本文選題：黃疸 + 回顧性研究��； 參考：《湖北中醫(yī)藥大學》2017年碩士論文

【摘要】：研究目的本研究利用湖北省中醫(yī)院的既往黃疸病人的住院醫(yī)案數(shù)據(jù),對回顧性醫(yī)案研究的方法進行探索;挖掘治療黃疸的核心處方、常用藥物及配伍規(guī)律,開展中醫(yī)治療黃疸病的證-治-效規(guī)律研究。為中醫(yī)藥對黃疸的臨床診治和研究提供思路和依據(jù)。研究方法從已經(jīng)掃描成圖像格式的回顧性病歷中,將1960-1978年間中醫(yī)診斷為黃疸的病歷篩出,所納入病歷須以中醫(yī)藥治療為主并具備相對完整的診療記錄,包括:入院記錄、病程記錄、中藥處方信息、檢查信息等。排除中醫(yī)診療信息不完整、無中藥治療及死亡的病歷。對符合納入標準的病歷使用電子病歷系統(tǒng)建立數(shù)據(jù)庫。對癥狀、體征、檢驗、檢查、醫(yī)囑等信息進行規(guī)范化、結(jié)構(gòu)化錄入,經(jīng)數(shù)據(jù)預處理后,利用聚類分析、復雜網(wǎng)絡等多種數(shù)據(jù)挖掘方法及數(shù)據(jù)統(tǒng)計方法,挖掘分析黃疸病的證候特征、核心方藥、療效特點等。研究結(jié)果1資料情況描述性分析1.1一般資料的分析本研究最終納入的1960-1978年間的中醫(yī)診斷為黃疸的病歷有520例,其中1961-1969年共278例,1970-1978年共242例;其中男性患者389例,占74.81%。女性患者131例,占25.19%,男性占多數(shù);其中年齡最小13歲,年齡最大78歲,年齡主要集中在20-40歲之間,以青、中年為主;計算患者的住院時間,其中住院時間最短者7天,住院時間最長者235天,住院時間主要集中在15-50天。1.2診斷特征情況本研究納入病歷的中醫(yī)疾病診斷全部為黃疸,其中入院時診斷為發(fā)熱、感冒、積聚、外感熱病者有7例;證候診斷中主要為陽黃(516例),陰黃較少(4例);西醫(yī)診斷中數(shù)量最多的是急性黃疸型肝炎(409例),然后依次為黃疸型肝炎(75例)、早期肝硬化(16例)、急性黃疸型傳染性肝炎(14例)、慢性肝炎(13例)等�？梢钥闯霰狙芯考{入的黃疸為肝源性黃疸,其中主要為急性黃疸型肝炎為代表的急性肝炎為主。但也包含了67例慢性肝病,如血吸蟲病、慢性肝炎、肝硬化等。1.3既往疾病分析在納入的黃疸病歷中,既往有肝病病史者123例,既往有其他病史者7例。1.4藥物一般情況分析針對520例黃疸病人使用的中藥共有327種,選取頻次排序的前30味中藥依次為:茵陳(2485)、茯苓(2157)、郁金(1552)、姜梔子(1398)、陳皮(1327)、白芍(1169)、炒麥芽(932)、當歸(911)、炒谷芽(908)、丹參(902)、澤瀉(853)、姜厚樸(766)、炒白術(765)、醋香附(751)、炒神曲(735)、甘草(646)、薏苡仁(611)、生大黃(602)、敗醬草(583)、車前草(574)、車前子(482)、北柴胡(473)、黃芩(473)、滑石粉(446)、黃柏(446)、白茅根(420)、板藍根(410)、法半夏(391)、炒枳實(389)、醋青皮(380)。共有中藥大類19類,其中利水滲濕藥、清熱藥、補虛藥使用頻次位列前三,使用頻次較高的為:理氣藥、活血化瘀藥、消食藥等,三者使用頻次相近;然后其他類藥物為:化痰藥、止血藥、化濕藥、解表藥、安神藥、瀉下藥、平肝熄風藥、祛風濕藥、開竅藥、收澀藥、溫里藥;驅(qū)蟲藥、攻毒殺蟲止癢藥使用最少。藥物歸經(jīng)頻次最高依次為脾經(jīng)、肝經(jīng)、肺經(jīng)、胃經(jīng)及膽經(jīng)。此階段的處方藥味數(shù)量集中在10-12味之間,處方較為精簡。中藥使用的劑量基本上符合國家規(guī)定的安全使用范圍,大多數(shù)的藥物劑量使用較穩(wěn)定。2臨床特征分析2.1總體癥狀分布共出現(xiàn)癥狀121種,以全身癥狀及消化道癥狀為主,常見全身癥狀有:乏力(2795)、小便黃赤(2756)、身目俱黃(1849)、脅痛(1143)、不寐(780)、頭昏(361)、黃色鮮明(340)、口苦(210)、胸悶(178)、發(fā)熱(154)、皮膚瘙癢(139)、下肢浮腫(34)、浮腫(33)、盜汗(33)、咳嗽(33)、頭痛(32)、其他癥狀(90)等;消化道癥狀有食欲不振(2364)、腹脹(1874)、惡心(704)、便溏(635)、口干渴(349)、厭油(289)、嘔吐(278)、便秘(239)、大便干結(jié)(230)、腹痛(149)等�；痉细涡渣S疸的癥狀分布。2.2舌、脈象分布舌質(zhì)以舌紅(3359)、舌淡紅(712)為主;苔質(zhì)以苔薄(2647)、苔膩(467)、苔厚(120)、苔厚膩(113)為主;苔色以苔白(2583)、苔黃(1398)、苔微黃(42)為主。提示本病以濕證、熱證為主。含有脈象14種,脈象主要為脈弦(349)、脈緩(741)、脈細(433)、脈數(shù)(205)、脈滑(161)、脈沉(46)等。2.3人群劃分根據(jù)社團劃分出5類人群,各模塊包含病人數(shù)依次為255、142、91、27、5例。根據(jù)卡方檢驗,對每組癥狀體征進行對比,發(fā)現(xiàn)第一類人群熱象較為明顯,第二類人群熱象較輕,第三類人群考慮為膽腑郁熱證,第四類人群介于陽黃與陰黃之間,第五類人群寒濕較重,考慮為陰黃。(1)第一類人群特異性癥狀體征有:苔黃、苔薄、口干渴、苔膩、口苦、脈數(shù)、發(fā)熱、渴不欲飲、口渴喜飲、苔厚膩、惡寒、脈細、心煩、咳嗽、咽干等。表現(xiàn)俱有濕熱之象,但以熱象表現(xiàn)為重。核心方的組成是:茵陳、茯苓、梔子、郁金、陳皮、白芍、澤瀉、丹參、當歸、麩炒白術、炒麥芽、炒谷芽。(2)第二類人群特異性癥狀體征有:舌紅、苔白、黃色鮮明、淡黃、苔厚膩、苔微黃、苔薄、不寐、苔膩、大便干結(jié)、口干渴、口苦、脈數(shù)、脈緩、浮腫、萎黃、渴不欲飲、渴喜冷飲、口渴喜飲、舌淡紅、惡寒等�？煽闯鲈擃惒∪吮憩F(xiàn)均有濕熱之象,但熱象較輕,以濕為主。核心方的組成是:茵陳、茯苓、炒白術、郁金、白芍、澤瀉、梔子、陳皮、炒谷芽、炒麥芽。(3)第三類人群特異性癥狀體征有:苔白、舌紅、黃色鮮明、口干渴、脅痛、脈緩、大便干結(jié)、口苦、胸悶、頭昏、渴喜冷飲、渴不欲飲、精神萎靡、大便時干時稀、脈數(shù)、苔厚膩、形體消瘦、舌淡紅、不寐、苔少、小便黃、胃脘痞悶、腰酸、苔微黃、視物不清、齒衄、目脹、口甜等。可以看出該類病人郁熱之象較為明顯,脅痛、胸悶癥狀明顯,為考慮為膽腑郁熱證。核心方的組成是茵陳、茯苓、郁金、梔子、白芍、丹參、陳皮、炒谷芽、炒麥芽、炒神曲、當歸等。(4)第四類人群特異性癥狀體征有:舌淡紅、苔白、脈細、不寐、精神萎靡、下肢浮腫、脈弱、淡黃、刺痛、尿頻、下肢酸痛、下肢疼痛、心悸、自汗、尿痛等。