【摘要】：目的:總結(jié)馬鴻斌主任醫(yī)師辨證論治慢性腎盂腎炎的臨證經(jīng)驗(yàn),主要通過臨床跟師學(xué)習(xí),收集導(dǎo)師臨床治療慢性腎盂腎炎的典型病例,總結(jié)概括導(dǎo)師治療本病的經(jīng)驗(yàn),并將導(dǎo)師的學(xué)術(shù)思想繼承發(fā)揚(yáng)。方法:(1)收集導(dǎo)師馬鴻斌主任醫(yī)師治療慢性腎盂腎炎的門診處方,運(yùn)用數(shù)據(jù)挖掘技術(shù)探討導(dǎo)師馬鴻斌主任醫(yī)師治療慢性腎盂腎炎的用藥規(guī)律。(2)主要通過臨床上跟隨導(dǎo)師學(xué)習(xí),根據(jù)臨床病例及導(dǎo)師的用藥特點(diǎn),整理并總結(jié)導(dǎo)師馬鴻斌主任醫(yī)師治療慢性腎盂腎炎的經(jīng)驗(yàn)。(3)本經(jīng)驗(yàn)總結(jié)總共通過收集的4例典型臨床病例,根據(jù)馬鴻斌主任醫(yī)師分型治療特點(diǎn),來評價(jià)導(dǎo)師分型論治慢性腎盂腎炎的治療效果。結(jié)果:(1)根據(jù)導(dǎo)師馬鴻斌主任醫(yī)師臨床治療慢性腎盂腎炎的用藥特點(diǎn)和選方特點(diǎn),從95個(gè)處方中進(jìn)行了詳細(xì)的總結(jié)和數(shù)據(jù)統(tǒng)計(jì),基于關(guān)聯(lián)規(guī)則分析的組方規(guī)律研究,基于熵聚類的方劑組方規(guī)律研究,基于復(fù)雜系統(tǒng)熵聚類的藥物核心組合分析,分別的選出了頻次前三位用藥主要為茯苓、續(xù)斷、甘草;前三位藥物組合分別是“黃柏,續(xù)斷”,“甘草,茯苓”,“牛膝,續(xù)斷”;演化出核心藥物組合3-4味,并得到4個(gè)新處方。最后又從四氣五味統(tǒng)計(jì)了導(dǎo)師的用藥特點(diǎn),其對味甘,性溫的藥物使用較為頻繁。(2)導(dǎo)師馬鴻斌主任醫(yī)師根據(jù)本病的臨床特點(diǎn),將慢性腎盂腎炎分為4種證型,即腎虛濕熱證(熱重型),腎虛濕熱證(濕重型),腎陽虧虛證,氣陰兩虛證;根據(jù)患者的臨床特點(diǎn),選取4例具有代表性的患者,根據(jù)患者的不同證型分別運(yùn)用不同的方劑進(jìn)行治療,3到4個(gè)療程后患者的臨床癥狀消失,尿常規(guī)等指標(biāo)明顯改善,證明臨床療效顯著。結(jié)論:通過對導(dǎo)師處方的統(tǒng)計(jì)和總結(jié),導(dǎo)師馬鴻斌主任醫(yī)師治療慢性腎盂腎炎的經(jīng)驗(yàn)分為4種證型和4種不同的方劑,符合臨床診治的需要,辨證與方藥相結(jié)合,方證對應(yīng),病證結(jié)合,提高了臨床療效,且根據(jù)導(dǎo)師用藥選方的相關(guān)規(guī)則,為臨床用藥及選方提供了新的依據(jù)。
[Abstract]:Objective: to summarize the clinical experience of treating chronic pyelonephritis by chief physician Ma Hongbin according to differentiation of symptoms and signs, and to collect the typical cases of chronic pyelonephritis treated by tutor, and summarize the experience of tutor in treating chronic pyelonephritis. And inherit and carry forward the academic thought of the tutor. Methods: (1) collect out-patient prescriptions for the treatment of chronic pyelonephritis by chief physician Ma Hongbin. The data mining technique was used to explore the regularity of drug use in the treatment of chronic pyelonephritis by mentor Ma Hongbin. (2) according to the clinical cases and the characteristics of the tutor's medication, it was mainly studied by following the tutor in clinical practice. (3) the experience in treating chronic pyelonephritis was summarized. (3) this experience summarized a total of 4 typical clinical cases collected, according to the characteristics of Dr. Ma Hongbin's classification and treatment of chronic pyelonephritis, To evaluate the therapeutic effect of tutors' classification theory on chronic pyelonephritis. Results: (1) according to the characteristics of medication and prescription selection of chief physician Ma Hongbin in treating chronic pyelonephritis, a detailed summary and data statistics were made from 95 prescriptions, and the rule of prescription based on association rule analysis was studied. Based on entropy clustering and complex system entropy clustering, the first three drugs were selected as Poria cocos, continuous break, licorice, and the core combination analysis of drugs based on complex system entropy clustering. The first three drug combinations were "Phellodendron cedar", "Glycyrrhiza uralensis", "Poria cocos", "Achyranthes bidentata", and evolved a core drug combination of 3 and 4 taste, and got four new prescriptions. Finally, according to the characteristics of four qi and five flavours, the use of drugs was more frequent. (2) Chief physician Ma Hongbin, mentor, divided chronic pyelonephritis into four syndrome types according to the clinical characteristics of the disease, and the clinical characteristics of chronic pyelonephritis were divided into four types, according to the clinical characteristics of the disease. Namely kidney deficiency damp-heat syndrome (heat heavy), kidney deficiency damp-heat syndrome (damp heavy), kidney yang deficiency syndrome, qi-yin deficiency syndrome; According to the clinical characteristics of the patients, 4 representative patients were selected and treated with different prescriptions according to the different syndrome types of the patients. After 3 to 4 courses of treatment, the clinical symptoms of the patients disappeared, urine routine and other indexes were obviously improved, and the clinical symptoms of the patients disappeared after 3 to 4 courses of treatment, and the urine routine was improved obviously. It is proved that the clinical curative effect is remarkable. Conclusion: according to the statistics and summary of the prescription of the tutor, the experience of chief physician Ma Hongbin in treating chronic pyelonephritis is divided into four types of syndromes and four different prescriptions, which accord with the needs of clinical diagnosis and treatment, the combination of syndrome differentiation and prescription, and the correspondence of prescription and syndrome. The combination of disease and syndrome improves the clinical efficacy and provides a new basis for clinical use and selection of drugs according to the relevant rules of prescription selection by mentors.
【學(xué)位授予單位】：甘肅中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2016
【分類號】：R249;R277.5

