【摘要】：原發(fā)性痛經(jīng)是育齡期女性的常見病、多發(fā)病,屬于婦科急癥范疇,嚴(yán)重者可影響女性的學(xué)習(xí)、生活和工作。黎烈榮教授為湖北中醫(yī)藥大學(xué)中醫(yī)婦科學(xué)教授,湖北省中醫(yī)院中醫(yī)婦科主任醫(yī)師,從事中醫(yī)臨床四十余年,具有豐富的臨證經(jīng)驗(yàn),對于原發(fā)性痛經(jīng)的治療有獨(dú)到經(jīng)驗(yàn)。目的本研究采用熵聚類等的數(shù)據(jù)挖掘方法,對黎烈榮教授治療原發(fā)性痛經(jīng)的用藥規(guī)律進(jìn)行初步探討,以分析其臨床辨治特色。方法所有病例均來自2015年12月1日到2016年12月31日就診于湖北省中醫(yī)院黎烈榮教授婦科門診的原發(fā)性痛經(jīng)患者,共42例,126次就診。將126首方劑錄入“中醫(yī)傳承輔助平臺(V2.5)”系統(tǒng),通過系統(tǒng)中的數(shù)據(jù)分析模塊,基于“關(guān)聯(lián)規(guī)則”、“熵聚類算法”及“改進(jìn)的互信息法”等算法,對數(shù)據(jù)進(jìn)行用藥頻次分析及用藥規(guī)律分析等。結(jié)果本研究中,符合標(biāo)準(zhǔn)的126首處方中,涉及中藥25味,所有藥物出現(xiàn)的頻次總和為1711次,頻次≥10的藥物分別是:當(dāng)歸、小茴香、白芍、肉桂、延胡索、香附、烏藥、桂枝、炙甘草、川芎、枸杞子、巴戟天、炒白術(shù)、蒲黃、細(xì)辛、炙黃芪、法半夏、人參、丹參、菟絲子。藥物四氣以溫性平性為主,五味以辛甘為主。藥物歸經(jīng)以肝、脾、心、腎為主。對于經(jīng)期用藥得到4個核心組合:1.烏藥-川芎-枸杞子;2.白芍-炒白術(shù)-炙甘草;3.巴戟天-法半夏-細(xì)辛;4.小茴香-炙甘草-炙黃芪。再將提取的核心組合,進(jìn)一步經(jīng)過無監(jiān)督的熵層次聚類分析,得出2個新方,分別是:1.烏藥-川芎-枸杞子-巴戟天-法半夏-細(xì)辛;2.白芍-炒白術(shù)-炙甘草-小茴香-炙黃芪。經(jīng)后期用藥得到6個核心組合,1.蒲黃-菟絲子-續(xù)斷;2.炒白術(shù)-小茴香-人參;3.巴戟天-小茴香-續(xù)斷;4.川芎-蒲黃-菟絲子-丹參;5.烏藥-炒白術(shù)-肉桂-續(xù)斷;6.巴戟天-小茴香-人參。再將提取的核心組合,進(jìn)一步經(jīng)過無監(jiān)督的熵層次聚類分析,得出3個新方,分別是:1.蒲黃-菟絲子-續(xù)斷-川芎-丹參;2.炒白術(shù)-小茴香-人參-烏藥-肉桂-續(xù)斷;3.巴戟天-小茴香-續(xù)斷-人參。對于經(jīng)前期用藥,得到4個核心組合:1.延胡索-蒲黃-炒白術(shù);2.延胡索-炒白術(shù)-巴戟天;3.蒲黃-炒白術(shù)-補(bǔ)骨脂;4.炒白術(shù)-巴戟天-枸杞子-補(bǔ)骨脂。再將提取的核心組合,進(jìn)一步經(jīng)過無監(jiān)督的熵層次聚類分析,得出2個新方,分別是:1.延胡索-蒲黃-炒白術(shù)-補(bǔ)骨脂;2.延胡索-炒白術(shù)-巴戟天-枸杞子-補(bǔ)骨脂。結(jié)論通過“中醫(yī)傳承輔助平臺(V2.5)”軟件的統(tǒng)計分析,歸納總結(jié)黎烈榮教授治療原發(fā)性痛經(jīng)的辨治特點(diǎn)。原發(fā)性痛經(jīng)的病機(jī)為“不通則痛”或“不榮則痛”,雖有虛、實(shí)之別,然臨床常相兼出現(xiàn),表現(xiàn)脾腎不足為本,氣滯寒凝血瘀為標(biāo)。治療兼顧虛實(shí)、通補(bǔ)并用,提倡溫性藥物的運(yùn)用,注重順應(yīng)月經(jīng)生理的分期治療,特別重視非經(jīng)期調(diào)治,同時指導(dǎo)患者經(jīng)期攝生。
[Abstract]:Primary dysmenorrhea is a common disease in women of childbearing age. Professor Li Lirong is professor of traditional Chinese medicine gynecology of Hubei University of traditional Chinese Medicine and chief physician of traditional Chinese medicine gynecology of Hubei traditional Chinese Medicine Hospital. He has been engaged in TCM clinic for more than 40 years and has rich clinical experience and unique experience in the treatment of primary dysmenorrhea. Objective to explore the rule of treating primary dysmenorrhea by using entropy clustering data mining method, and to analyze the clinical characteristics of treating dysmenorrhea. Methods from December 1, 2015 to December 31, 2016, all patients with primary dysmenorrhea were admitted to the Department of Gynecology of Hubei Provincial traditional Chinese Medicine Hospital. There were 42 patients with dysmenorrhea and 126 visits. In this paper, 126 prescriptions are inputted into the system of "Chinese Medicine inheritance and Assistance platform (V2.5)". Through the data analysis module of the system, based on the algorithms of "association rules", "entropy clustering algorithm" and "improved mutual information method", etc. The frequency and regularity of drug use were analyzed. Results among the 126 prescriptions in this study, 25 herbs were involved. The total frequency of all drugs was 1711. The drugs with frequency 鈮，

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