【摘要】：目的：運(yùn)用數(shù)據(jù)挖掘技術(shù)研究高天舒教授治療糖尿病腎病的用藥規(guī)律,探析高天舒教授辨證及用藥經(jīng)驗(yàn)。材料與方法：收集高天舒教授治療糖尿病腎病病例,記錄患者一般資料及處方用藥等信息,使用WPS-Excel 2016建立病例信息及處方數(shù)據(jù)庫(kù),采用頻數(shù)、相關(guān)性及聚類等分析方法進(jìn)行處方分析。結(jié)果：1.172名患者中,平均年齡59.41±12.10歲,男性占64.53%;女性占35.47%。女性與男性的比例為1：1.82;BMI在24.0~27.9kg/m2(超重)者最多,占47.09%;合并高血壓最多,占70.35%。2.以納入及排除標(biāo)準(zhǔn)篩選處方共191則,涉及中藥179味,使用總頻次為2463次。其中使用頻率超過(guò)10%的中藥共有39味,排在前十位的藥物依次為黃芪、山茱萸、澤瀉、生地、茯苓、烏梅、益母草、菟絲子、桑椹和丹皮。3.179味中藥中寒性藥居多,溫性藥其次,分別占36.88%和31.28%;藥味以甘、苦、辛居多;藥物歸經(jīng)順序依次為肝、腎、肺、脾、心經(jīng),其中歸肝經(jīng)的藥物使用頻次為1339次,占54.36%,歸腎經(jīng)藥物使用頻次為1224次,占49.70%。4.涉及16類藥物,補(bǔ)虛藥、清熱藥、利水滲濕藥位于前列,使用頻率依次為27.49%、17.30%、11.21%。其中補(bǔ)虛藥以補(bǔ)陰藥(45.20%)、補(bǔ)氣藥(35.01%)居多,清熱藥以清熱涼血藥(52.37%)為首。5.結(jié)合跟師經(jīng)驗(yàn),相關(guān)性分析得出6個(gè)常用藥對(duì),聚類分析得出4個(gè)聚類方。結(jié)論：1.高天舒教授認(rèn)為氣陰兩虛,痰瘀阻絡(luò),是糖尿病腎病病機(jī);“腎絡(luò)微型ve瘕”是糖尿病腎病的病理關(guān)鍵環(huán)節(jié)。治療上高天舒教授主張益氣養(yǎng)陰,活血化瘀,軟堅(jiān)散結(jié)。2.黃芪、山茱萸、澤瀉、生地、茯苓、烏梅、益母草、菟絲子、桑椹和丹皮是高天舒教授治療糖尿病腎病的核心用藥。3.用藥以寒性藥稍多,溫性藥其次,藥味以甘、苦、辛為主,主歸肝經(jīng),其次為腎、肺、脾、心經(jīng)。4.補(bǔ)虛藥、清熱藥、利水滲濕藥、活血化瘀藥是高天舒教授常用的藥物類別,體現(xiàn)高天舒教授補(bǔ)氣養(yǎng)陰、活血消ve的治療主張。同時(shí)高天舒教授重視軟堅(jiān)散結(jié)中藥如海藻、昆布在糖尿病腎病中的應(yīng)用。
[Abstract]:Objective: to study the rule of drug use of Professor Gao Tianshu in the treatment of diabetic nephropathy by using data mining technology, and to explore professor Gao Tianshu's syndrome differentiation and drug use experience. Materials and methods: professor Gao Tianshu for the treatment of diabetic nephropathy cases, records the general information of patients and prescription medication information, using WPS-Excel 2016 to establish case information and prescription database, using frequency, Correlation and cluster analysis methods were used for prescription analysis. Results among 1.172 patients, the average age was 59.41 鹵12.10 years old, male was 64.53 and female was 35.477.The average age was 59.41 鹵12.10 years old. The female-male ratio of 1: 1.82 was the highest in 24.0~27.9kg/m2 (47.09), and the highest in hypertension (70.35.2.). A total of 191 prescriptions were screened by inclusion and exclusion criteria, involving 179 kinds of traditional Chinese medicine, with a total frequency of 2463 times. Among them, 39 herbs were used more than 10% frequently. The top ten drugs were astragalus, Cornus officinalis, alisma, Rhizoma alisma, Poria cocos, Wumei, Leonurus, semen Cuscuta, Mulberry and Danpi. 3.179 herbs were mostly cold drugs, followed by warm drugs. 36.88% and 31.28%, respectively, the medicine taste was sweet, bitter and Xin, and the order of drug meridian was liver, kidney, lung, spleen and heart meridian, in which the frequency of drug use was 1339 times, accounting for 54.36 times, and the frequency of drug use for kidney meridian was 1224 times, accounting for 49.70 times. Involving 16 kinds of drugs, tonifying deficiency medicine, clearing heat medicine, promoting water and permeating wet medicine in the front row, the frequency of use is 27.49, 17.30 and 11.21. The drugs of tonifying deficiency were tonifying yin (45.20%), invigorating qi (35.01%), and clearing away heat and cooling blood (52.37%). According to the experience of teachers, 6 common drug pairs were obtained by correlation analysis, and 4 clusters were obtained by cluster analysis. Conclusion 1. Professor Gao Tianshu thinks that deficiency of qi and yin, phlegm and stasis are the pathogenesis of diabetic nephropathy, and "kidney mini ve" is the key link of diabetic nephropathy. On the treatment of Professor Gao Tianshu advocated invigorating qi and yin, promoting blood circulation and removing blood stasis, soft strong scattered knot. 2. Astragalus membranaceus, Cornus officinalis, alisma, Rhizoma Astragali, Poria cocos, Wupai, Motherwort, Cuscuta, Mulberry and Dannan are the core drugs used by Professor Gao Tianshu in the treatment of diabetic nephropathy. Cold medicine is used a little more, warm medicine is next, medicinal taste is sweet, bitter, Xin mainly, main return liver classics, next is kidney, lung, spleen, heart Jing. 4. The medicine of tonifying deficiency, clearing away heat, promoting water and infiltrating dampness, activating blood circulation and removing blood stasis are commonly used by professor Gao Tianshu, which embodies professor Gao Tianshu's treatment proposition of nourishing qi and nourishing yin and activating blood circulation and eliminating ve. At the same time, Professor Gao Tianshu attaches importance to the application of Chinese medicine such as seaweed and kelp in diabetic nephropathy.
【學(xué)位授予單位】：遼寧中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R259

