基于醫(yī)案挖掘痙病的證素研究
發(fā)布時間：2019-05-24 11:26
【摘要】：目的:本研究通過古今醫(yī)案研究結(jié)合現(xiàn)代數(shù)理統(tǒng)計分析方法,挖掘并分析痙病的核心癥狀,總結(jié)探討痙病的主要證素特點,闡明痙病病因病機。以期為中醫(yī)痙病的辨證論治提供借鑒與新思路,為痙病指南修訂提供參考。方法:以大型電子叢書《中華醫(yī)典》作為古代痙病醫(yī)案主要來源,選取古代醫(yī)籍中具有代表性醫(yī)家的醫(yī)案、醫(yī)話及醫(yī)論等,挑選出痙病醫(yī)案部分的內(nèi)容;以各大中文數(shù)據(jù)庫作為現(xiàn)代痙病醫(yī)案來源,從中國生物醫(yī)學(xué)文獻(xiàn)服務(wù)系統(tǒng)(CBM)、維普中文期刊數(shù)據(jù)庫(VIP)、中國知識資源總庫(CNKI)、萬方學(xué)術(shù)期刊全文數(shù)據(jù)庫、中國中醫(yī)藥期刊文獻(xiàn)數(shù)據(jù)庫檢索系統(tǒng)、讀秀數(shù)據(jù)庫等大型中文數(shù)據(jù)庫,以及中國優(yōu)秀博碩士學(xué)位論文、會議文獻(xiàn)中檢索2015年1月之前的所有關(guān)于痙病的文獻(xiàn),提取出痙病醫(yī)案的部分;制定納入標(biāo)準(zhǔn)與排除標(biāo)準(zhǔn),嚴(yán)格按照納入排除標(biāo)準(zhǔn)篩選及規(guī)范化處理所搜集醫(yī)案,建立古今痙病醫(yī)案數(shù)據(jù)庫。以《中華醫(yī)典》及現(xiàn)代文獻(xiàn)中有關(guān)痙病醫(yī)案的內(nèi)容為研究對象,對癥狀進(jìn)行頻數(shù)分析、關(guān)聯(lián)規(guī)則分析,得出核心癥狀,依據(jù)“以主癥為中心進(jìn)行辨證”的中醫(yī)基礎(chǔ)理論,參考朱文鋒教授所著《證素辨證學(xué)》提取痙病證素。結(jié)果:本研究共收集263則痙病醫(yī)案,其中古代內(nèi)科醫(yī)案153例,現(xiàn)代文獻(xiàn)內(nèi)科醫(yī)案110例。得出203個癥狀,全身癥狀共有145條,累計頻數(shù)有1537次,出現(xiàn)頻次在10次以上的癥狀有61個,百分比在10%以上的有19個癥狀,包括四肢抽搐、神昏、牙關(guān)緊閉、發(fā)熱、便秘、項背強急、手足攣急、心煩、汗出、角弓反張、頭痛及口渴等12個全身癥狀,舌象34條,脈象20條,其中百分比在10%以上包括脈弦、脈數(shù)、脈細(xì)、舌紅、苔白、脈滑及脈沉等7個舌脈癥狀。初步統(tǒng)計數(shù)據(jù)經(jīng)關(guān)聯(lián)規(guī)則分析,有22條關(guān)聯(lián)涉及癥狀和6條舌象脈象,推出痙病核心癥狀為:四肢抽搐、牙關(guān)緊閉、發(fā)熱、神昏、項背強急。最終推測出痙病的主要病位證素有:心神(腦)、肝、經(jīng)絡(luò);病性證素有:暑、動風(fēng)、火(熱)、津虧、陰虛。結(jié)論:本研究通過數(shù)據(jù)挖掘技術(shù)對痙病醫(yī)案進(jìn)行數(shù)理統(tǒng)計分析,整理、歸納、總結(jié)痙病常見癥狀,得出痙病核心癥狀為四肢抽搐、牙關(guān)緊閉、發(fā)熱、神昏、項背強急,依據(jù)“以主癥為中心進(jìn)行辨證”的中醫(yī)基礎(chǔ)理論,參考朱文鋒·《證素辨證學(xué)》中證素提取標(biāo)準(zhǔn),得出痙病主要病位證素:心神(腦)、肝、經(jīng)絡(luò),病性證素:暑、動風(fēng)、火(熱)、津虧、陰虛。這些痙病核心要素為中醫(yī)痙病的辨證論治提供了借鑒與新思路,并為痙病指南修訂提供參考。
[Abstract]:Objective: through the study of ancient and modern medical records combined with modern mathematical statistical analysis methods, this study excavates and analyzes the core symptoms of spasm, summarizes and discusses the main syndrome elements of spasm, and expounds the etiology and pathogenesis of spasm. In order to provide reference and new ideas for the syndrome differentiation and treatment of spasm in traditional Chinese medicine, and to provide reference for the revision of spasmodic guidelines. Methods: taking the large electronic series Chinese Medical Code as the main source of ancient spasmodic medical records, the medical records, medical words and medical theories of representative doctors in ancient medical books were selected to select the contents of spasmodic medical records. Taking each major Chinese database as the source of modern spasmodic medical records, from the Chinese Biomedical Literature Service system (CBM), Weipu Chinese Journal Database (VIP), China knowledge Resources General Library (CNKI), Wanfang academic Journal full-text Database, Chinese traditional Chinese medicine periodical literature database retrieval system, read show database and other large Chinese databases, as well as Chinese excellent master's degree thesis, the conference literature to retrieve