基于數(shù)據(jù)挖掘方法總結周乃玉教授治療類風濕關節(jié)炎用藥規(guī)律研究
發(fā)布時間：2018-12-16 00:02
【摘要】：1.研究背景類風濕關節(jié)炎是一種以慢性、侵蝕性多關節(jié)炎為主要表現(xiàn)的自身免疫病,屬中醫(yī)“痹病”范疇。本病目前尚無根治的方法,西醫(yī)治療的主要目的是改善癥狀,減少和防止關節(jié)骨的破壞。中醫(yī)學在痹病的治療方面積累了豐富的診療經驗,中醫(yī)治療應用個體化的辨證論治,多層次、多靶點地作用于機體,在緩解癥狀、防止復發(fā)及安全性等方面具有一定的優(yōu)勢。周乃玉教授是國家級名老中醫(yī),為全國第三、四、五批中醫(yī)藥專家學術經驗繼承帶教指導老師,對類風濕關節(jié)炎等疾病積累了豐富的臨證經驗、見解獨到,其經驗值得不斷總結與進一步挖掘。2.研究目的系統(tǒng)梳理周乃玉教授治療類風濕關節(jié)炎的病案,總結名老中醫(yī)經驗,初步歸納其診治該病的學術思想,為提高中醫(yī)藥治療類風濕關節(jié)炎的臨床療效提供借鑒和參考。3.研究方法3.1按照病例納入及排除標準,收集周乃玉教授門診治療類風濕關節(jié)炎的病案。將病案中患者信息(一般情況、癥狀、病位、證候分型、藥物)錄入Excel表格,后進行標準化處理,建立病案數(shù)據(jù)庫。3.2運用“中醫(yī)傳承輔助平臺系統(tǒng)”對數(shù)據(jù)庫中的數(shù)據(jù)進行描述性分析、藥物頻次統(tǒng)計及關聯(lián)規(guī)則、復雜系統(tǒng)熵聚類分析,對周乃玉教授治療類風濕關節(jié)炎的用藥特點及規(guī)律進行總結,并結合中醫(yī)的辨證分型進行研究,探索周乃玉教授治療該病的用藥特色。4.結果研究發(fā)現(xiàn),周乃玉教授治療類風濕關節(jié)炎的常用藥物有甘草、黃芪、白芍、桂枝、白芥子、穿山甲、片姜黃、防風、熟地黃、防己、全蝎、當歸、補骨脂、丹參、白術、骨碎補、柴胡、白鮮皮、威靈仙、附子。所用藥物從“四氣五味”分析,以甘、溫類藥應用最多。從藥物“歸經”分析,入肝經藥物最多,其次分別為入脾經、肺經、胃經、腎經。證候分析中寒濕痹阻證所占比例最高,其次分別為濕熱痹阻證、痰瘀痹阻證。按藥物功效分類,以補虛藥應用最多,其次為活血化瘀藥、解表藥、祛風濕藥、清熱藥等。周乃玉教授常用的藥物組合有甘草、白芍;黃芪、甘草、白芍;穿山甲、白芥子;黃芪、桂枝;黃芪、當歸等。這些藥對組合以益氣健脾、益氣養(yǎng)陰、益氣養(yǎng)血、活血化痰為主要功效,符合周乃玉教授治療類風濕關節(jié)炎注重扶正固本的思想。5.結論周乃玉教授認為類風濕關節(jié)炎發(fā)病的內因是脾腎陽虛、氣血不足,外因中寒濕之邪為主要的致病因素,同時十分重視痰濁瘀血、肝氣郁結在類風濕關節(jié)炎發(fā)病中的作用,因此在類風濕關節(jié)炎的中醫(yī)治療中強調扶正固本,以調補氣血為先、重視溫補脾腎,治療時將化痰逐瘀貫穿始終,輔以疏肝理氣。常用黃芪桂枝五物湯益氣溫經、和血通痹,善用柴胡劑疏肝理氣,蟲類藥物搜剔通絡止痛。
[Abstract]:1. Background Rheumatoid arthritis is an autoimmune disease characterized by chronic and erosive polyarthritis, which belongs to the category of arthralgia. There is no cure for the disease. The main purpose of western medicine is to improve the symptoms and reduce and prevent the destruction of joint bone. Traditional Chinese medicine (TCM) has accumulated rich experience in diagnosis and treatment of arthralgia. Chinese medicine has some advantages in relieving symptoms, preventing recurrence and safety by applying individualized syndrome differentiation and multi-level, multi-target action on the body. Professor Zhou Naiyu is a famous old Chinese medicine doctor at the national level. He inherits the academic experience of the third, fourth, and fifth groups of TCM experts in the country and has accumulated rich clinical experience and unique opinions on rheumatoid arthritis and other diseases. Its experience is worth continuously summing up and further excavating. 2. Objective to study the history of Professor Zhou Naiyu's treatment of rheumatoid arthritis, summarize the experience of famous Chinese medicine, and preliminarily sum up his academic thoughts on the diagnosis and treatment of rheumatoid arthritis. In order to improve the treatment of rheumatoid arthritis with traditional Chinese medicine, the clinical efficacy of reference and reference. 