可以看出該類病人不能分辨出屬于陽黃與陰黃,介于陰陽黃之間。核心方的組成是茯苓、茵陳、郁金、陳皮、丹參、白芍、梔子、當歸、炒谷芽、炒麥芽、炒神曲。(5)第五類人群包含病人最少,只有5例,由于包含的癥狀較少,故將其全部癥狀體征列出。其包含厭油、苔白、精神萎靡、黃色晦暗、頭昏、苔黃、苔厚、苔薄、舌嫩、舌紅、大便干結(jié)、便溏、胸悶、畏寒、舌淡紅、皮膚瘙癢、面色無華、脈遲等癥狀體征,明顯表現(xiàn)出陰黃癥狀。核心方組成為茵陳、茯苓、厚樸、蒼術、豆蔻、梔子、郁金、陳皮、滑石、炒谷芽、炒麥芽、丹參。2.4療效分析2.4.1中醫(yī)藥對黃疸病癥狀體征的影響選取病歷首次病程、中間病程、末次病程的陽性癥狀體征數(shù)據(jù),通過對各病程陽性癥狀體征數(shù)量、頻次、頻率的對比,發(fā)現(xiàn)在中間、末次病程中也出現(xiàn)明顯地遞減,并且在住院期間較少出現(xiàn)入院時未出現(xiàn)的癥狀、體征,也從側(cè)面反映大部分黃疸經(jīng)中醫(yī)藥治療,病情得到有效地控制。2.4.2基于肝功能指標的療效分析利用統(tǒng)計學方法對病人治療前后的黃疸指數(shù)、膽紅質(zhì)及谷丙轉(zhuǎn)氨酶的對比。得出P值明顯小于0.00,具有顯著統(tǒng)計學意義。黃疸病人在經(jīng)過系統(tǒng)中醫(yī)藥治療后生化指標得到明顯改善,證明中醫(yī)藥在降酶、退黃中有較好的療效。3基于有效病歷的核心方提取我們將黃疸指數(shù)的下降作為有效病歷判定的標準。最后納入有效病歷479例,對應的中藥方有3086個。我們基于有效病歷的方藥信息進行了社團劃分,得出有意義的10大類,各類包含的方劑數(shù)量依次為:684、607、579、386、276、174、120、38、30、24個。我們利用多層復雜網(wǎng)絡分別提取了各類方劑模塊的核心藥物組成。(1)模塊1的核心藥物為:茵陳、茯苓、澤瀉、梔子、車前子、陳皮、郁金、炒白術、大黃、豬苓、厚樸、板藍根。為茵陳蒿合四苓散加減。(2)模塊2核心方的藥物組成:茵陳、郁金、白芍、敗醬草、茯苓、丹參、陳皮、香附、當歸、薏苡仁、梔子、車前草、板藍根、龍膽。(3)模塊3核心藥物為:當歸、丹參、郁金、茯苓、茵陳、青皮、柴胡、陳皮、白芍、炒白術、炒谷芽、炒麥芽、梔子。(4)模塊4核心藥物組成:茵陳、茯苓、澤瀉、炒麥芽、炒谷芽、梔子、郁金、炒神曲。(5)模塊5核心藥物組成:茵陳、茯苓、炒神曲、厚樸、滑石粉、陳皮、法半夏、甘草。(6)模塊6核心藥物組成:大黃、芒硝、梔子、黃柏、枳實、厚樸、茵陳。(7)模塊7核心藥物組成:茯苓、白芍、牡丹皮、黨參、甘草、郁金、黃芩。(8)模塊8核心藥物組成:青蒿、龍膽、大黃、炒麥芽、炒谷芽等。(9)模塊9核心藥物組成:海金沙藤、車前草、青蒿、金錢草、金銀花、紅糖。(10)模塊10核心藥物組成:車前草、茵陳、赤茯苓、雞內(nèi)金、梔子、蘆根、神曲、枳殼。結(jié)論通過數(shù)據(jù)分析的方法對回顧性住院病歷研究做了有益探索,為我院繼續(xù)開展回顧性研究積累了經(jīng)驗。通過利用數(shù)據(jù)挖掘方法,分析了黃疸病的5類人群,各類人群的特異性癥狀、體征及核心方藥。并從癥狀體征的變化、生化指標的改善的角度對黃疸病歷做了療效分析。基于有效病歷進行方劑的社團劃分,提取出10類常用核心方。通過對我院19年間治療黃疸病的“證-治-效”規(guī)律研究,可以看出此一時期雖然處于學術研究的低谷期,但在治療黃疸中仍體現(xiàn)了比較高的診療水平。該時期治療黃疸病的學術思想是清熱與利濕兼顧,不忘活血與解毒,重視理脾和調(diào)肝,扶正與祛邪共施。常用茵陳五苓散、茵陳蒿湯、梔子柏皮湯、大承氣湯等經(jīng)方及其他時方治黃,沿襲晚清至民國時期重視從血分、肝膽脾入手診治黃疸的思想,并且與現(xiàn)代名老中醫(yī)治療黃疸的理論相似,說明此一時期我院治療黃疸病的經(jīng)驗已經(jīng)比較成熟和全面。本研究所得出的結(jié)果也可為臨床治療黃疸疾病提供一些思路。
[Abstract]:The purpose of the study was to explore the methods of the retrospective medical case study by using the data of hospitalized medical cases of patients with previous jaundice in Hubei Provincial Traditional Chinese Medical Hospital, to excavate the core prescriptions of jaundice, the commonly used drugs and compatibility rules, to carry out the TCM treatment of jaundice, and to study the clinical diagnosis and treatment and research of jaundice. For the retrospective medical records, which have been scanned into image format, the Chinese medicine has been diagnosed as the medical record of jaundice in 1960-1978 years. The medical records must be mainly treated with traditional Chinese medicine and have a relatively complete record of diagnosis and treatment, including admission records, medical records, prescription information of traditional Chinese medicine, inspection information and so on. The information of diagnosis and treatment is incomplete, there is no medical history of traditional Chinese medicine and death. The database is set up for the use of electronic medical records system which meets the standard of medical records. The information of symptoms, signs, inspection, inspection, medical orders