all the literature on spasmodic before January 2015. Extract the part of spasmodic medical record; To establish the inclusion standard and exclusion standard, to screen and standardize the collected medical cases according to the inclusion exclusion criteria, and to establish the database of ancient and modern spasmodic medical records. Taking the contents of spasmodic medical records in Chinese Medical Code and modern literature as the research object, the frequency analysis of symptoms and the analysis of association rules were carried out, and the core symptoms were obtained, according to the basic theory of TCM differentiation of symptoms and signs centered on the main symptoms. With reference to Professor Zhu Wenfeng's syndrome differentiation, spasmodic syndrome elements were extracted. Results: a total of 263 spasmodic medical records were collected, including 153 cases of ancient internal medicine and 110 cases of modern literature. 203 symptoms were obtained, with a total of 145 systemic symptoms, with a cumulative frequency of 1537 times, 61 symptoms with a frequency of more than 10 times, and 19 symptoms with a percentage of more than 10 per cent, including twitching of limbs, dizziness, closed teeth, fever and constipation. There are 12 systemic symptoms, such as strong back, clonic hand and foot, upset, sweating, angular arch reflexive, headache and thirst, etc., there are 34 tongue images and 20 pulse images, of which more than 10% include pulse string, pulse number, pulse fineness, tongue red, moss white, There are 7 symptoms of tongue and vein, such as pulse slippage and pulse sedimentation. According to the analysis of association rules, 22 related symptoms and 6 tongue pulse images were found. The core symptoms of spasmodic were as follows: twitching of limbs, closure of teeth, fever, dizziness and urgency of item back. Finally, it is inferred that the main symptoms of spasm are heart (brain), liver, meridians and collaterals, and the pathological syndromes are heat, wind, fire (heat), Jin deficiency and yin deficiency. Conclusion: through data mining technology, this study makes mathematical statistical analysis, collates, sums up and summarizes the common symptoms of spasm. It is concluded that the core symptoms of spasm are twitching of limbs, closed teeth, fever, dizziness and urgency of the back of the item. According to the basic theory of TCM syndrome differentiation centered on the main symptoms, and referring to Zhu Wenfeng's syndrome differentiation standard of syndrome differentiation, it is concluded that the main syndrome elements of spasmodic disease are heart and mind (brain), liver, meridians and collaterals, disease syndrome elements: heat and wind. Fire (heat), Jin deficiency, yin deficiency. These core elements of spasm provide a reference and new idea for the syndrome differentiation and treatment of spasm in traditional Chinese medicine, and provide a reference for the revision of spasmodic guidelines.
