基于數(shù)據(jù)挖掘技術(shù)分析當(dāng)代中醫(yī)名家濕疹驗(yàn)方經(jīng)驗(yàn)研究
發(fā)布時(shí)間：2018-08-04 09:08
【摘要】：[目的]病和證的結(jié)合乃是現(xiàn)代中醫(yī)臨床的主導(dǎo)醫(yī)學(xué)形式,而“審證求機(jī)”則是中醫(yī)辨證論治過程中的重要環(huán)節(jié)。深入了解濕疹的病證特點(diǎn)及其理、法、方、藥,可以有效指導(dǎo)臨床,進(jìn)一步提升療效。文獻(xiàn)研究發(fā)現(xiàn),古今醫(yī)家對(duì)濕疹的病位認(rèn)識(shí)有其共性,共識(shí)是主要病因與肺脾腎三臟密切,涉及心肝。不過對(duì)其癥狀、治法及處方用藥的認(rèn)識(shí),各位醫(yī)家的觀點(diǎn)龐雜而欠系統(tǒng)整理。有見及此,本研究選擇當(dāng)代中醫(yī)名家治療濕疹的有效醫(yī)案驗(yàn)案,透過強(qiáng)化FP-Growth算法的關(guān)聯(lián)分析,尋找其組方配伍規(guī)律,和提取一些新的認(rèn)識(shí),冀能為中醫(yī)臨床和中醫(yī)科研提供借鑒與參考。I方法]檢索發(fā)表于1988年2月～2014年11月于中國知網(wǎng)有關(guān)中醫(yī)濕疹的醫(yī)案,并依據(jù)納入排除標(biāo)準(zhǔn),構(gòu)建中醫(yī)濕疹醫(yī)案數(shù)據(jù)庫；當(dāng)開展數(shù)據(jù)探析、統(tǒng)計(jì)整理時(shí),需要對(duì)原醫(yī)療信息的藥物名進(jìn)行全面調(diào)整、改正錯(cuò)別字、調(diào)整臨床術(shù)語、搜索原始數(shù)據(jù)等開展一系列的預(yù)處理方案；再將符合標(biāo)準(zhǔn)入選共354診次的中醫(yī)濕疹醫(yī)案,采用Medcase V3.2倉公診籍國臨床治療信息檔案進(jìn)行全面性分析,形成臨床醫(yī)療信息整合、存儲(chǔ)信息庫,并對(duì)信息庫記載的臨床信息進(jìn)行載錄調(diào)整與重復(fù)性的信息整合。且整理癥狀術(shù)語詞匯共87條、累計(jì)規(guī)范1040頻次的前提下,形成了集搜索、儲(chǔ)存、規(guī)范、研究、深挖相結(jié)合的、多類信息深挖模式與框架組建的臨床信息深挖系統(tǒng)；通過Medcase V3.2軟件,經(jīng)完善有關(guān)規(guī)則信息深挖測(cè)算系統(tǒng)、Medcase Record Mining軟件、Association Rule Analysis模型、Xminer Operation Tool系統(tǒng)與健全FP-Growth計(jì)算系統(tǒng),按照統(tǒng)計(jì)學(xué)方式進(jìn)行探索,并總結(jié)測(cè)試結(jié)果,通過舌像、脈象、處方、治療手段等各個(gè)方面按照中醫(yī)學(xué)知識(shí)開展對(duì)中醫(yī)濕疹醫(yī)案經(jīng)驗(yàn)的總結(jié)。[結(jié)果]對(duì)于頻數(shù)研究而言,現(xiàn)今一些醫(yī)生在醫(yī)治濕疹疾病的過程中,發(fā)現(xiàn)其典型的臨床癥狀包括：瘙癢、便干、失眠、煩躁和口干；皮損依次有滲出、丘疹、紅斑、結(jié)痂、糜爛和抓痕；病變的部位依次分為全身、頭面、四肢、軀干。舌象依次為舌質(zhì)紅、舌質(zhì)淡紅、苔薄白、苔黃膩、舌質(zhì)淡、苔黃、苔白和苔白膩；脈象方面依次為滑、數(shù)、細(xì)、弦、沉、弱、浮、緩、濡、指紋紫、指紋紫滯、大、平、微、指紋沉滯、指紋赤、指紋紫紅、虛、指紋淡紫、結(jié)、指紋紅、指紋青、指紋青紫。當(dāng)代醫(yī)家治療濕疹的醫(yī)案中出現(xiàn)的高頻治法依次為清熱、止癢、祛風(fēng)、健脾、除濕、利濕、解毒、養(yǎng)血、涼血、疏風(fēng)、燥濕、活血、溫陽、祛濕、潤燥、滲濕、益氣、散寒、化濕和養(yǎng)陰。對(duì)高頻治法整合規(guī)范后,發(fā)現(xiàn)濕疹高頻治法與上�？茖W(xué)技術(shù)出版社陸德銘主編的《中醫(yī)外科學(xué)》中所列濕疹治法相符,說明濕疹臨床治法仍以清熱、利濕、養(yǎng)血、祛風(fēng)、健脾、疏風(fēng)為主；研究發(fā)現(xiàn)當(dāng)代醫(yī)家的醫(yī)案治法靈活,反映濕疹病情多復(fù)雜多變、虛實(shí)寒熱錯(cuò)雜皆有。當(dāng)代醫(yī)家治療濕疹的醫(yī)案中高頻中藥依次為白鮮皮、甘草、防風(fēng)、蒼術(shù)、茯苓、薏苡仁、地膚予、生地、丹皮、當(dāng)歸、黃柏、苦參、蟬蛻、白術(shù)、赤芍。參考上�？茖W(xué)技術(shù)出版社雷載權(quán)主編的《中藥學(xué)》將以上的高頻中藥分類后,高頻藥物種類為：清熱燥濕藥、解表藥、利水滲濕藥、利尿通淋藥、清熱涼血藥、補(bǔ)血藥、清熱解毒藥、健脾滲濕藥、涼血藥等。藥物內(nèi)關(guān)聯(lián)方面,名老醫(yī)家治療濕疹常用的15對(duì)藥對(duì),它們之間都有較高置信度。1.白鮮皮、地膚子；2.白鮮皮、苦參；3.白鮮皮、甘草；4.白鮮皮、防風(fēng)；5.白鮮皮、生地；6.白鮮皮、慧苡仁；7.白鮮皮、蒼歹忙；8.白鮮皮、茯苓；9.甘草、生地；10.生地、丹皮；11.蒼術(shù)、黃柏;12.蒼術(shù)、防風(fēng)；13.蒼術(shù)、薏苡仁；14.防風(fēng)、甘草；15.防風(fēng)、地膚子。治則治法與藥物外關(guān)聯(lián)方面：1.與發(fā)泄瘀熱、養(yǎng)血、潤燥外關(guān)聯(lián)有較高置信度的藥物是生地。2.與養(yǎng)血外關(guān)聯(lián)有較高置信度的藥物是當(dāng)歸。3.與祛風(fēng)外關(guān)聯(lián)有較高置信度的藥物是防風(fēng)、荊芥、當(dāng)歸。4.與宣表有較高置信度的藥物是浮萍。5.與益氣、健脾、溫陽有較高置信度的藥物是黃芪。6.與疏風(fēng)、透邪有較高置信度的藥物是麻黃。7.與補(bǔ)肝、補(bǔ)腎有較高置信度的藥物是龍骨。8.與止癢外關(guān)聯(lián)有較高置信度的藥物是蒼術(shù)、荊芥。[結(jié)論]選取了當(dāng)代醫(yī)家治療濕疹的醫(yī)案,然后進(jìn)行數(shù)據(jù)挖掘,當(dāng)中包括統(tǒng)計(jì)分析和關(guān)聯(lián)規(guī)則分析,其結(jié)論大多都是臨床行之有效或是古今適用的傳統(tǒng)中醫(yī)理論和認(rèn)識(shí),和一般教科書當(dāng)中的理論相近,從而推論出應(yīng)用數(shù)據(jù)挖掘進(jìn)行醫(yī)案分析是有效可行的。并且透過高頻藥物的組來總結(jié)分析濕疹常用中藥的配伍應(yīng)用關(guān)系。通過有關(guān)研究,發(fā)現(xiàn)醫(yī)治規(guī)則和藥物間、臨床體征和藥物間存在的內(nèi)在聯(lián)系能夠通過定量的公式表達(dá)出來,令“癥法藥”相統(tǒng)一,整理了新的觀點(diǎn),有不少能夠在臨床上進(jìn)行實(shí)踐論證,可以看出信息深挖與健全FP-Growth系統(tǒng)對(duì)整理中醫(yī)臨床資料及學(xué)習(xí)中醫(yī)知識(shí)是一個(gè)極其有效的探索手段。
