本文選題：張鳴鶴 + 類(lèi)風(fēng)濕關(guān)節(jié)炎�。� 參考：《山東中醫(yī)藥大學(xué)》2016年碩士論文

【摘要】：目的:采用數(shù)據(jù)挖據(jù)方法,統(tǒng)計(jì)分析張鳴鶴教授診治的類(lèi)風(fēng)濕關(guān)節(jié)患者的病歷、醫(yī)案,結(jié)合實(shí)際臨床,闡明其辨治思路、遣方用藥規(guī)律,總結(jié)臨證經(jīng)驗(yàn),以促其學(xué)術(shù)思想的更好傳承。方法:通過(guò)收集、整理門(mén)診病歷及醫(yī)案樣本,提取并預(yù)處理其中相關(guān)診療信息,如癥狀、中藥處方等,以“中醫(yī)傳承輔助系統(tǒng)V2.5”為工具,建立數(shù)據(jù)庫(kù),使用系統(tǒng)所集成的頻數(shù)分析、Apriori規(guī)則算法、無(wú)監(jiān)督熵層次聚類(lèi)法、復(fù)雜系統(tǒng)熵聚類(lèi)法等數(shù)據(jù)挖掘方法,對(duì)部分臨床癥狀、體征及治療類(lèi)風(fēng)濕關(guān)節(jié)炎的處方進(jìn)行分析,并參照對(duì)張教授的實(shí)際問(wèn)訪內(nèi)容作綜合探討。結(jié)果:頻數(shù)統(tǒng)計(jì)結(jié)果顯示,211例患者的癥狀、體征以關(guān)節(jié)疼痛、關(guān)節(jié)腫脹最為普遍,分別占到95.26%,70.14%;266個(gè)處方共涵蓋98味中藥,分屬于14個(gè)藥物類(lèi)別,常用的藥味有大血藤、羌活、金銀花、獨(dú)活、虎杖、雷公藤、川牛膝、豬苓等,最主要的藥用類(lèi)別涉及清熱藥、祛風(fēng)除濕藥、利水滲濕藥、活血化瘀藥。經(jīng)關(guān)聯(lián)分析得出了處方中核心藥物彼此間的配伍規(guī)律及主方整體組配模式。經(jīng)熵聚類(lèi)的組方規(guī)律分析挖掘出16個(gè)潛在藥物組合,演化成8個(gè)新處方。結(jié)論:熱毒與濕邪是RA最重要的病理因素,本病的核心病機(jī)是濕熱毒阻痹經(jīng)絡(luò);張教授將清熱解毒、祛濕通絡(luò)作為基本治法,組方是以清熱解毒祛濕為原則,同時(shí)又辨證權(quán)衡藥味加減、辨位引經(jīng)用藥,體現(xiàn)出“病證結(jié)合”的辨治思維;針對(duì)某些特殊病機(jī)、臨床表現(xiàn)或是兼證的加減配伍,是對(duì)基本治法和組方的豐富與拓展,體現(xiàn)出其遣方用藥的靈活性。
[Abstract]:Objective: to analyze the medical records and medical records of rheumatoid joints diagnosed and treated by Professor Zhang Minghe by using the method of data digging, to clarify the thinking of differentiation and treatment, to summarize the clinical experience, and to summarize the clinical experience. In order to promote the better transmission of his academic ideas. Methods: through collecting and sorting out outpatient medical records and medical records samples, extracting and pretreating the related diagnosis and treatment information, such as symptoms, prescription of traditional Chinese medicine and so on, the database was established with the aid system of traditional Chinese Medicine (TCM), V2.5. Some clinical symptoms, signs and prescriptions for treating rheumatoid arthritis were analyzed by using some data mining methods, such as Apriori rule algorithm, unsupervised entropy hierarchical clustering method and complex system entropy clustering method. And with reference to Professor Zhang's actual interview content for a comprehensive discussion. Results: the results of frequency statistics showed that the symptoms and signs of 211 patients were joint pain and joint swelling, which accounted for 95.260.14.The 266 prescriptions covered 98 kinds of traditional Chinese medicine, belonging to 14 kinds of drugs, the commonly used drugs were Dipterygium sinensis, Notopterygium Notopterygii. Honeysuckle, Duhuo, Polygonum cuspidatum, Tripterygium wilfordii, Achyranthes bidentata, Polyporus umbellata, etc. Based on the correlation analysis, the compatibility of the core drugs in the prescription and the overall combination pattern of the principal prescription were obtained. According to the rule of entropy clustering, 16 potential drug combinations were found and evolved into 8 new prescriptions. Conclusion: heat toxin and dampness evil are the most important pathological factors in RA, the core pathogenesis of this disease is damp-heat and toxin blocking and blocking meridian, Professor Zhang takes clearing heat and detoxifying toxin, dispelling dampness and dredging collaterals as the basic treatment method, and the composition prescription is based on the principle of clearing heat and detoxicating toxin and removing dampness. At the same time, the combination of disease and syndromes is reflected in the thinking of differentiation and treatment, and the combination of the clinical manifestations and the combination of symptoms and signs is the enrichment and expansion of the basic treatment method and the prescription. It reflects the flexibility of its prescriptions.
【學(xué)位授予單位】：山東中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2016
【分類(lèi)號(hào)】：R249;R259

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