【學(xué)位授予單位】：湖北中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2016
【分類號】：R249;R256.44
本文編號：2484822
[Abstract]:Objective: through the study of ancient and modern medical records combined with modern mathematical statistical analysis methods, this study excavates and analyzes the core symptoms of spasm, summarizes and discusses the main syndrome elements of spasm, and expounds the etiology and pathogenesis of spasm. In order to provide reference and new ideas for the syndrome differentiation and treatment of spasm in traditional Chinese medicine, and to provide reference for the revision of spasmodic guidelines. Methods: taking the large electronic series Chinese Medical Code as the main source of ancient spasmodic medical records, the medical records, medical words and medical theories of representative doctors in ancient medical books were selected to select the contents of spasmodic medical records. Taking each major Chinese database as the source of modern spasmodic medical records, from the Chinese Biomedical Literature Service system (CBM), Weipu Chinese Journal Database (VIP), China knowledge Resources General Library (CNKI), Wanfang academic Journal full-text Database, Chinese traditional Chinese medicine periodical literature database retrieval system, read show database and other large Chinese databases, as well as Chinese excellent master's degree thesis, the conference literature to retrieve all the literature on spasmodic before January 2015. Extract the part of spasmodic medical record; To establish the inclusion standard and exclusion standard, to screen and standardize the collected medical cases according to the inclusion exclusion criteria, and to establish the database of ancient and modern spasmodic medical records. Taking the contents of spasmodic medical records in Chinese Medical Code and modern literature as the research object, the frequency analysis of symptoms and the analysis of association rules were carried out, and the core symptoms were obtained, according to the basic theory of TCM differentiation of symptoms and signs centered on the main symptoms. With reference to Professor Zhu Wenfeng's syndrome differentiation, spasmodic syndrome elements were extracted. Results: a total of 263 spasmodic medical records were collected, including 153 cases of ancient internal medicine and 110 cases of modern literature. 203 symptoms were obtained, with a total of 145 systemic symptoms, with a cumulative frequency of 1537 times, 61 symptoms with a frequency of more than 10 times, and 19 symptoms with a percentage of more than 10 per cent, including twitching of limbs, dizziness, closed teeth, fever and constipation. There are 12 systemic symptoms, such as strong back, clonic hand and foot, upset, sweating, angular arch reflexive, headache and thirst, etc., there are 34 tongue images and 20 pulse images, of which more than 10% include pulse string, pulse number, pulse fineness, tongue red, moss white, There are 7 symptoms of tongue and vein, such as pulse slippage and pulse sedimentation. According to the analysis of association rules, 22 related symptoms and 6 tongue pulse images were found. The core symptoms of spasmodic were as follows: twitching of limbs, closure of teeth, fever, dizziness and urgency of item back. Finally, it is inferred that the main symptoms of spasm are heart (brain), liver, meridians and collaterals, and the pathological syndromes are heat, wind, fire (heat), Jin deficiency and yin deficiency. Conclusion: through data mining technology, this study makes mathematical statistical analysis, collates, sums up and summarizes the common symptoms of spasm. It is concluded that the core symptoms of spasm are twitching of limbs, closed teeth, fever, dizziness and urgency of the back of the item. According to the basic theory of TCM syndrome differentiation centered on the main symptoms, and referring to Zhu Wenfeng's syndrome differentiation standard of syndrome differentiation, it is concluded that the main syndrome elements of spasmodic disease are heart and mind (brain), liver, meridians and collaterals, disease syndrome elements: heat and wind. Fire (heat), Jin deficiency, yin deficiency. These core elements of spasm provide a reference and new idea for the syndrome differentiation and treatment of spasm in traditional Chinese medicine, and provide a reference for the revision of spasmodic guidelines.
【學(xué)位授予單位】：湖北中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2016
【分類號】：R249;R256.44
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，本文編號：2484822
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