3. Methods 3.1 according to the criteria of inclusion and exclusion, Professor Zhou Naiyu's outpatient treatment of rheumatoid arthritis was collected. The patient information (general condition, symptom, disease position, syndrome type, drug) in the medical record was entered into the Excel form, and then standardized treatment was carried out. 3.2 descriptive analysis of data in the database, statistics of drug frequency and association rules, entropy cluster analysis of complex systems, This paper summarizes the characteristics and laws of professor Zhou Naiyu's treatment of rheumatoid arthritis, studies the syndrome differentiation of traditional Chinese medicine, and explores the characteristics of professor Zhou Naiyu's treatment of rheumatoid arthritis. 4. Results the common drugs used by Professor Zhou Naiyu to treat rheumatoid arthritis were liquorice, astragalus, Radix Paeoniae Alba, Guizhi, White mustard, pangolin, turmeric, Fangfeng, cooked Rehmannia, Fangji, Scorpio, Angelica sinensis, Psoralen, Salvia miltiorrhiza, Atractylodes macrocephala. Broken bone, Bupleurum, white fresh skin, Weiling Xian, aconite. The use of drugs from the "four-gas five-flavor" analysis, Gan, the most used warm drugs. According to the analysis of medicine, the drugs into the liver channel were the most, followed by the spleen meridian, the lung meridian, the stomach meridian and the kidney meridian. In syndrome analysis, the proportion of cold and dampness arthralgia syndrome was the highest, followed by damp-heat arthralgia syndrome and phlegm stasis arthralgia syndrome. According to the classification of drug efficacy, tonifying medicine is the most used, followed by activating blood circulation and removing blood stasis, antitabular drugs, antirheumatic drugs, heat-clearing drugs and so on. Professor Zhou Naiyu commonly used combination of liquorice, Radix Paeoniae Alba, Radix Astragali, Radix Glycyrrhizae, Radix Paeoniae Alba, Pangolin, White mustard seed, Astragalus, Guizhi, Astragalus, Angelica and so on. These medicines to invigorate qi and invigorate spleen, invigorate qi and nourish yin, invigorate qi and nourish blood, and promote blood circulation and dissipate phlegm as the main efficacy, in line with professor Zhou Naiyu's thoughts of treating rheumatoid arthritis and paying attention to strengthening and strengthening the root of rheumatoid arthritis. 5. Conclusion Professor Zhou Naiyu thinks that the internal cause of rheumatoid arthritis is deficiency of spleen and kidney yang, deficiency of qi and blood, and external pathogenic factor of cold and dampness. At the same time, he attaches great importance to the role of phlegm and turbid blood stasis and stagnation of liver qi in the pathogenesis of rheumatoid arthritis. Therefore, in the treatment of rheumatoid arthritis, emphasis is placed on strengthening and strengthening the essence of rheumatoid arthritis, focusing on warming and tonifying spleen and kidney by regulating qi and blood, and dispelling phlegm and removing blood stasis throughout the treatment, supplemented by soothing the liver and regulating qi. Commonly used Astragalus Cinnamomum decoction, and blood-free, make good use of Bupleurum decoction to soothe the liver and qi, insect drugs search tick Tongluo pain.
