syndrome syndrome drug prescription" The rule analysis shows the symptoms of five common syndrome types, the relationship between the drugs and the common core prescriptions corresponding to the syndrome types. The decision tree analysis of the symptoms and syndromes is carried out. The diagnosis model of the common syndrome types, such as SLE liver kidney yin deficiency syndrome, Qi Yin two deficiency syndrome, spleen and kidney two deficiency syndrome, rheumatic fever syndrome, heat and poison inability syndrome, is preliminarily constructed. Conclusion: 1. using the relevant methods of data analysis can be used to extract the rule of Professor Meng Ru's treatment of SLE. For example, the frequency analysis can be used to induce the high frequency symptoms, syndromes and prescriptions, so that it is the most common rule to differentiate and treat the systemic lupus erythematosus. The law of compatibility of drugs and the relationship between "syndrome - syndrome - drug - prescription" and the use of the decision tree can clearly and clearly reflect the close relationship between symptoms and syndrome types to make the syndrome diagnosis objective. At the same time, the academic experience of Professor Meng Ru's identification and treatment of SLE is further summed up. (1) the disease is the outline, the combination of disease and syndrome, syndrome differentiation, and (2) pay attention to the whole and grasp the disease. Machine, detailed examination of the disease; (3) good grasp the main disease, the overall inspection, the implementation of simple control complex; (4) keep the disease machine, use the meridian, the compatibility; (5) to use the medicine pair, the new efficiency, the effect of the modern data analysis method can be analyzed from various aspects of the clinical experience of the famous old Chinese medicine Feng Fu from many aspects, so as to sum up the rule of differentiation and treatment, so that the famous old Chinese medicine classics can be summed up, so that the famous old Chinese medicine classics can be summed up, so that the famous old Chinese medicine classics can be summed up to make the famous old Chinese medicine classics through. It is more intuitionistic, easy to understand, and can get objective and practical conclusions. It is of guiding significance to clinical work, and has important practical significance to the research of the academic experience of old Chinese medicine and the development of traditional Chinese medicine.
【學(xué)位授予單位】：云南中醫(yī)學(xué)院
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R249;R259

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4 解放軍福州總醫(yī)院風(fēng)濕科 李憶農(nóng)博士;系統(tǒng)性紅斑狼瘡是絕癥嗎？[N];福建科技報(bào);2004年

5 栗占國(guó) 羅剛;系統(tǒng)性紅斑狼瘡用藥要規(guī)范[N];健康報(bào);2006年

6 孫維生;如何早期防治系統(tǒng)性紅斑狼瘡？[N];潮州日?qǐng)?bào);2009年

7 陳靜;系統(tǒng)性紅斑狼瘡研究成果獲國(guó)家科技進(jìn)步二等獎(jiǎng)[N];保健時(shí)報(bào);2010年

8 本報(bào)記者 胡德榮;降伏紅斑狼瘡 “仁濟(jì)”領(lǐng)跑[N];健康報(bào);2010年

9 通訊員 孫國(guó)根　記者 陳青;系統(tǒng)性紅斑狼瘡有新療法[N];文匯報(bào);2011年

10 孫國(guó)根;治療系統(tǒng)性紅斑狼瘡有了“新鑰匙”[N];中國(guó)醫(yī)藥報(bào);2011年

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