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 張超;張春艷;周瑋莎;郭歡芳;嚴(yán)亞萍;吉勤;;濟(jì)生腎氣丸合真武湯加減治療脾腎陽虛型慢性腎衰竭的臨床觀察[J];中國中西醫(yī)結(jié)合腎病雜志;2015年12期

2 汪文來;鞠大宏;劉梅潔;趙宏艷;于崢;王少君;潘靜華;李岳澤;吳佳瑩;趙紅霞;;續(xù)斷有效成分藥理學(xué)研究進(jìn)展[J];中國醫(yī)藥導(dǎo)刊;2015年10期

3 于曉雯;王學(xué)斌;王中琳;;當(dāng)歸貝母苦參丸治療濕熱下注型淋證23例[J];山東中醫(yī)雜志;2015年08期

4 張振英;;慢性腎盂腎炎臨床治療分析[J];中國現(xiàn)代藥物應(yīng)用;2015年07期

5 萬秋英;宋麗君;;五鶴續(xù)斷總皂苷抗皮膚衰老的作用及其機(jī)制[J];中國應(yīng)用生理學(xué)雜志;2015年02期

6 周忠光;丑小月;費(fèi)洪新;韓玉生;廖婷;張英博;王金庫;杜徽;樸成玉;白云;李寶龍;仲麗麗;孟鑫雨;;丹溪痛風(fēng)方對小鼠急性痛風(fēng)性關(guān)節(jié)炎的實(shí)驗(yàn)研究[J];中醫(yī)藥學(xué)報(bào);2015年01期

7 趙濤;王鵬飛;溫旭;侯小雪;史焱;朱丹;;濟(jì)生腎氣丸治療脾腎陽虛型慢性腎小球腎炎[J];吉林中醫(yī)藥;2015年01期

8 鐘裕元;李會珍;謝怡堂;張秋彬;;慢性腎盂腎炎的中西醫(yī)結(jié)合治療研究[J];吉林醫(yī)學(xué);2014年25期

9 張奇峰;楊寧;陳園園;;當(dāng)歸貝母苦參湯聯(lián)合α受體阻滯劑治療Ⅲ型前列腺炎臨床隨機(jī)對照研究[J];遼寧中醫(yī)雜志;2014年07期

10 程傳紅;;中西醫(yī)結(jié)合治療慢性腎盂腎炎的臨床療效觀察[J];現(xiàn)代診斷與治療;2014年11期

，

本文編號：2460402