1. 上海中医药大学附属龙华医院中医外科,上海,200032
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邢捷, 阙华发. 基于数据挖掘的唐汉钧治疗复杂性窦道经验研究[J]. 上海中医药杂志, 2020,54(9):27-31.
XING Jie, QUE Huafa. Data mining based research on professor Tang Hanjun’s experience in treating complex sinuses[J]. Shanghai Journal of Traditional Chinese Medicine, 2020,54(9):27-31.
邢捷, 阙华发. 基于数据挖掘的唐汉钧治疗复杂性窦道经验研究[J]. 上海中医药杂志, 2020,54(9):27-31. DOI: 10.16305/j.1007-1334.2020.2001073.
XING Jie, QUE Huafa. Data mining based research on professor Tang Hanjun’s experience in treating complex sinuses[J]. Shanghai Journal of Traditional Chinese Medicine, 2020,54(9):27-31. DOI: 10.16305/j.1007-1334.2020.2001073.
目的:运用数据挖掘方法,分析唐汉钧教授临床治疗复杂性窦道内治用药及外治方法的使用规律,总结其学术思想。 方法:整理唐汉钧教授治疗复杂性窦道的病历资料,建立复杂性窦道中医临床诊疗信息数据库,使用频数分析、关联分析等数据挖掘技术,分析患者的一般特征、内治处方中的组方配伍规律及外治方法使用情况。 结果:①本研究共纳入265份病历资料,涉及265例患者,男性多于女性,中位年龄55岁,中位病程210 d;合并有糖尿病、乙型病毒性肝炎等其他疾病者共计136例(占51.32%),最常见的发病部位为胸壁(34.7%),最常见的病因为手术(64.53%)和感染(23.40%);中医辨证分型以余毒未尽证最为常见(78.87%),其次为气血两虚证(20.38%),正虚毒恋证相对少见(0.75%)。②共有229例患者内服中药,涉及229种药物,总计使用频次4 234,使用频次>100的中药共有13味,主要集中在益气健脾、健脾活血和益气渗湿类药物。③关联分析结果显示,最为常用的2味药物配伍组合主要是益气健脾、健脾活血和益气渗湿药,3味药物配伍组合主要是健脾养血、健脾活血、益气健脾、健脾渗湿、健脾托毒药,4味药物配伍组合主要是生黄芪、白术、茯苓合渗湿、活血、托毒药物组合,5味药物配伍组合是生黄芪、白术、茯苓、赤芍、丹参组成的益气健脾扶正、凉血活血祛滞药物组合。④常用的外治方法有外用掺药、贴敷、冲洗灌注疗法、药捻、纱条引流等。 结论:唐汉钧教授治疗复杂性窦道重视扶正,尤重脾胃,补益、疏调气血经络的同时又不忘托毒、解毒,体现了其扶正治疗外科疾病的学术思想;在内治的同时灵活运用多种外治法,取得满意疗效。
Objective:To analyzes the rules of Professor Tang Hanjun’s internal and external treatment methods for complex sinuses, and summarize his academic thoughts through data mining methods. MethodsThe medical records of Professor Tang Hanjun’s treatment of complex sinuses were sorted out, and TCM clinical diagnosis and treatment information database of complex sinuses was established. Data mining technologies such as frequency analysis and correlation analysis were used to analyze the general characteristics of patients, the compatibility rules of formulas in internal treatment and the use of external treatment methods. Results:①The study included 265 medical records. Among 265 patients, there were more males than females, with a median age of 55 years old and a median course of disease of 210 days. A total of 136 cases (51.32%) were complicated with diabetes, viral hepatitis B and other diseases. The most commonly affected area was chest wall (34.7%), and surgery (64.53%) and infection (23.40%) were common causes. According to syndrome differentiation and classification of traditional Chinese medicine (TCM), incompletely removed residual toxin syndrome was the most common syndrome(78.87%), followed by dual deficiency of qi and blood syndrome (20.38%), but vital qi deficiency and lingering toxin syndrome was relatively rare (0.75%). ②A total of 229 patients received TCM treatment orally, involving 229 kinds of medicinals, with a total use frequency of 4,234 times. A total of 13 kinds of medicinals were used more than 100 times, mainly focusing on medicinals for invigorating qi and spleen, invigorating spleen and activating blood circulation, and invigorating qi and removing dampness. ③The results of correlation analysis showed that the most commonly used pair compatibility combinations were mainly medicinals for invigorating qi and spleen, invigorating spleen and activating blood circulation, and invigorating qi and removing dampness. The compatibility combinations of three medicinals mainly included combinations of medicinals for invigorating spleen and nourishing blood, invigorating spleen and activating blood circulation, invigorating qi and spleen, invigorating spleen and removing dampness, invigorating spleen and expelling toxin. The compatibility combinations of four medicinals were mainly the combinations of raw Huangqi (Radix Astragali), Baizhu (Rhizoma Atractylodis Macrocephalae), Fulin (Poria Cocos) and medicinals for removing dampness, activating blood circulation and expelling toxin by supporting vital qi. The compatibility combinations of five medicinals was the combination of medicinals for invigorating qi, invigorating spleen, strengthening vital qi, cooling blood, activating blood circulation and eliminating stagnation composed of raw Huangqi (Radix Astragali), Baizhu (Rhizoma Atractylodis Macrocephalae), Fulin (Poria Cocos), Chishao (Radix Paeoniae Rubra) and Danshen (Radix Salviae Miltiorrhizae). ④Commonly used external treatment methods included dusting powdered drugs, plastering and application, flushing and infusing therapy, corrosive drug stick, and drainage through gauze, etc. Conclusion:Professor Tang Hanjun attaches great importance to strengthening vital qi in the treatment of complex sinuses, especially the supplementation of spleen and stomach. He applies the methods of tonifying, dredging and regulating qi, blood, channels and collaterals while expelling and removing toxins, which embody his academic thought of treating complex sinuses by strengthening vital qi. Various external treatment methods are flexibly used with the internal treatment methods to achieve satisfactory therapeutic effects.
复杂性窦道窦瘘名医经验数据挖掘唐汉钧
complex sinusfistulaveteran TCM doctor’s experiencedata miningTang Hanjun
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