【摘要】：1.研究目的通過(guò)回顧分析山東中醫(yī)藥大學(xué)附屬醫(yī)院第一診斷為冠心病的患者,對(duì)單純冠心病與冠心病合并糖尿病患者的中藥使用進(jìn)行對(duì)比研究,分析糖尿病對(duì)冠心病患者中藥使用的影響,為中醫(yī)治療冠心病及冠心病合并糖尿病提供用藥思路。2.研究方法收集山東中醫(yī)藥大學(xué)附屬醫(yī)院2014年9月-2015年12月第一診斷為冠心病的住院病例,建立數(shù)據(jù)庫(kù),基于數(shù)據(jù)庫(kù)運(yùn)用Excel、SPSS等軟件分析中藥之間的關(guān)聯(lián)程度,并比較研究單純冠心病與冠心病合并糖尿病患者中藥使用的異同。3.結(jié)果共搜集病例300例,涉及中藥237味,經(jīng)頻數(shù)分析得出中藥總頻數(shù)4650。其中黃芪、白芍、黨參、紅花、三七粉等藥在單純冠心病患者中使用頻數(shù)比冠心病合并糖尿病患者高,而川芎、瓜蔞、黃連、生地、黃芩、赤芍、槲寄生等藥在冠心病合并糖尿病的患者中使用頻數(shù)高于單純冠心病患者。對(duì)于藥物分類分析,補(bǔ)氣藥、化痰除濕藥、理氣藥以及安神藥在單純冠心病患者中所占比例高于冠心病合并糖尿病患者,而冠心病合并糖尿病組以活血化瘀、清熱養(yǎng)陰、解表藥為主。經(jīng)關(guān)聯(lián)規(guī)則算法分析得到藥物間有意義的關(guān)聯(lián)規(guī)則489條,川芎是出現(xiàn)次數(shù)最多的藥物,為152次,在冠心病組茯苓和白術(shù)配伍的支持度最高,瓜蔞、薤白、甘草配伍的置信度最高;冠心病合并糖尿病組,甘草、丹參配伍的支持度最高,麥冬、五味子、葛根配伍的置信度最高。4.結(jié)論通過(guò)本研究發(fā)現(xiàn),治療單純冠心病以補(bǔ)氣、化痰除濕的中藥為主,常配伍補(bǔ)血、活血、理氣、利水藥,而治療合并糖尿病的冠心病則多在活血化瘀、滋陰清熱藥的基礎(chǔ)上配伍使用補(bǔ)氣、化痰、解表藥。
[Abstract]:1. Objective to analyze the first diagnosed patients with coronary heart disease in the affiliated Hospital of Shandong University of traditional Chinese Medicine, and to compare the use of traditional Chinese medicine in patients with simple coronary heart disease and coronary heart disease complicated with diabetes mellitus. To analyze the influence of diabetes on the use of traditional Chinese medicine in patients with coronary heart disease, and to provide the thinking of medication for treating coronary heart disease and coronary heart disease complicated with diabetes mellitus. Methods the hospitalized cases of coronary heart disease were collected from September 2014 to December 2015 in the affiliated Hospital of Shandong University of traditional Chinese Medicine, and the database was established. Based on the database, the degree of association between traditional Chinese medicine was analyzed by Excel,SPSS and other software. And compare the similarities and differences between simple coronary heart disease and coronary heart disease complicated with diabetes mellitus. 3. Results A total of 300 cases involving 237 herbs were collected. The total frequency of TCM was 4650 by frequency analysis. Among them, Astragalus membranaceus, Radix Paeoniae Alba, Radix Codonopsis, Safflower and Notoginseng Powder were used more frequently in patients with simple coronary heart disease than in patients with coronary heart disease complicated with diabetes. Mistletoe and other drugs were used more frequently in patients with coronary heart disease complicated with diabetes than in patients with simple coronary heart disease. For the classification analysis of drugs, the proportion of drugs for tonifying qi, removing dampness for phlegm and removing dampness, regulating qi and tranquilizing drugs in patients with simple coronary heart disease were higher than those with coronary heart disease complicated with diabetes mellitus. Antiepiphytic is the main antidote. Through the analysis of association rule algorithm, 489 meaningful association rules were obtained. Ligusticum Chuanxiong was the most frequently seen drug, which was 152 times. In the coronary heart disease group, Poria cocos and Atractylodes macrocephala had the highest support, Trichosanthes, Xiebai, etc. The confidence of Glycyrrhiza uralensis compatibility was the highest; The combination of Radix Glycyrrhizae and Salvia miltiorrhiza had the highest level of support, and the compatibility of Radix Ophiopogonis, Schisandra chinensis and Radix Puerariae had the highest confidence level. 4. Conclusion through this study, it is found that the treatment of simple coronary heart disease is mainly to replenish qi, remove phlegm and dehumidify dampness. It is often combined with blood invigorating, activating blood circulation, regulating qi and promoting water, while coronary heart disease with diabetes mellitus is mostly treated with activating blood circulation and removing blood stasis. Nourishing Yin and Clearing Heat on the basis of compatible use of tonifying qi, resolving phlegm, antisuperficial drugs.
【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
【分類號(hào)】：R259

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