and other information are normalized, structured and recorded, and after data preprocessing, data mining methods and data statistics such as cluster analysis, complex network and so on are used. Methods, the characteristics of the syndrome of jaundice, the core prescriptions and the characteristics of the curative effect were analyzed. Results 1 descriptive analysis of the results of the research results, 1.1 general data of the data were analyzed in the last 1960-1978 years of the study. There were 520 cases of jaundice diagnosed in 1960-1978 years, of which 278 cases were 1961-1969 years, and 1970-1978 years were 242 cases, and the male patients were 389, and 74 .81%. women were 131 cases, accounting for 25.19%, and male accounted for the majority. The age was 13 years old and the oldest was 78 years old. The age was mainly between the age of 20-40 and the middle age. The time of hospitalization was calculated, the shortest hospitalization time was 7 days, the longest hospitalization time was 235 days, and the hospitalization time was mainly concentrated in the diagnosis of the.1.2 diagnosis of 15-50 days. The diagnosis of TCM diseases included in the medical record was jaundice, of which 7 cases were diagnosed as fever, cold, accumulation, and exogenous fever. The diagnosis was mainly Yang Huang (516 cases), less Yin Yellow (4 cases); the most of the western medicine diagnosis was acute jaundice hepatitis (409 cases), and then the jaundice hepatitis (75 cases) and the early cirrhosis (16 Cases of acute jaundice type infectious hepatitis (14 cases), chronic hepatitis (13 cases) and so on. It can be seen that the jaundice in this study is hepatoteric jaundice, mainly for acute jaundice hepatitis as the representative of acute hepatitis, but also contains 67 cases of chronic liver disease, such as schistosomiasis, chronic hepatitis, cirrhosis and other.1.3 disease analysis in the yellow into the yellow. In the history of jaundice, 123 cases of previous history of liver disease, 7 cases of previous history of.1.4 medicine general analysis for 520 cases of jaundice used in the total of 327 kinds of Chinese medicine, the first 30 traditional Chinese medicine in order to select the frequency sequence are: Yin Chen (2485), Poria (2157), tulip (1552), ginger Gardenia (1398), orange peel (1327), Radix Paeoniae (1169), stir fried malt (932), angelica) (911) fry Valley buds (908), Salvia miltiorrhiza (902), Alisma orientalis (853), Jiang Houpu (766), stir fry Atractylodes (765), vinegar (735), licorice (646), coix seed (611), raw rhubarb (602), Plantago (583), Plantago (583), Plantago (574), Radix bupleurum, Radix Scutellariae, cypress, Radix Isatidis, Radix Isatidis, fry trifoliate Real (389), vinegar green (380). There are 19 categories of Chinese traditional medicine, among which water leudiation and humidifying drugs, antipyretic drugs and deficiency drugs are used in the first three, the use frequency is high: Qi medicine, blood