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 張寧;李自輝;于卉;劉冠璋;趙洪偉;董婉茹;劉樹民;;玄參及其各組分的降血糖作用[J];中藥藥理與臨床;2016年05期

2 劉夢(mèng)超;滕福斌;王耀獻(xiàn);;王耀獻(xiàn)應(yīng)用和解聚散方加減治療慢性腎病驗(yàn)案二則[J];中國(guó)中醫(yī)藥信息雜志;2015年09期

3 付婷婷;王國(guó)賢;陳婷婷;張忠英;;黃精多糖對(duì)糖尿病腎病大鼠腎臟的保護(hù)作用[J];中藥藥理與臨床;2015年04期

4 徐佳;高天舒;楊瀟;周喜玉;曲金橋;;富碘中藥復(fù)方與碘過(guò)量對(duì)碘缺乏NOD.H-2~(h4)小鼠心、腎2型脫碘酶mRNA表達(dá)的影響[J];遼寧中醫(yī)藥大學(xué)學(xué)報(bào);2015年03期

5 楊紅;楊彩虹;朱曉東;岳仁宋;;中西結(jié)合探析甘味中藥在糖尿病中的應(yīng)用[J];光明中醫(yī);2014年12期

6 周加興;;丹紅注射液治療早期糖尿病腎病的療效觀察[J];四川中醫(yī);2014年12期

7 趙宇輝;唐丹丹;陳丹倩;馮亞龍;李全福;李鵬飛;趙英永;;利尿藥茯苓、茯苓皮、豬苓和澤瀉的化學(xué)成分及其利尿作用機(jī)制研究進(jìn)展[J];中國(guó)藥理學(xué)與毒理學(xué)雜志;2014年04期

