發(fā)布時間：2018-05-10 13:56

  本文選題：呂仁和 + 小兒原發(fā)性腎病綜合征�。� 參考：《北京中醫(yī)藥大學》2017年碩士論文

【摘要】：背景:腎病綜合征是以大量蛋白尿、低蛋白血癥、水腫和高脂血癥為主要臨床表現(xiàn)的一組臨床癥候群,是小兒常見的腎臟疾病之一,研究表明,原發(fā)性腎病綜合征約占小兒腎病綜合征的90%。目前西醫(yī)治療主要以激素和(或)免疫抑制劑為主,雖取得一定療效,但小兒易出現(xiàn)反復感冒后復發(fā),生長發(fā)育受限,記憶力減退等神經(jīng)系統(tǒng)發(fā)育受阻的副作用。呂仁和教授在治療小兒原發(fā)性腎病綜合征方面具有獨特的學術理念,且療效顯著。在信息化的今天,數(shù)據(jù)挖掘技術為我們提供了提煉老專家經(jīng)驗的新方式,對傳承名老中醫(yī)經(jīng)驗具有很大推動作用。目的:采用數(shù)據(jù)挖掘技術對呂仁和教授治療小兒原發(fā)性腎病綜合征的經(jīng)驗進行探索,探求其證治規(guī)律,以總結呂仁和教授治療該病的經(jīng)驗及獨特的學術思想。方法:收集并篩選于2008年8月～2017年2月間就診于呂仁和教授專家門診的小兒原發(fā)性腎病綜合征患者的病例資料。對于合格的病例進行數(shù)據(jù)預處理,然后建立Excel數(shù)據(jù)庫,運用SAS 9.1軟件進行頻數(shù)統(tǒng)計和聚類分析,頻數(shù)統(tǒng)計包括病因、癥狀體征、證型、藥物、激素不同分期的癥狀體征、證型、藥物以及初診、末次就診的癥狀體征、理化檢查;聚類分析,對頻數(shù)在5次以上,累積頻率為95.95%的80味中藥進行聚類分析,采用R型聚類,類平均法計算,以探求呂教授常用藥對和藥串。結果:1.頻數(shù)統(tǒng)計結果:(1)病因:以稟賦不足最多見,頻率高達77.77%,其次為外感,頻率達22.22%。(2)證型:以氣陰兩虛最多見,頻率為20.33%,其次為血熱瘀滯,頻率為14.99%。(3)藥物:27例病例、451診次的處方藥物總頻數(shù)3086次,其中使用頻數(shù)前27味的中藥,頻數(shù)均在20次以上,累積頻率達78.68%,是治療小兒原發(fā)性腎病綜合征的主要藥物。(4)療效:初診和末次就診出現(xiàn)3次以上的癥狀體征數(shù)分別為9個和5個,初診蛋白尿以中、重度為主,累積頻率為55.56%,末次就診以正常蛋白尿為主,頻率為77.78%。2.聚類分析:得到呂教授治療小兒原發(fā)性腎病綜合征常用藥對6對,藥串3串。
[Abstract]:Background: nephrotic syndrome is a group of clinical syndromes with large proteinuria, hypoproteinemia, edema and hyperlipidemia as the main clinical manifestation. It is one of the common renal diseases in children. Primary nephrotic syndrome accounts for about 90% of nephrotic syndrome in children. At present, the main treatment of western medicine is hormone and (or) immunosuppressant, although it has certain curative effect, but children are prone to relapse after repeated colds, limited growth and development, memory loss and other side effects of nervous system development retardation. Professor Lv Renhe has a unique academic idea in the treatment of pediatric primary nephrotic syndrome, and the curative effect is remarkable. Today, data mining technology provides us with a new way to refine the experience of old experts, which has a great role in promoting the inheritance of famous old Chinese medicine experience. Objective: to explore the experience of Professor Lv Renhe in the treatment of pediatric primary nephrotic syndrome by using data mining technique, to explore the rule of syndrome and treatment, and to summarize Professor Lv Renhe's experience in treating this disease and his unique academic ideas. Methods: the data of children with primary nephrotic syndrome were collected and screened from August 2008 to February 2017. The data of qualified cases were preprocessed, then Excel database was established, frequency statistics and cluster analysis were carried out by using SAS 9.1 software. Frequency statistics included etiology, symptoms and signs, syndromes, drugs, hormones, symptoms and signs in different stages, syndromes and syndromes. Drugs, symptoms and signs of the first visit, physical and chemical examination, cluster analysis, the frequency of more than 5 times, cumulative frequency of 95.95% of 80 Chinese medicine cluster analysis, using R-type clustering, cluster average calculation, In order to explore Professor Lu common medicine pair and drug string. The result is 1: 1. Frequency statistics results: etiology: the most common etiology was the deficiency of endowment, the frequency was as high as 77.77 and the second was external feeling, and the frequency was 22.22.t2) syndrome type: Qi and Yin deficiency was the most common, the frequency was 20.33 and the next was blood heat stasis. The total frequency of prescribing drugs was 3086 times, of which the first 27 kinds of traditional Chinese medicines were used more than 20 times. The cumulative frequency was 78.68, which was the main drug for the treatment of pediatric primary nephrotic syndrome. The number of symptoms and signs more than three times at first visit and the last visit were 9 and 5, respectively. The first diagnosed proteinuria was mainly moderate and severe. The cumulative frequency was 55.56, the last visit was normal proteinuria, the frequency was 77.78. Cluster analysis: professor Lu in the treatment of children with primary nephrotic syndrome, 6 pairs of drugs, drug string 3 strings.
【學位授予單位】：北京中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R249;R272

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