circulation removing stasis medicine, digestion medicine and so on, the three use frequency similar; then the other drugs are phlegm medicine, hemostat, humidifying medicine, antipyretic drug, diarrhea medicine, leveling liver extinguishing. The dosage of wind medicine, dispelling wind and wetting medicine, taking astringent medicine, warming Li medicine, deworming medicine, attacking poison and killing antipruritic medicine are the least. The highest frequency of drug return is the spleen meridian, liver meridian, lung meridian, stomach meridian and bile meridian. The prescription of prescription is concentrated between 10-12 flavors at this stage, the prescription is more concise. The dosage of traditional Chinese medicine is basically in conformity with the safety regulations stipulated by the state. Using the range, most of the drug dose used more stable.2 clinical features analysis of 2.1 general symptoms of the total symptoms of 121 symptoms, mainly systemic symptoms and digestive tract symptoms, common systemic symptoms are: fatigue (2795), urinating yellow (2756), body yellow (1849), hypochondriac pain (1143), insomnia (780), dizziness (361), yellow (340), oral pain (210), chest distress (210). 178) fever (154), skin pruritus (139), edema (34), swollen (33), night sweating (33), cough (33), headache (32), other symptoms (90), digestive tract symptoms (2364), abdominal distention (1874), nausea (704), loose stool (635), vomiting, vomiting, constipation, abdominal pain, etc.. Basically conforms to hepatic jaundice. The symptoms distribution.2.2 tongue, the pulse image distribution tongue with red tongue (3359), lingual red (712) mainly, moss with moss thin (2647), moss (467), moss thick (120), moss thick (113) mainly, moss with moss white (2583), yellow moss (1398), yellow moss yellow (42) mainly. Suggesting that the disease is wet syndrome and heat syndrome is 14, pulse is mainly pulse chord (349), vein slowly (741), vein fine ( 433), pulse number (205), pulse skating (161), pulse sinks (46) and other.2.3 groups were divided into 5 groups according to the community. The number of patients in each module was 255142,91,27,5 in turn. According to Chi square test, the symptoms and signs of each group were compared. The heat image of the first group was more obvious, the second groups were lighter in heat image, and the third groups were considered to be the heat of the gallbladder. Syndrome, fourth groups of people are between yellow and Yin Yellow, fifth groups of people with heavy cold and dampness, considered as Yin Huang. (1) the first group of special symptoms and signs are: moss yellow, moss, thirst, moss, tongue, fever, thirst, thirst, thirst and drink, thirsty, cold, cold, pulse, vexed, coughing, pharynx dry and so on. There is a hot image, but with a hot image, but heat image, but heat image, but heat image, but heat image, but heat image, but heat image, but heat elephant, but heat elephant, but heat