[Abstract]:[Objective] the combination of disease and syndrome is the leading medical form of modern Chinese medicine, and "examining and seeking the machine" is an important link in the process of syndrome differentiation and treatment in traditional Chinese medicine. A thorough understanding of the characteristics of the syndrome and its principle, method, prescription and medicine can effectively guide the clinical and improve the curative effect. The literature study found that the ancient and modern doctors have the understanding of the eczema. The common sense is that the common understanding is that the main cause of the disease is closely related to the three organs of the lung and spleen and kidney, which involves the heart and the liver. However, the understanding of the symptoms, the treatment and prescription of the prescription, the views of the doctors are complex and not systematic. In this case, this study chooses the effective medical case of the famous contemporary Chinese medicine people to treat eczema, and seeks the correlation analysis of the FP-Growth algorithm. The law of compatibility of its groups and some new knowledge are extracted. We can provide reference and reference.I methods for Chinese medicine clinical and traditional Chinese medicine research and retrieve medical cases related to Chinese medicine eczema published from February 1988 to November 2014. According to the exclusion criteria, the database of medical case of Chinese medicine eczema is constructed. At the time, it is necessary to adjust the drug name of the original medical information comprehensively, correct the wrong words, adjust the clinical terms, search the original data and so on to carry out a series of preprocessing plans; then, the medical case of the Chinese medicine eczema, which conforms to the standard admission 354 times, has been analyzed comprehensively by the medical records of Medcase V3.2. The bed medical information is integrated, the information storage is stored, and the clinical information recorded in the information base is integrated with the information of the clinical information. There are 87 terms of the symptom terminology and the cumulative standard of 1040 frequency. It forms a combination of search, storage, specification, research, deep excavation, multi type information deep excavation mode and frame set up. Information deep excavation system; through Medcase V3.2 software, through the improvement of the relevant rules information depth measurement system, Medcase Record Mining software, Association Rule Analysis model, Xminer Operation Tool system and sound FP-Growth computing system, explore according to statistical methods, and summarize the test results, through the tongue, pulse, prescription, treatment. Methods and other aspects in accordance with the knowledge of traditional Chinese medicine to carry out a summary of the experience of Chinese medicine eczema. [results] for frequency research, some of the doctors in the process of treating eczema, found that the typical clinical symptoms include pruritus, stool, insomnia, irritability, and dry mouth; skin lesions are exudative, papules, erythema, scab, erosion. And scratches; the site of the lesion is divided into whole body, head, limbs, trunk. The tongue is in turn red tongue, pale red tongue, pale moss, greasy tongue, yellowish tongue, yellow moss, white and white moss; the pulse image in turn is slippery, number, fine, chord, weak, floating, gentle, fingerprints, purple, fingerprints, fingerprints, fingerprints, fingerprints, fingerprints, fingerprints, fingerprints, fingerprints, red and imaginary fingerprints. The high-frequency treatment in the medical case for the treatment of eczema in the medical case of contemporary medical treatment is the order of clearing heat, stopping itching, removing wind, invigorating the spleen, dehumidifying, dehumidification, detoxification, nourishing blood, cooling blood, drying wet, blood circulation, warming Yang, removing dampness, moistening dryness, moistening, moistening, humidifying and nourishing yin. High