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吴婷婷. 基于数据挖掘的历代小儿时行疾病舌象、脉象与用药规律研究[J]. 上海中医药杂志, 2020,54(6):66-71.
WU Tingting. Data mining of tongue images, pulse diagnosis and medication rules of seasonal pathogen induced diseases in children[J]. Shanghai Journal of Traditional Chinese Medicine, 2020,54(6):66-71.
吴婷婷. 基于数据挖掘的历代小儿时行疾病舌象、脉象与用药规律研究[J]. 上海中医药杂志, 2020,54(6):66-71. DOI: 10.16305/j.1007-1334.2020.06.004.
WU Tingting. Data mining of tongue images, pulse diagnosis and medication rules of seasonal pathogen induced diseases in children[J]. Shanghai Journal of Traditional Chinese Medicine, 2020,54(6):66-71. DOI: 10.16305/j.1007-1334.2020.06.004.
目的:运用数据挖掘方法,研究历代医案中小儿时行疾病的舌象、脉象特征与用药规律。 方法:以《历代儿科医案集成》中的634例小儿时行疾病医案为数据源,建立规范化数据库,使用频次统计、Logistic回归分析、关联规则等方法,对舌象、脉象与中药之间的相关性以及中药之间的规律性进行数据分析。 结果:①本研究共纳入从汉代至现代的医案634则,共涉及方剂634首,中药250种。②涉及小儿时行疾病共23种,其中以外感温热病居多。频数≥4的舌象共16种,舌质主要以红舌、绛舌、芒刺舌等热性舌象居多,舌苔以腻苔、黄苔、白苔、厚苔等居多。频数≥3的脉象共16种,以数脉、滑脉、弦脉、细脉等居多。频数≥82的中药有22项,以杏仁、甘草、连翘等居多。③发现15条舌象与中药相关性结果,如红舌与地骨皮、竹沥、瓜蒌等相关性较强,腻苔与炮姜、佩兰、麻黄等相关性较强,黄苔与党参、黄连、枳实等相关性较强,等。④发现13条脉象与中药相关性结果,如数脉与淡豆豉、葛根、玄参等相关性较强,滑脉与竹沥、忍冬藤、地骨皮等相关性较强,弦脉与夏枯草、橘络、忍冬藤等相关性较强,等。⑤置信度较高的药对为枇杷叶-浙贝母、紫菀-杏仁、薄荷-连翘等,支持度较高的药对为浙贝母-杏仁、金银花-连翘、栀子-连翘等。⑥置信度较高的舌脉关联关系为黄苔-数脉、白苔-数脉、红舌-数脉等。支持度较高的舌脉关联关系为红舌-数脉、腻苔-数脉、黄苔-数脉等。 结论:《历代儿科医案集成》中小儿时行疾病的舌象以湿热性舌象居多,脉象以数脉、滑脉、弦脉等居多,用药以杏仁、甘草、连翘等居多;部分特定舌象、脉象与用药之间存在相关性,部分药物之间亦存在关联规律,可作为药对配伍使用。历代儿科医案中的诊疗经验,或可为现代中医儿科临床所借鉴。
Objective:To study the characteristics of tongue images, pulse conditions and medication rules of seasonal pathogen induced diseases in children based on the data mining method. MethodsA standardized database was established by including medical records of 634 cases of seasonal pathogen induced diseases in children extracted from the Collection of Pediatric Medical Records of Past Dynasties, and the correlation between tongue images, pulse diagnosis and Chinese herbal medicines (CHMs) and the medication rules were analyzed by using frequency statistics, logistic regression analysis, association rules and other methods. Results:①A total of 634 cases of medical records from Han dynasty to modern times were included, involving 634 prescriptions and 250 kinds of CHMs. ②There were 23 kinds of seasonal pathogen induced diseases in children, most of which were exogenous warm febrile diseases. There were 16 kinds of tongue images with frequency greater than or equal to 4. The tongue images mainly indicated a heat syndrome, including red tongue, crimson tongue and prickly tongue, etc., with greasy coating, yellow coating, white coating or thick coating, etc. There were 16 kinds of pulse conditions with frequency greater than or equal to 3, most of which were rapid pulse, slippery pulse, wiry pulse and fine pulse, etc. There were 22 kinds of CHMs with frequency greater than or equal to 82, which were Xingren (Armeniacae Semen Amarum), Gancao (Radix Glycyrrhizae), Lianqiao (Fructus Forsythiae), etc. ③There were 15 strong correlations between tongue images and CHMs. For instance, red tongue had a strong correlation with Digupi (Cortex Lycii), Zhuli (Succus Bambusae) and Gualou (Fructus Trichosanthis); greasy coating had a strong correlation with Paojiang (Rhizoma Zingiberis Preparata), Peilan (Herba Eupatorii) and Mahuang (Herba Ephedrae); and yellow coating had a strong correlation with Dangshen (Radix Codonopsis), Huanglian (Rhizoma Coptidis) and Zhishi (Fructus Aurantii Immaturus). ④There were 13 strong correlations between pulse conditions and CHMs. For instance, rapid pulse had a strong correlation with Douchi (Semen Sojae Preparatum), Gegen (Radix Puerariae) and Xuanshen (Radix Scrophulariae); slippery pulse had a strong correlation with Zhuli (Succus Bambusae), Rendongteng (Caulis Lonicerae) and Digupi (Cortex Lycii); and wiry pulse had a strong correlation with Xiakucao (Prunella Vulgaris), Juluo (Citri Reticulatae Exocarpium Album) and Rendongteng (Caulis Lonicerae), etc. ⑤The drug pairs with high confidence were Pipaye (Folium Eriobotryae) and Zhebeimu (fritillaria thunbergii), Ziwan (Radix Asteris) and Xingren (Armeniacae Semen Amarum), Bohe (Herba Menthae) and Lianqiao (Fructus Forsythiae), etc. The drug pairs with high support were Zhebeimu (fritillaria thunbergii) and Xingren (Armeniacae Semen Amarum), Jinyinhua (Flos Lonicerae) and Lianqiao (Fructus Forsythiae), Shanzhizi (Fructus Gardeniae) and Lianqiao (Fructus Forsythiae), etc. ⑥The correlations between tongue images and pulse conditions with high confidence were yellow coating and rapid pulse, white coating and rapid pulse, red tongue and rapid pulse, etc. The correlations between tongue images and pulse conditions with high support were red tongue and rapid pulse, greasy coating and rapid pulse, yellow coating and rapid pulse, etc. Conclusion:Seasonal pathogen induced diseases recorded in the Collection of Pediatric Medical Records of Past Dynasties mostly have damp-heat tongue images, pulse conditions are rapid pulse, slippery pulse and wiry pulse, and most CHMs used are Xingren (Armeniacae Semen Amarum), Gancao (Radix Glycyrrhizae) and Lianqiao (Fructus Forsythiae), etc. There are correlations among certain tongue images, pulse conditions and CHMs used and association rules in the compatibility of CHMs. Modern pediatric clinical practice of traditional Chinese medicine may learn from the experience of diagnosis and treatment in pediatric medical records of previous dynasties.
时行疾病小儿舌象脉象中医诊断中药诊疗规律数据挖掘回归分析
epidemic diseaseschildrentongue imagepulse conditiontraditional Chinese medicine diagnosisChinese herbal medicinerule of diagnosis and treatmentdata miningregression analysis
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