8 金春花;赫慧;;海藻多糖膠囊對(duì)高脂血癥大鼠血脂的影響[J];特產(chǎn)研究;2014年02期

9 仝小林;周強(qiáng);趙林華;田佳星;;糖尿病腎病的中醫(yī)辨治經(jīng)驗(yàn)[J];中華中醫(yī)藥雜志;2014年01期

10 江丹;林明欣;朱章志;;朱章志教授從“三陰病”論治糖尿病腎病經(jīng)驗(yàn)[J];中華中醫(yī)藥雜志;2013年09期

相關(guān)博士學(xué)位論文 前8條

1 周靜鑫;芪衛(wèi)顆粒干預(yù)糖尿病腎病臨床療效及其保護(hù)足細(xì)胞作用機(jī)制研究[D];北京中醫(yī)藥大學(xué);2014年

2 依秋霞;益氣解毒活絡(luò)復(fù)方防治早期糖尿病腎病大鼠腎損傷的實(shí)驗(yàn)研究[D];遼寧中醫(yī)藥大學(xué);2014年

3 生生;益氣解毒活絡(luò)方對(duì)早期糖尿病腎病大鼠“毒損腎絡(luò)”病理機(jī)制影響的實(shí)驗(yàn)研究[D];遼寧中醫(yī)藥大學(xué);2014年

4 奚悅;三黃糖腎康對(duì)早期DN大鼠微炎癥狀態(tài)影響的實(shí)驗(yàn)研究及臨床療效觀察[D];遼寧中醫(yī)藥大學(xué);2013年

5 李景;糖尿病腎病中醫(yī)藥療效綜合評(píng)價(jià)體系研究[D];北京中醫(yī)藥大學(xué);2012年

6 魏軍平;林蘭教授糖尿病三型辨證學(xué)術(shù)思想淵源與臨床經(jīng)驗(yàn)整理研究[D];中國(guó)中醫(yī)科學(xué)院;2012年

7 郭小舟;糖微康膠囊對(duì)早期糖尿病腎病的干預(yù)及療效機(jī)理研究[D];中國(guó)中醫(yī)科學(xué)院;2011年

8 張曉清;乳腺癌與甲狀腺疾病的關(guān)系及乳腺鈉碘轉(zhuǎn)運(yùn)體功能調(diào)控的研究[D];廣州中醫(yī)藥大學(xué);2011年

相關(guān)碩士學(xué)位論文 前10條

1 肖鳴;大株紅景天對(duì)氣虛血瘀型糖尿病腎病氧化應(yīng)激干預(yù)研究[D];云南中醫(yī)學(xué)院;2016年

2 丁琛一;澤瀉對(duì)GK大鼠糖尿病治療效果的評(píng)價(jià)[D];浙江大學(xué);2015年

3 梁志堅(jiān);糖尿病腎病中醫(yī)古籍文獻(xiàn)方藥規(guī)律挖掘研究[D];廣州中醫(yī)藥大學(xué);2014年

4 謝秀儀;降糖三黃片治療糖尿病腎病早期臨床療效觀察[D];廣州中醫(yī)藥大學(xué);2014年

5 曲金橋;富碘中藥與碘過(guò)量對(duì)碘缺乏NOD.H-2~(h4)小鼠甲狀腺氧化應(yīng)激的比較[D];遼寧中醫(yī)藥大學(xué);2014年

6 王文豪;溫臟扶正祛邪方治療早期糖尿病腎病的臨床觀察[D];廣州中醫(yī)藥大學(xué);2013年

7 侯小燕;渴絡(luò)欣膠囊治療糖尿病腎病的療效觀察及其作用機(jī)制的探討[D];福建中醫(yī)藥大學(xué);2012年

8 徐新穎;昆布在實(shí)驗(yàn)性高脂血癥中降血脂和抗氧化作用的研究[D];青島大學(xué);2011年

9 高英;降血糖中藥篩選及黃精降血糖活性成分的研究[D];西南大學(xué);2010年

10 郭瑞清;水蛭地龍注射液對(duì)糖尿病大鼠腎臟保護(hù)作用的研究[D];重慶醫(yī)科大學(xué);2007年

，

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