elephant, but heat elephant, but heat elephant, but heat elephant, but heat elephant, but heat elephant, but heat elephant, but heat elephant, but heat elephant, but heat elephant, but heat elephant, but heat elephant, but heat elephant, but heat elephant, but heat elephant, but heat elephant, but heat elephant, but heat elephant, but heat elephant, but heat elephant, but heat elephant, but heat elephant, but heat elephant, but heat elephant, but heat elephant, but heat elephant, but heat elephant, but heat elephant, but heat elephant, but heat elephant, but heat elephant, but heat elephant, but heat elephant, but heat elephant, but heat elephant, but heat elephant, but heat elephant, but heat elephant, but heat elephant, but heat elephant, but heat elephant, but heat elephant, but heat elephant, all The composition of the core is: Artemisia, Poria, gardenia, tulip, tulip, peel, Radix Paeoniae, Radix Paeoniae, Rhizoma Alisma, Rhizoma Alisma, Rhizoma Alisma, Rhizoma Alisma, Radix Angelicae, Radix Angelicae, Radix Angelicae, Rhizoma Alisma, stir fry, fried Valley buds. (2) the symptoms and signs of the second groups are: tongue red, white, yellow, yellowing, yellowing, yellowish moss, thin moss, insomnia, stool dry knot, mouth thirst, mouth pain, pulse number, pulse number, pulse number, bran, puffiness There is no desire to drink yellow, thirsty, thirst for cold drink, thirst and drink, pale red tongue and cold, and so on. It can be seen that the symptoms of this kind of patients are damp and hot, but the thermal image is light and wet. The composition of the core is: Yin Chen, tuckahoe, roasted alba, tulips, Alisma Alisi, gardenia, tangerine, fried Valley buds, fried malt. (3) the symptoms of the third groups are: moss white, lingual red. Bright yellow, thirsty, hypochondriac, slow pulse, mouth pain, chest tightness, dizziness, thirst, cold drink, thirst, dispirited, dry time, thin veins, thick skin, thin body, light red, insomnia, little moss, yellowing, stomach and epigastric depression, low back, slight yellows, dilation, sweetness and so on. More obvious, hypochondriac pain, chest tightness symptoms obvious, to consider the syndrome of gallbladder depression. The core components are Yin Chen, Poria cocos, tulip, gardenia, Radix Paeoniae, Radix Salviae, tangerine, fried Valley buds, fried malt, fried divine music, angelica, angelica and so on. (4) the symptoms and signs of the fourth groups of people are: pale red tongue, white, thin, sleepless, swollen lower limbs, weak, weak, yellowish, tingling. Frequency of urine, soreness of lower limbs, pain of lower limbs, palpitation, sweating, urine pain and so on. It can be seen that this kind of patient can not distinguish between Yang Huang and Yin Huang, between yin and Yang yellow. The composition of the core is Poria, Artemisia, tulip, orange peel, Salvia miltiorrhiza, Radix Paeoniae, gardenia, fried malt, stir fry the Shenqu. (5) only 5 cases of the fifth groups include