摘要
目的通过病案数据分析探讨周仲瑛辨治原发性肝癌"症-机-证-方-药"经验。方法收集和整理1994—2014年整理周仲瑛教授门诊经治的原发性肝癌病例记录,形成病案数据库,经数据清洗,采用频数分析、因子分析、关联规则方法,对证候、病机、处方用药等多方面进行数据挖掘分析。结果共纳入病案279例,共998诊次,其中分析初诊病案得到:病机频次最高的为湿热瘀毒互结、肝脾两伤。病理因素主要为瘀、湿、热、癌毒、气郁、痰。药物使用频次最高的为白花蛇舌草,其后依次为半枝莲、鸡内金、八月札、莪术。结论原发性肝癌的病位主要在肝脾,涉及胃、肾,病理性质为本虚标实,虚实夹杂,本虚以肝脾两伤、气阴两虚、肝肾阴亏为主,标实以瘀、湿、热、癌毒、气郁、痰为主。辨治规律:复法组方,扶正祛邪,理当兼顾;小方复合,辨证与辨病相结合;顾护脾胃,化瘀切勿动血耗血;因机立法,循法而治,随证加减。
Objective:The data mining was used to explore symptom-pathogenesis-drug-evidence-prescription experience of Professor ZHOU Zhongying in treating liver cancer based on analysis.Methods:This research collected Professor ZHOU Zhongying’s clinical case report in treating liver cancer from 1994 to 2014 and established the database including symptom,pathogenesis and prescription.Frequencies,factor analysis,association rules were used to explore laws among symptom,pathogenesis,drug and so on.Results:Finally 279 clinical case reports and 998 flow rate of the outpatients were collected.From First-visit patient case record we found,The highest frequency pathogenesis was dampness-heat-blood stasis-toxin compound,deficiency of liver and spleen.The highest frequency drug was Hedyotis diffusa,followed by Barbed Skullcap Herb.The pathological factors mainly included blood stasis,dampness,heat,qi stagnation,toxin,phlegm.Conclusion:The location of liver cancer was mainly in the liver and spleen,involving the stomach and kidney.the nature of disease was deficiency in origin and enrichment in symptom,intermingled deficiency and excess.The former included deficiency of the liver and spleen,the deficiency Qi and Yin,the liver and kidney yin deficiency,the main pathological factors are was blood stasis,dampness,heat,qi stagnation,toxin,phlegm.Principle of treatment:compound method and prescription,strengthening healthy qi to eliminate pathogens;careing about combining dieses and sign,using flexible and changeable prescription;harmonizing stomach and spleen;treating the disease on the basis of pathogenesis differentiation.
作者
张宾
梁秋雨
叶放
ZHANG Bin;LIANG Qiuyu;YE Fang(Nanjing University of Chinese Medicine,Nanjing 210029,Jiangsu,China;Nanjing Gaochun Hospital of Traditional Chinese Medicine,Nanjing 211300,Jiangsu,China)
出处
《辽宁中医药大学学报》
CAS
2020年第1期147-150,共4页
Journal of Liaoning University of Traditional Chinese Medicine
基金
国家自然科学基金(81873207)
国家中医药管理局“国医大师周仲瑛传承工作室”建设项目(国中医药人教发[2010]59号).
作者简介
张宾(1992-),男,山西晋中人,硕士,研究方向:名老中医经验传承及肝脏病研究;通讯作者:叶放(1965-),男,江苏徐州人,教授、主任医师,博士,研究方向:名老中医经验传承。