【學位授予單位】：中國中醫(yī)科學院
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R249;R259
[Abstract]:1. Background Rheumatoid arthritis is an autoimmune disease characterized by chronic and erosive polyarthritis, which belongs to the category of arthralgia. There is no cure for the disease. The main purpose of western medicine is to improve the symptoms and reduce and prevent the destruction of joint bone. Traditional Chinese medicine (TCM) has accumulated rich experience in diagnosis and treatment of arthralgia. Chinese medicine has some advantages in relieving symptoms, preventing recurrence and safety by applying individualized syndrome differentiation and multi-level, multi-target action on the body. Professor Zhou Naiyu is a famous old Chinese medicine doctor at the national level. He inherits the academic experience of the third, fourth, and fifth groups of TCM experts in the country and has accumulated rich clinical experience and unique opinions on rheumatoid arthritis and other diseases. Its experience is worth continuously summing up and further excavating. 2. Objective to study the history of Professor Zhou Naiyu's treatment of rheumatoid arthritis, summarize the experience of famous Chinese medicine, and preliminarily sum up his academic thoughts on the diagnosis and treatment of rheumatoid arthritis. In order to improve the treatment of rheumatoid arthritis with traditional Chinese medicine, the clinical efficacy of reference and reference. 3. Methods 3.1 according to the criteria of inclusion and exclusion, Professor Zhou Naiyu's outpatient treatment of rheumatoid arthritis was collected. The patient information (general condition, symptom, disease position, syndrome type, drug) in the medical record was entered into the Excel form, and then standardized treatment was carried out. 3.2 descriptive analysis of data in the database, statistics of drug frequency and association rules, entropy cluster analysis of complex systems, This paper summarizes the characteristics and laws of professor Zhou Naiyu's treatment of rheumatoid arthritis, studies the syndrome differentiation of traditional Chinese medicine, and explores the characteristics of professor Zhou Naiyu's treatment of rheumatoid arthritis. 4. Results the common drugs used by Professor Zhou Naiyu to treat rheumatoid arthritis were liquorice, astragalus, Radix Paeoniae Alba, Guizhi, White mustard, pangolin, turmeric, Fangfeng, cooked Rehmannia, Fangji, Scorpio, Angelica sinensis, Psoralen, Salvia miltiorrhiza, Atractylodes macrocephala. Broken bone, Bupleurum, white fresh skin, Weiling Xian, aconite. The use of drugs from the "four-gas five-flavor" analysis, Gan, the most used warm drugs. According to the analysis of medicine, the drugs into the liver channel were the most, followed by the spleen meridian, the lung meridian, the stomach meridian and the kidney meridian. In syndrome analysis, the proportion of cold and dampness arthralgia syndrome was the highest, followed by damp-heat arthralgia syndrome and phlegm stasis arthralgia syndrome. According to the classification of drug efficacy, tonifying medicine is the most used, followed by activating blood circulation and removing blood stasis, antitabular drugs, antirheumatic drugs, heat-clearing drugs and so on. Professor Zhou Naiyu commonly used combination of liquorice, Radix Paeoniae Alba, Radix Astragali, Radix Glycyrrhizae, Radix Paeoniae Alba, Pangolin, White mustard seed, Astragalus, Guizhi, Astragalus, Angelica and so on. These medicines to invigorate qi and invigorate spleen, invigorate qi and nourish yin, invigorate qi and nourish blood, and promote blood circulation and dissipate phlegm as the main efficacy, in line with professor Zhou Naiyu's thoughts of treating rheumatoid arthritis and paying attention to strengthening and strengthening the root of rheumatoid arthritis. 5. Conclusion Professor Zhou Naiyu thinks that the internal cause of rheumatoid arthritis is deficiency of spleen and kidney yang, deficiency of qi and blood, and external pathogenic factor of cold and dampness. At the same time, he attaches great importance to the role of phlegm and turbid blood stasis and stagnation of liver qi in the pathogenesis of rheumatoid arthritis. Therefore, in the treatment of rheumatoid arthritis, emphasis is placed on strengthening and strengthening the essence of rheumatoid arthritis, focusing on warming and tonifying spleen and kidney by regulating qi and blood, and dispelling phlegm and removing blood stasis throughout the treatment, supplemented by soothing the liver and regulating qi. Commonly used Astragalus Cinnamomum decoction, and blood-free, make good use of Bupleurum decoction to soothe the liver and qi, insect drugs search tick Tongluo pain.
【學位授予單位】：中國中醫(yī)科學院
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R249;R259
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