the patients. The symptoms are less, so the symptoms and signs are listed. They include the oil, the white, the spirit, the yellow dark, dizziness, the moss, the thickness of the tongue, the tongue, the tender tongue, the dry knot of the tongue, the loose stools, the cold, the faint red tongue, the skin pruritus, the symptoms of the skin, the dyke and the Yellow symptoms. Ling, Magnolia, Atractylodes, nutmeg, gardenia, tulips, tangerine, talcum, talcum, fried Valley buds, fried malt, Salvia miltiorrhiza.2.4 effect analysis of the effect of 2.4.1 traditional Chinese medicine on the symptoms and signs of jaundice, the first course of medical records, the middle course, the last course of positive symptoms and signs, through the number of symptoms, frequency, frequency of the positive symptoms of the disease, found in the comparison, found in the number of symptoms, frequency, frequency of the positive symptoms of the disease, found in the contrast, found in the number of symptoms, frequency, frequency of the positive symptoms of the disease in the comparison, found in the number of symptoms, frequency, frequency of the positive symptoms of the disease in the comparison, found in the number of symptoms, frequency, frequency of the positive symptoms of the course of the disease in the comparison, found in the number of symptoms, frequency, frequency of the positive symptoms of the disease in the comparison, found in the number of symptoms, frequency, frequency of the positive symptoms in the course of the disease. During the course of the last time, there was also a significant decrease in the course of the disease, and the symptoms, signs, and most jaundice were treated by traditional Chinese medicine in the hospital during the hospitalization. The condition of the disease was effectively controlled by the analysis of the curative effect of.2.4.2 based on the liver function index, and the jaundice index, bile red before and after the treatment of the patients was used. The contrast between the quality and the glutamic Pyrex aminotransferase showed that the P value was obviously less than 0. The biochemical indexes of the patients with jaundice were obviously improved after the system of traditional Chinese medicine treatment. It proved that the traditional Chinese medicine has a good effect in reducing the enzyme and retreating yellow..3 is based on the core of the effective medical records to take the decline of the jaundice index as an effective disease. In the end, 479 cases of effective medical records are included, and there are 3086 Chinese medicines. We divide the community based on the information of the effective medical records, and get 10 significant categories. The number of various kinds of prescriptions in turn are 684607579386276174120,38,30,24. We extract various kinds of parties with multi-layer complex network respectively. Core drugs of the agent module. (1) the core drugs of module 1 are: Yin Chen, Poria