本文選題：抽動障礙 + 關(guān)聯(lián)規(guī)則　； 參考：《河南中醫(yī)藥大學(xué)》2016年碩士論文

【摘要】：目的:運用關(guān)聯(lián)規(guī)則Apriori算法和復(fù)雜熵聚類算法,對鄭啟仲教授治療兒童抽動障礙(tic disorders,TD)處方用藥進(jìn)行數(shù)據(jù)挖掘分析,研究鄭啟仲教授治療兒童TD用藥規(guī)律,提取核心處方,發(fā)掘潛在藥物組合,為臨床治療兒童TD提供參考依據(jù)。方法:收集整理2012年1月1日至2015年12月31日期間,河南中醫(yī)藥大學(xué)第一附屬醫(yī)院鄭啟仲教授門診治療的兒童TD患者的就診資料,以及鄭啟仲教授治療兒童TD典型醫(yī)案。運用中醫(yī)傳承輔助平臺系統(tǒng)(traditional Chinese medicine inheritance support system,TCMISS)建立病案數(shù)據(jù)庫。首先進(jìn)行一般資料統(tǒng)計,包括用藥頻次、中藥四氣、五味、歸經(jīng)、癥狀頻次、證型頻次等;運用關(guān)聯(lián)規(guī)則Apriori算法提取用藥模式,總結(jié)核心處方并進(jìn)行網(wǎng)絡(luò)展示;運用復(fù)雜熵聚類對所有處方進(jìn)行分析,提取常用藥物組合;依據(jù)出現(xiàn)頻次最多的3個癥狀,分別提取含該癥狀的病案,對處方用藥進(jìn)行關(guān)聯(lián)規(guī)則分析,總結(jié)用藥加減規(guī)律。依據(jù)中醫(yī)證侯分布,提取各證侯使用的處方,進(jìn)行關(guān)聯(lián)規(guī)則分析,提取核心處方。結(jié)果:共收集整理病案110個,得到處方395首,涉及199味中藥。使用頻次在30次以上的藥物共40味,前10味分別是:白芍、僵蠶、蟬蛻、甘草、全蝎、天麻、谷精草、白附子、片姜黃、龍骨;以寒、平、溫性藥物居多;以甘、辛、苦味中藥使用最多;歸經(jīng)以肝經(jīng)最多,肺經(jīng)、脾經(jīng)其次。運用關(guān)聯(lián)規(guī)則Apriori算法分析處方用藥模式,設(shè)置支持個數(shù)為81(支持度≥20%),置信度為0.6,共得到48組用藥模式,出現(xiàn)頻次前三位的是:白芍與僵蠶、蟬蛻與僵蠶、白芍與蟬蛻組合。設(shè)置信度為0.8,共得到50項置信度較高的用藥組合,置信度最高的3個組合是:白芍,蟬蛻,片姜黃→僵蠶(置信度0.94186);白附子,甘草→白芍(置信度0.933333333);白芍,片姜黃→僵蠶(置信度0.929293)。最終得到總核心處方是:白芍、僵蠶、蟬蛻、片姜黃、白附子、甘草、天麻、龍骨、谷精草、全蝎。通過復(fù)雜熵聚類提取10個用藥組合,功效分別為:滋陰潛陽息風(fēng)、祛風(fēng)濕通經(jīng)絡(luò)、鎮(zhèn)肝息風(fēng)、清熱疏風(fēng)、活血通絡(luò)、理氣化痰、清熱化痰、升清降濁。癥狀頻次分析得到出現(xiàn)最多的3個癥狀是:眨眼、清嗓子、注意力不集中,分別對含相應(yīng)癥狀的病案進(jìn)行提取,并進(jìn)行關(guān)聯(lián)規(guī)則分析,發(fā)現(xiàn)針對不同的癥狀,用藥均有:白芍、僵蠶、蟬蛻、片姜黃、甘草、白附子、全蝎。出現(xiàn)眨眼癥狀時,多用谷精草清肝明目,柴胡、黃芩調(diào)節(jié)肝膽氣機,升清降濁;出現(xiàn)清嗓子癥狀多從“痰”論治,注重“調(diào)理肝氣”;出現(xiàn)注意力不集中癥狀多從“心、腎”論治,治療時多以生地黃、牡蠣、炙龜甲滋陰養(yǎng)血,重鎮(zhèn)安神。證侯分析發(fā)現(xiàn),病案中風(fēng)邪犯肺證、痰熱動風(fēng)證、脾虛肝亢證、陰虛陽亢證出現(xiàn)頻次較多,各證型使用的處方進(jìn)行關(guān)聯(lián)規(guī)則分析共得到4個核心處方。結(jié)論:鄭啟仲教授認(rèn)為兒童TD為本虛標(biāo)實之證,病位在肝,氣機失調(diào)、升降失常為其基本病機,風(fēng)、痰濁、熱(火)為病理產(chǎn)物;通過關(guān)聯(lián)規(guī)則和復(fù)雜熵聚類等數(shù)據(jù)挖掘方法分析,鄭啟仲教授治療兒童TD以“僵蠶、蟬蛻、片姜黃、白芍、甘草、白附子、龍骨、全蝎、天麻、谷精草”為核心處方;以和法為大法,升降藥物同用,寒溫藥物并舉,旨在升清降濁,調(diào)暢氣機;臨床辨證以痰熱動風(fēng)證為主;該課題的研究結(jié)果證實了鄭教授治療兒童抽動障TD“升清降濁”的學(xué)術(shù)思想。
[Abstract]:Objective: using the association rule Apriori algorithm and the complex entropy clustering algorithm, the data mining analysis of Professor Zheng Qizhong's tic disorders (TD) prescription is carried out, and the rule of Professor Zheng Qizhong's TD medication is studied, the core prescription is extracted and the potential drug combination is excavated, so as to provide the reference basis for the clinical treatment of children's TD. Methods: from January 1, 2012 to December 31, 2015, the data on the treatment of TD patients in the outpatient department of Professor Zheng Qizhong, the First Affiliated Hospital of Henan University of traditional Chinese medicine, and Professor Zheng Qizhong's treatment of children's TD typical medical cases were collected. The traditional Chinese Medicine Inheritance support system, T CMISS) set up a database of medical records. First of all, the general data statistics, including frequency of drug use, traditional Chinese medicine, five flavors, recurrent symptoms, frequency of symptoms, frequency of syndrome, and so on; use the association rule Apriori algorithm to extract the drug pattern, summarize the core prescription and carry on the network display; use the complex entropy clustering to analyze all the prescriptions and extract the commonly used drug combinations; According to the 3 symptoms of the most frequent occurrence, the symptoms were extracted respectively, the rule of association rules was analyzed, and the rule of addition and subtraction was summarized. According to the distribution of TCM syndromes, the prescription of each syndrome was extracted, the association rules were analyzed and the core prescription was extracted. The results were collected and collected in 110 cases, and 395 of the prescriptions were obtained, involving 19. 