基于数据挖掘技术的马伟明治疗胃食管反流病组方用药规律研究
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摘要
目的:探讨马伟明主任中医师治疗胃食管反流病(GERD)的组方用药规律,阐述其临证经验。方法:收集及选取马伟明主任中医师临床治疗GERD处方。基于中医传承辅助系统软件,采用关联规则、复杂系统熵聚类等数据挖掘方法,分析其组方规律;并分析及阐述马伟明主任中医师治疗胃食管反流病的用药经验。结果:纳入马伟明主任中医师治疗胃食管反流病446首处方,明确其常用药物10个、核心组合10组及新处方4首。将病案分为肝胃郁热、中虚气逆、脾虚湿热、痰气交阻、瘀血阻络及肝胃阴虚6个证型,确定6个证型的常用药物。以上结果,均绘制其网络图进行展现。结论:基于中医传承辅助系统软件进行数据挖掘,提出马师治疗GERD以"和、清、通、降"为四大常法;并体现其"用药轻润,注意顾护脾胃""病久痰瘀论治"的临证特点。
Objective:To analyze professor MA Weiming's medication rule in treating GERD and summarize his clinical experience. Methods: Prescriptions for treating GERD by professor MA Weiming were collected. Relation between drugs was analyzed by using the association rule algorithm and complex system entropy clustering based on traditional Chinese medicine inheiritance support system. The experience of doctor was analyzed and expounded. Results: Based on the analysis of 466 medical records,10 commonly-used drugs of evolution and 10 core combinations and 4 new prescriptions were mined from the database. The patients were divided into six syndromes, including stagnation-heat in liver and stomach,deficiency and reversed flow of Qi, dampness-heat due to spleen deficiency, qi and phlegm obstruction,stasis blocking channels and Yin deficiency in liver and stomach. Commonly-used drugs of evolution were identified. All the above results were shown in the network diagram. Conclusion: Based on the data mining of traditional cCinese medicine inheiritance support system, it is proposed that the clinical experience of MA Weiming treating GERD with harmonization, heat-clearing, dredging and descending as the four common laws. It also reflects the characteristics of the clinical evidence of the medicine being light and taking care for spleen and stomach and treatment from phlegm and blood stasis in long illness.
Objective:To analyze professor MA Weiming's medication rule in treating GERD and summarize his clinical experience. Methods: Prescriptions for treating GERD by professor MA Weiming were collected. Relation between drugs was analyzed by using the association rule algorithm and complex system entropy clustering based on traditional Chinese medicine inheiritance support system. The experience of doctor was analyzed and expounded. Results: Based on the analysis of 466 medical records,10 commonly-used drugs of evolution and 10 core combinations and 4 new prescriptions were mined from the database. The patients were divided into six syndromes, including stagnation-heat in liver and stomach,deficiency and reversed flow of Qi, dampness-heat due to spleen deficiency, qi and phlegm obstruction,stasis blocking channels and Yin deficiency in liver and stomach. Commonly-used drugs of evolution were identified. All the above results were shown in the network diagram. Conclusion: Based on the data mining of traditional cCinese medicine inheiritance support system, it is proposed that the clinical experience of MA Weiming treating GERD with harmonization, heat-clearing, dredging and descending as the four common laws. It also reflects the characteristics of the clinical evidence of the medicine being light and taking care for spleen and stomach and treatment from phlegm and blood stasis in long illness.
引文
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[8] 张声生,朱生樑,王宏伟,等.胃食管反流病中医诊疗专家共识意见[J].中国中西医结合消化杂志,2017,25(5):321-326.
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[11] 王烨燃,张洋,秦琦冰,等.基于数据挖掘的肾阴虚型消渴病方剂用药规律分析[J].中药新药与临床药理,2018(1):97-103.
[12] 刘婧,张兰.基于数据挖掘的早期糖尿病肾病中医治疗用药规律研究[J].中医药导报,2018(1):60-63.
[13] 王佳佳,王洪峰.基于著作类数据挖掘针灸治疗痞满的腧穴优选与配伍规律谱[J].中华中医药杂志,2018(2):694-698.
[14] 赵健,梁玉丹,王小寅, 等.基于数据挖掘的针灸综合疗法治疗子宫内膜异位症的应用规律研究[J].中国全科医学,2018(1):104-108.
[15] 朱青,朱垚,陆明.基于国医大师周仲瑛临证肝胆医案的经验解构研究[J].中华中医药杂志,2017,32(4):1814-1817.
[16] 赵菲,高日阳,陈新林, 等.基于数据挖掘的岭南内科痰证医案用药特色探讨[J].辽宁中医杂志,2017,44(11):2260-2263.
