【摘要】：目的:通過整理歸納閻洪臣教授臨床診治頭痛的醫(yī)案,應(yīng)用數(shù)據(jù)挖掘技術(shù),初步分析、總結(jié)閻洪臣教授治療頭痛的辨證思維特點(diǎn)及用藥規(guī)律,傳承名老中醫(yī)經(jīng)驗(yàn)。方法:通過跟師出診,收集2013年9月至2016年2月期間閻洪臣教授診治的頭痛醫(yī)案,記錄整理電子版診療信息,篩選符合標(biāo)準(zhǔn)的醫(yī)案共206例。按照名老中醫(yī)臨床醫(yī)案管理系統(tǒng)的統(tǒng)一格式,將患者的基本情況、臨床癥狀、舌苔脈象、辨證分型、治法、方劑、藥物及藥量等病例信息錄入數(shù)據(jù)庫,通過數(shù)據(jù)分析及處理,在當(dāng)代名老中醫(yī)案解析系統(tǒng)中進(jìn)行數(shù)據(jù)挖掘及統(tǒng)計(jì)。通過多維分析及關(guān)聯(lián)分析,得出閻洪臣教授診療頭痛臨床癥狀、舌苔脈象、辨證分型的頻數(shù)及之間的關(guān)聯(lián),結(jié)合筆者2年余的跟診體會,總結(jié)其治療頭痛的辨證思維特點(diǎn);對用藥數(shù)據(jù)進(jìn)行證型-藥物的多維分析及對比分析等得出閻洪臣教授治療頭痛的總體用藥分布及各證型的用藥分布,通過用藥分析,得出各證型所應(yīng)用藥物的性味歸經(jīng),結(jié)合中醫(yī)藥理論知識,得出閻洪臣教授治療頭痛的用藥規(guī)律。結(jié)果:1證型分布特點(diǎn):出現(xiàn)頻次最多的證型為痰熱上擾證,痰濕上阻證次之,肝郁氣逆證、氣虛失養(yǎng)證、風(fēng)火上擾證、肝火上炎證等出現(xiàn)頻率亦較高。2癥狀、舌脈分布特點(diǎn):所納入的206例頭痛患者中,出現(xiàn)頻次較多的癥狀及舌脈依次為:頭痛、脈沉、頭暈、舌質(zhì)紅、乏力、脈弦、眠差、口干、易怒、胸悶、舌質(zhì)淡等,并通過多維及對比分析得出證型與癥狀舌脈之間的關(guān)系。3用藥分布特點(diǎn):用藥頻次較多的藥物依次為:甘草、陳皮、茯苓、白芷、半夏、菊花、天麻、枳實(shí)、全蝎、蜈蚣、梔子、白術(shù)、竹茹、鉤藤、遠(yuǎn)志、川芎、柴胡、川楝子、川木通、香附,并應(yīng)用證型-用藥分析得出各證型的用藥分布特點(diǎn)。4各證型用藥性味歸經(jīng)特點(diǎn):痰熱上擾證的用藥性味依次為:辛、苦、溫、平、甘,歸肺、脾、胃、心、肝經(jīng);痰濕上阻證用藥性味依次為:甘、苦、溫、平、辛,歸經(jīng)依次為:肺、脾、胃、肝、心;并得出其他證型用藥性味歸經(jīng)特點(diǎn)。結(jié)論:通過數(shù)據(jù)挖掘技術(shù)統(tǒng)計(jì)分析,總結(jié)得出閻洪臣教授治療頭痛的辨證思維特點(diǎn)及用藥規(guī)律,包括辨證分型、癥狀、用藥分布以及性味歸經(jīng)特點(diǎn),為今后頭痛的辨治提供了寶貴的經(jīng)驗(yàn)。
[Abstract]:Objective: to summarize professor Yan Hongchen's clinical diagnosis and treatment of headache, apply data mining technology, analyze preliminarily, summarize the characteristics of professor Yan Hongchen's dialectical thinking and drug use in the treatment of headache, and pass on the famous and old TCM experience. Methods: from September 2013 to February 2016, the headache medical records of Professor Yan Hongchen were collected, and the information of electronic diagnosis and treatment was recorded and sorted out. According to the unified format of the clinical case management system of the famous old Chinese medicine, the basic information of the patient, clinical symptoms, tongue coating pulse, syndrome differentiation, treatment method, prescription, medicine and drug quantity were entered into the database, and the data were analyzed and processed. Data mining and statistics are carried out in the analysis system of famous old Chinese medicine cases. Through multi-dimensional analysis and correlation analysis, the authors obtained the frequency and correlation of clinical symptoms, tongue coating pulse, syndrome differentiation and classification of headache diagnosed and treated by Professor Yan Hongchen, and summarized the characteristics of dialectical thinking in the treatment of headache combined with the author's more than 2 years' experience in following diagnosis. The multi-dimensional analysis and comparative analysis of drug use data were used to obtain the overall distribution of drugs used by Professor Yan Hongchen for headache treatment and the distribution of drug use of each syndrome type. Through drug use analysis, the characteristics of the drugs used in each syndrome type were analyzed and the characteristics and classics of the drugs used in each syndrome type were obtained. Combined with the theoretical knowledge of traditional Chinese medicine, Professor Yan Hongchen for the treatment of headache drug law. Results the distribution characteristics of syndrome type: the most frequent syndromes were phlegm and heat disorder, phlegm dampness and dampness obstruction, liver stagnation and qi inversion, deficiency of qi, disturbance of wind and fire, inflammation of liver fire, and so on. The characteristics of tongue vein distribution: the frequency of symptoms and tongue vein were headache, dizziness, red tongue, fatigue, pulse string, poor sleep, dry mouth, irritability, chest tightness, light tongue and so on, among 206 patients with headache, the symptoms of frequency and frequency were: headache, dizziness, red tongue, fatigue, pulse string, poor sleep, dry mouth, irritability, chest tightness, light tongue, etc. The relationship between syndromes and tongue veins was obtained by multi-dimensional and contrastive analysis. The characteristics of drug use were as follows: liquorice, Chenpi, Poria cocos, Radix angelicae dahurica, Pinellia ternata, Chrysanthemum, Gastrodia elata, Aurantii, Scorpio, centipede, etc. Gardenia, Atractylodes macrocephala, Bamboo Ru, Hook Rattan, Radix Polygala, Ligusticum chuanxiong, Bupleurum chinensis, Needendan seed, Akebia chinensis, The distribution characteristics of drug use in each syndrome type were obtained. 4. The characteristics of drug quality of each syndrome type were as follows: Xin, bitter, warm, Ping, Gan, Gui lung, spleen, stomach, heart and liver meridian; The characteristics of phlegm dampness blocking syndrome were as follows: sweet, bitter, warm, flat, Xin, and meridian in turn: lung, spleen, stomach, liver, heart, and other syndromes. Conclusion: through statistical analysis of data mining techniques, the characteristics of syndrome differentiation thinking and drug use of Professor Yan Hongchen in the treatment of headache were summarized, including syndrome differentiation, symptoms, drug use distribution and characteristics of sexual taste and meridian. It provides valuable experience for the diagnosis and treatment of headache in the future.
【學(xué)位授予單位】：長春中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2016
【分類號】：R249;R277.7

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