發(fā)布時間：2019-07-09 20:38

【摘要】：目的:探尋陳民教授治療肝脾不調(diào)型老年慢性疾病的用藥規(guī)律,挖掘其辨證論治中的理、法、方、藥,以總結(jié)吾師治療老年慢性疾病的辨證思維和處方規(guī)律,發(fā)揮中醫(yī)在診治老年慢性疾病中的優(yōu)勢。材料與方法:本研究通過收集2015年7月至2017年1月就診于遼寧中醫(yī)藥大學(xué)附屬醫(yī)院專家門診,由陳民教授診治的符合納入標準和排除標準的186例老年慢性疾病患者的初、復(fù)診信息,并將藥味錄入WPS-Excel2016,建立處方數(shù)據(jù)表格,進行頻數(shù)、頻率、性味歸經(jīng)及功效分類分析,將使用頻率在30%以上的藥味導(dǎo)入IBM SPSS Statistics 22.0,采用相關(guān)性分析及聚類分析等數(shù)據(jù)挖掘技術(shù)進行分析。結(jié)果:1.根據(jù)納排標準共篩選出186首方,一共總結(jié)出136味中藥,使用總頻次為3482次。其中頻率大于30%的共22味,依頻次從高到低分別為白術(shù),柴胡,陳皮,白芍,茯苓,合歡花,砂仁,黃芩,甘草,半夏,炙甘草,當(dāng)歸,川芎,菊花,酸棗仁,黃芪,白扁豆,龍骨,桔梗,桂枝,枳殼,薏苡仁。2.136味藥中以溫性藥物居多,占36.24%,寒性、平性次之,分別占29.98%、26.45%;藥味以甘、苦、辛居多,分別占34.19%、26.49%、26.19%;歸經(jīng)以脾、胃、肺、心、肝居多,分別占20.77%、15.26%、15.08%、13.58%、13.24%。3.136味藥中共涉及17類藥,其中補虛藥最多,占26.39%,解表藥次之,占12.89%,安神藥、清熱藥、理氣藥、活血化瘀藥、利水滲濕藥、化痰藥亦均為治療老年慢性疾病的常用藥。4.將使用頻率大于30%的22味中藥用IBM SPSS Statistics 22.0進行相關(guān)性分析和聚類分析,得出常用藥對及聚類后組成的3個聚類方。結(jié)論:吾師治療肝脾不調(diào)型老年慢性疾病堅持以“和”為本,異病同治,注重肝脾兩臟發(fā)病之主從、內(nèi)在之聯(lián)系,并結(jié)合老年人的病理生理特點,在調(diào)和肝脾的同時不忘以補虛為治療的基礎(chǔ),并結(jié)合兼證轉(zhuǎn)化,靈活運用藥物及藥物間配伍,辨證論治。
文內(nèi)圖片：
圖片說明：補虛藥高頻次藥物（2）解表藥高頻次分析
[Abstract]:Objective: to explore the law of medicine used by Professor Chen Min in the treatment of chronic diseases of liver and spleen in the elderly, and to excavate the reason, method, prescription and medicine in syndrome differentiation and treatment, so as to summarize the dialectical thinking and prescription law of our teacher in the treatment of chronic diseases in the elderly, and to give full play to the advantages of traditional Chinese medicine in the diagnosis and treatment of chronic diseases in the elderly. Materials and methods: from July 2015 to January 2017, this study collected the initial and revisit information of 186 elderly patients with chronic diseases diagnosed and treated by Professor Chen Min in the affiliated Hospital of Liaoning University of traditional Chinese Medicine from July 2015 to January 2017. The drug flavor was input into WPS-Excel2016, to establish prescription data table, and the frequency, sexual taste return and efficacy classification analysis were carried out. The drug flavor with frequency of more than 30% was introduced into IBM SPSS Statistics 22.0, and the data mining techniques such as correlation analysis and cluster analysis were used for analysis. Result: 1. According to the standard of Naxai, a total of 136 kinds of traditional Chinese medicine were screened out, and the total frequency of use was 3482 times. Among them, the frequency was more than 30%, the frequency was Atractylodes macrocephala, Bupleurum chinense, Radix Paeoniae Alba, Paeonia lactiflora, Poria, Acacia flower, Amomum villosum, Radix Scutellariae, Glycyrrhiza uralensis, Pinellia ternata, Angelica sinensis, Ligusticum chuanxiong, chrysanthemum, jujube kernel, Astragalus, lentil, keel, Platycodon grandiflorum, Cinnamomum cassia, Fructus Aurantii, Coix seed. Among the 2.136 herbs, warm drugs accounted for 36.24%, cold, flatness, 29.98%, respectively. 26.45%; The taste of medicine was sweet, bitter and bitter, accounting for 34.19%, 26.49% and 26.19%, respectively. Spleen, stomach, lung, heart and liver accounted for 20.77%, 15.26%, 15.08%, 13.58%, 13.24%, 13.24%, 13.24%, 13.24%, 13.24%, 13.24%, 13.24%, 13.24%, 13.24%, 13.24%, 13.24%, 13.24%, 13.24%, 13.24%, 13.24%, 13.24%, 13.24%, 26.39%, 12.89%, 12.89%, 12.89%, 12.89%, 12.89%, 12.89%, 12.89%, 12.89%, 12.89%, 12.89%, 12.89%, 20.77%, 15.08%, 13.58% and 13.24%, respectively. The correlation analysis and cluster analysis of 22 kinds of traditional Chinese medicine with frequency more than 30% were carried out with IBM SPSS Statistics 22.0, and the common drug pairs and three cluster prescriptions formed after clustering were obtained. Conclusion: our teacher insists on "harmony" as the basis for the treatment of chronic diseases of liver and spleen disorder, pays attention to the main cause and internal relationship of the incidence of liver and spleen, and combines the pathophysiological characteristics of the elderly, while regulating the liver and spleen, not forgetting to supplement deficiency as the basis of treatment, combined with the transformation of both syndromes, flexible use of drugs and compatibility of drugs, syndrome differentiation and treatment.
【學(xué)位授予單位】：遼寧中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R249;R259

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