frequency therapy is consistent with the treatment of eczema listed in "Chinese medicine surgery", edited by Shanghai science and Technology Press, Lu De Ming. It shows that the clinical treatment of eczema is still characterized by clearing heat, humid, blood raising, dispelling wind, invigorating the spleen, and sparsely wind. The high frequency Chinese medicine in the medical case for the treatment of eczema is in turn: white fresh skin, licorice, wind proof, Atractylodes, Poria, coix seed, ground skin, radix, Radix Angelicae, Cortex Phellodendri, Radix Sophorae, cicada, Atractylodes, radix paeoniae rubra. According to the classification of Chinese medicine above the high frequency medicine of Shanghai science and Technology Publishing House, the high frequency drugs are classified as: clearing heat dampness medicine, Antipyretic drugs, diuretic drugs, diuresis, antipyretic, blood medicine, blood clearing and detoxifying drugs, spleen invigorating and humidifying drugs, cold blood medicine, and other 15 pairs of drugs commonly used by old doctors to treat eczema, they all have high reliability.1. white fresh skin, ground skin, 2. white fresh skin, Sophora flavescens; 3. white fresh skin, licorice; 4. white fresh skin, windproof. 5. white fresh skin, raw land; 6. white fresh skin, Hui's kernels; 7. white fresh skin, black and bad; 8. white fresh skin, Poria; 9. licorice, 10. raw land, red skin; 11. Atractylodes, cypress; 12. Atractylodes, coix seed; 14. windbreak, licorice; 15. wind, skin. Treatment method and drug related aspects: 1. and circulation stasis heat, nourishing blood stasis, moistening dryness The drug associated with high reliability is the high reliability of the drug associated with the.2. and the blood raising. The drug associated with the.3. and the dispelling wind is a drug with high reliability. The drugs with higher reliability are the duckweed.5. and the Yiqi, the invigorating spleen and the warm yang, which have high reliability of the drug are Astragalus.6. and sparse wind. The drugs with high reliability are ephedra.7. and liver filling, and the drugs with high reliability for the kidney have higher reliability. The drug which has higher reliability of the association of the keel.8. and the antipruritic is Atractylodes, and Jing. [Conclusion] selected the medical cases of the modern doctors to treat eczema, and then carry on the data mining, including the statistical analysis and the association rules analysis, which are most of the conclusions. The theory and understanding of traditional Chinese medicine, which is effective in clinical practice or in ancient and modern times, is similar to the theory in general textbooks. Thus it is effective and feasible to deduce the analysis of medical cases by using data mining. And through the group of high frequency drugs, the relationship of Wu Yingyong with the common Chinese medicine used in eczema is summarized and analyzed. The internal connection between the clinical physical signs and the drugs can be expressed in a quantitative formula, so that the "symptomatic medicine" is unified and a new viewpoint is arranged. Many can be proved in clinical practice. It can be seen that the information deep and sound FP-Growth system is one of the clinical data and knowledge of traditional Chinese medicine. An extremely effective means of exploration.
【學(xué)位授予單位】：南京中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：博士
【學(xué)位授予年份】：2016
【分類號(hào)】：R249;R275.9
本文編號(hào)：2163333