[17] 李森,唐仕欢,刘金玲,等.基于数据挖掘和整合药理学的人参用药规律分析及治疗冠心病的分子机制探讨[J].中国中药杂志,2018(1):1-8.
[18] 周巧,刘健,忻凌, 等.基于关联规则挖掘中药内外合治骨关节炎对免疫炎症指标的影响[J].中华中医药学刊,2017,35(8):2070-2073.
[19] 齐英娜.胃食管反流病中医证候分布及其与睡眠质量关系的研究[D].北京:北京中医药大学,2015.
[20] 闫早兴,戚经天,苗嘉萌,等.基于中医传承辅助平台系统的中医药治疗胃食管反流病方剂的组方规律分析[J].辽宁中医杂志,2017,44(3):456-459.
[21] 康年松,韩旭丰,陈笑腾,等.马伟明辨治功能性消化不良重叠肠易激综合征经验[J].浙江中医杂志,2014,49(7):473-474.
[2] El-Serag HB,Sweet S,Winchester CC,et al.Update on the Epidemiology of Gastroesophageal Reflux Disease: a Systematic Review[J].Gut, 2014,63(6):871-880.
[3] Gerona LB,Kahrila PJ,Fass R. Insights into gastroesophageal reflux disease- associated dyspeptic symptoms[J]. Clin Gastroenterol Hepatol, 2011,9(10):824-833.
[4] Hershcovivi T,Fass R.Managenment of gastroesophageal reflux disease that does not respond well to proton pump inhibitors[J].Curr Opin Gastroenterol,2010, 26(4): 367-378.
[5] Schindlbeck NE,Klauser AG,Berghammer G,et al.Three year follow up of patients with gastrooesophageal reflux disease[J].Gut,1992,33(8):1016-1019.
[6] Vigneri S,Termini R,Leandro G,et al.A comparison of five maintenance therapies for reflux esophagitis[J].N Engl J Med,1995,333(17):1106-1110.
[7] 中华医学会消化病学分会.中国胃食管反流病专家共识意见[J].中华消化杂志,2014,34(10):649-661.
[8] 张声生,朱生樑,王宏伟,等.胃食管反流病中医诊疗专家共识意见[J].中国中西医结合消化杂志,2017,25(5):321-326.
[9] 陈淑彬.隐性知识显性化在数学教学中的作用[J].科技信息,2009,21: 643.
[10] 辛枫冬.知识型服务企业隐性知识管理有效性评价[J].工业技术经济,2011,30(2):339.
[11] 王烨燃,张洋,秦琦冰,等.基于数据挖掘的肾阴虚型消渴病方剂用药规律分析[J].中药新药与临床药理,2018(1):97-103.
[12] 刘婧,张兰.基于数据挖掘的早期糖尿病肾病中医治疗用药规律研究[J].中医药导报,2018(1):60-63.
[13] 王佳佳,王洪峰.基于著作类数据挖掘针灸治疗痞满的腧穴优选与配伍规律谱[J].中华中医药杂志,2018(2):694-698.
[14] 赵健,梁玉丹,王小寅, 等.基于数据挖掘的针灸综合疗法治疗子宫内膜异位症的应用规律研究[J].中国全科医学,2018(1):104-108.
[15] 朱青,朱垚,陆明.基于国医大师周仲瑛临证肝胆医案的经验解构研究[J].中华中医药杂志,2017,32(4):1814-1817.
[16] 赵菲,高日阳,陈新林, 等.基于数据挖掘的岭南内科痰证医案用药特色探讨[J].辽宁中医杂志,2017,44(11):2260-2263.
[17] 李森,唐仕欢,刘金玲,等.基于数据挖掘和整合药理学的人参用药规律分析及治疗冠心病的分子机制探讨[J].中国中药杂志,2018(1):1-8.
[18] 周巧,刘健,忻凌, 等.基于关联规则挖掘中药内外合治骨关节炎对免疫炎症指标的影响[J].中华中医药学刊,2017,35(8):2070-2073.
[19] 齐英娜.胃食管反流病中医证候分布及其与睡眠质量关系的研究[D].北京:北京中医药大学,2015.
[20] 闫早兴,戚经天,苗嘉萌,等.基于中医传承辅助平台系统的中医药治疗胃食管反流病方剂的组方规律分析[J].辽宁中医杂志,2017,44(3):456-459.
[21] 康年松,韩旭丰,陈笑腾,等.马伟明辨治功能性消化不良重叠肠易激综合征经验[J].浙江中医杂志,2014,49(7):473-474.