cocos, Alisma orientalis, gardenia, Plantago, tulip, roasted alba, rhubarb, Polyporus, cortex magnolia, Radix Isatis Root. (2) module 2 core drugs: Yin Chen, tulip, Paeonia lactiflora, sauces, Poria, Salvia miltiorrhiza, Chen peel, Xiang Fu, angelica, Chinese angelica, coix seed, gardenia (3) module 3 core drugs are: Angelica, Salvia miltiorrhiza, tulip, tuckahoe, Poria, chchen, Radix Bupleuri, peel, white peony, roasted alba, fried malt, gardenia. (4) module 4 core drugs: Yin Chen, tuckahoe, Alisma, fried malt, fried Valley buds, gardenia, tulip, fried divine comedy. (5) module 5 core drugs: Yin Chen, tuckahoe, fry. (5) module 5 core drugs Shen Qu, Magnolia, talcum, tangerine, French Banxia, licorice. (6) module 6 core drugs: rhubarb, mirabilite, gardenia, Cortex Phellodendri, Fructus aurantii, Magnolia officinalis, (7) module 7 core drugs: Poria, Paeonia lactiflora, peony skin, Radix Codonopsis, licorice, tulip, Scutellaria. (8) module 8 core drugs: Artemisia, rhubarb, rhubarb, fried malt, fried Valley buds, etc. (9) module 9 core medicine. Composition: hay sands, Plantago, Artemisia, Herba Artemisia, Lonicera, honeysuckle, red sugar. (10) module 10 core drugs: Plantago, Artemisia, red Poria, chicken gold, gardenia, reed root, Shen Qu, Fructus aurantii. Conclusion through data analysis methods for retrospective study of hospitalized medical records have done a useful exploration for our hospital to continue to carry out retrospective study accumulated experience. By means of data mining, the specific symptoms, signs and core prescriptions of 5 types of jaundice were analyzed, and the curative effect of jaundice was analyzed from the changes of symptoms and signs and the improvement of biochemical indexes. Based on the effective medical records, 10 kinds of common core parties were extracted. The study of "syndrome treatment effect" of jaundice in the past 19 years shows that although it is in the low period of academic research, it still manifests a high level of diagnosis and treatment in the treatment of jaundice. The academic thought for the treatment of jaundice in this period is both heat clearing and dampness, not forgetting to live blood and detoxification, paying attention to spleen and regulating liver, strengthening and dispelling evil spirits. The common use of Yin Chen Wuling powder, Artemisia wormwood soup, gardenia peel soup, Dachengqi soup, and other times Fang Zhihuang, followed the late Qing Dynasty to the Republic of China during the period of the Republic of China to pay attention to the idea of treating jaundice from the blood, the liver and the spleen and spleen into the palpation, and similar to the theory of modern famous old Chinese medicine for the treatment of jaundice. The results obtained in this study can also provide some ideas for clinical treatment of jaundice.
【學位授予單位】：湖北中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R249;R259

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