9 traditional Chinese medicine. The use of the frequency of more than 30 times a total of 40 flavors, the first 10 flavors are: white peony, silkworm, cicada, licorice, scorpion, gastrodia, valleys, white aconite, turmeric, keel; cold, flat, warm medicine most of the use of Gansu, symplectic, bitter Chinese medicine most; the liver meridian most, lung meridian, splenic meridian next. Use the association rules Apriori algorithm analysis Prescription medication model, set up the number of support 81 (support degree more than 20%), confidence of 0.6, a total of 48 groups of drugs, the first three are: white peony and silkworm, cicada and silkworm, white peony and cicada. The reliability is 0.8, a total of 50 high reliability of the combination, the highest confidence of the 3 combinations are: Paeonia Paeoniae, cicada, tablets, tablets. Turmeric and silkworm (confidence degree 0.94186); white aconite, licorice and Paeonia lactiflora (confidence degree 0.933333333); Paeonia lactiflora, turmeric and silkworm (confidence level 0.929293). The ultimate core prescription is: Paeonia lactiflora, silkworm, cicadas, turmeric, white aconite, licorice, Gastrodia elata, keel, cereal, scorpion. 10 combinations are extracted by complex entropy clustering, the efficacy is as follows: Nourishing yin and nourishing the wind, removing wind and damp through the meridian, the town liver and the wind, the heat and the wind, the circulation of blood and the collaterals, the Qi and the phlegm, the heat and the phlegm, the rise of the clear and the turbidity. The most 3 symptoms of the symptom frequency analysis are: blinking, clearing the throat, and not concentrating on the symptoms. The symptoms of the medicine are: Paeonia lactiflora, silkworm, cicada, Curcuma, licorice, white aconite, scorpion. When there is a blink of the eye, it is used to clear the liver and liver, and to adjust the liver and gallbladder Qi by the Radix Bupleuri and Scutellaria baicalensis. The symptoms of the clear throat are mostly treated from "phlegm" and pay attention to "regulating the liver qi", and the symptoms of attention are not concentrated mostly from "heart and kidney". During the treatment, there were 4 key prescriptions in the analysis of the prescription of each type of syndrome. Zheng Qizhong thought that children's TD was a virtual standard. In fact, the disease position is the basic pathogenesis of the disease in the liver, the maladjustment of the Qi machine and the disorder of the ascending and descending, the wind, the phlegm and the heat (fire) are the pathological products. Through the analysis of the data mining methods such as the association rules and the complex entropy clustering, Professor Zheng Qizhong treats the children with "silkworm, cicada, Curcuma, white peony, licorice, white aconite, keel, scorpion, gastrodia, and valley grass" as the core prescription; Using the method as the great law, the ascending and descending drugs are used in the same use and the cold and warm drugs are used simultaneously. The purpose of the study is to raise the clear and reduce the turbidity and adjust the Qi Qi. The clinical syndrome differentiation is based on the phlegm thermal wind syndrome, and the research results of this subject confirm the academic thought of Professor Zheng's treatment of children's TD "lift the clear and reduce the turbidity".
【學(xué)位授予單位】：河南中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2016
【分類號】：R277.7

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