[Abstract]:[Objective] the combination of disease and syndrome is the leading medical form of modern Chinese medicine, and "examining and seeking the machine" is an important link in the process of syndrome differentiation and treatment in traditional Chinese medicine. A thorough understanding of the characteristics of the syndrome and its principle, method, prescription and medicine can effectively guide the clinical and improve the curative effect. The literature study found that the ancient and modern doctors have the understanding of the eczema. The common sense is that the common understanding is that the main cause of the disease is closely related to the three organs of the lung and spleen and kidney, which involves the heart and the liver. However, the understanding of the symptoms, the treatment and prescription of the prescription, the views of the doctors are complex and not systematic. In this case, this study chooses the effective medical case of the famous contemporary Chinese medicine people to treat eczema, and seeks the correlation analysis of the FP-Growth algorithm. The law of compatibility of its groups and some new knowledge are extracted. We can provide reference and reference.I methods for Chinese medicine clinical and traditional Chinese medicine research and retrieve medical cases related to Chinese medicine eczema published from February 1988 to November 2014. According to the exclusion criteria, the database of medical case of Chinese medicine eczema is constructed. At the time, it is necessary to adjust the drug name of the original medical information comprehensively, correct the wrong words, adjust the clinical terms, search the original data and so on to carry out a series of preprocessing plans; then, the medical case of the Chinese medicine eczema, which conforms to the standard admission 354 times, has been analyzed comprehensively by the medical records of Medcase V3.2. The bed medical information is integrated, the information storage is stored, and the clinical information recorded in the information base is integrated with the information of the clinical information. There are 87 terms of the symptom terminology and the cumulative standard of 1040 frequency. It forms a combination of search, storage, specification, research, deep excavation, multi type information deep excavation mode and frame set up. Information deep excavation system; through Medcase V3.2 software, through the improvement of the relevant rules information depth measurement system, Medcase Record Mining software, Association Rule Analysis model, Xminer Operation Tool system and sound FP-Growth computing system, explore according to statistical methods, and summarize the test results, through the tongue, pulse, prescription, treatment. Methods and other aspects in accordance with the knowledge of traditional Chinese medicine to carry out a summary of the experience of Chinese medicine eczema. [results] for frequency research, some of the doctors in the process of treating eczema, found that the typical clinical symptoms include pruritus, stool, insomnia, irritability, and dry mouth; skin lesions are exudative, papules, erythema, scab, erosion. And scratches; the site of the lesion is divided into whole body, head, limbs, trunk. The tongue is in turn red tongue, pale red tongue, pale moss, greasy tongue, yellowish tongue, yellow moss, white and white moss; the pulse image in turn is slippery, number, fine, chord, weak, floating, gentle, fingerprints, purple, fingerprints, fingerprints, fingerprints, fingerprints, fingerprints, fingerprints, fingerprints, fingerprints, red and imaginary fingerprints. The high-frequency treatment in the medical case for the treatment of eczema in the medical case of contemporary medical treatment is the order of clearing heat, stopping itching, removing wind, invigorating the spleen, dehumidifying, dehumidification, detoxification, nourishing blood, cooling blood, drying wet, blood circulation, warming Yang, removing dampness, moistening dryness, moistening, moistening, humidifying and nourishing yin. High frequency therapy is consistent with the treatment of eczema listed in "Chinese medicine surgery", edited by Shanghai science and Technology Press, Lu De Ming. It shows that the clinical treatment of eczema is still characterized by clearing heat, humid, blood raising, dispelling wind, invigorating the spleen, and sparsely wind. The high frequency Chinese medicine in the medical case for the treatment of eczema is in turn: white fresh skin, licorice, wind proof, Atractylodes, Poria, coix seed, ground skin, radix, Radix Angelicae, Cortex Phellodendri, Radix Sophorae, cicada, Atractylodes, radix paeoniae rubra. According to the classification of Chinese medicine above the high frequency medicine of Shanghai science and Technology Publishing House, the high frequency drugs are classified as: clearing heat dampness medicine, Antipyretic drugs, diuretic drugs, diuresis, antipyretic, blood medicine, blood clearing and detoxifying drugs, spleen invigorating and humidifying drugs, cold blood medicine, and other 15 pairs of drugs commonly used by old doctors to treat eczema, they all have high reliability.1. white fresh skin, ground skin, 2. white fresh skin, Sophora flavescens; 3. white fresh skin, licorice; 4. white fresh skin, windproof. 5. white fresh skin, raw land; 6. white fresh skin, Hui's kernels; 7. white fresh skin, black and bad; 8. white fresh skin, Poria; 9. licorice, 10. raw land, red skin; 11. Atractylodes, cypress; 12. Atractylodes, coix seed; 14. windbreak, licorice; 15. wind, skin. Treatment method and drug related aspects: 1. and circulation stasis heat, nourishing blood stasis, moistening dryness The drug associated with high reliability is the high reliability of the drug associated with the.2. and the blood raising. The drug associated with the.3. and the dispelling wind is a drug with high reliability. The drugs with higher reliability are the duckweed.5. and the Yiqi, the invigorating spleen and the warm yang, which have high reliability of the drug are Astragalus.6. and sparse wind. The drugs with high reliability are ephedra.7. and liver filling, and the drugs with high reliability for the kidney have higher reliability. The drug which has higher reliability of the association of the keel.8. and the antipruritic is Atractylodes, and Jing. [Conclusion] selected the medical cases of the modern doctors to treat eczema, and then carry on the data mining, including the statistical analysis and the association rules analysis, which are most of the conclusions. The theory and understanding of traditional Chinese medicine, which is effective in clinical practice or in ancient and modern times, is similar to the theory in general textbooks. Thus it is effective and feasible to deduce the analysis of medical cases by using data mining. And through the group of high frequency drugs, the relationship of Wu Yingyong with the common Chinese medicine used in eczema is summarized and analyzed. The internal connection between the clinical physical signs and the drugs can be expressed in a quantitative formula, so that the "symptomatic medicine" is unified and a new viewpoint is arranged. Many can be proved in clinical practice. It can be seen that the information deep and sound FP-Growth system is one of the clinical data and knowledge of traditional Chinese medicine. An extremely effective means of exploration.
【學(xué)位授予單位】：南京中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：博士
【學(xué)位授予年份】：2016
【分類號(hào)】：R249;R275.9
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