樊永平教授诊治脑震荡辨证及用药规律研究
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摘要
目的探讨脑震荡(concussion)患者的临床特点、中医证型分布及用药规律。方法采用临床病例分析法,分析54例脑震荡患者的临床特点、中医证型,基于关联规则和复杂系统熵聚类算法分析中医治疗脑震荡的用药规律。结果 54例脑震荡患者男女比例1. 5∶1,平均年龄(39. 69±16. 34)岁,20～50岁的青壮年人群占70%;车祸伤居外伤原因首位;主要临床症状表现为头晕、头痛、失眠、健忘、烦躁易怒、情绪低落、纳差、恶心等;痰瘀阻窍是脑震荡的核心病机,主要的中医证型包括气虚痰瘀(38%),心肾不交、瘀血内阻(13%),肝郁痰瘀(11%)和肾虚痰瘀(9%),气虚痰瘀为主要证候类型;桃仁、石菖蒲、茯苓、川芎、清半夏是治疗脑震荡的基本用药。结论辨证论治是中医治疗脑震荡的关键,痰瘀阻窍是脑震荡的核心病机,中医辨证以气虚痰瘀为主,基础用药是桃仁、石菖蒲、茯苓、川芎、清半夏,不同证候类型随证加减用药。
Objective To explore the clinical characteristics of concussion patients,traditional Chinese medicine( TCM) syndrome type distribution and prescription regularity. Methods The clinical characteristics and syndrome types of 54 patients with concussion were analyzed with the method of case analysis,and the prescription regularity of TCM for concussion were analyzed based on association rules and complex system entropy clustering algorithm. Results The ratio of male to female in 54 concussion patients was 1. 5∶ 1. The average age of the enrolled patients was( 39. 69 ± 16. 34) years old. Young crowd aged between 20-50 years old were in majority.Traffic accident injury was the first cause of mild traumatic brain injury. The main clinical symptoms were dizziness,headache,insomnia,forgetfulness,irritability,depression,poor appetite,nausea,and so on. Phlegm stasis obstruction was the core pathogenesis of concussion. The main TCM syndrome type included qi deficiency and phlegm stasis,heart-kidney imbalance and stasis,liver depression and phlegm stasis,and kidney deficiency and phlegm stasis. Qi deficiency and phlegm stasis was the most important syndrome type.Semen Persicae,Acorus Tatarinowii,Poria Cocos,Ligusticum Chuanxiong,Rhizoma Pinelliae( processed with alum) were the basic herbs for concussion treatment. Conclusion TCM syndrome differentiation was the key point to the concussion treatment. Phlegm stasis obstruction was the core pathogenesis of concussion. Qi deficiency and phlegm stasis was the most important syndrome type. The basic prescription was Semen Persicae,Acorus Tatarinowii,Poria Cocos,Ligusticum Chuanxiong,Rhizoma Pinelliae( processed with alum).The patients with different syndrome type were treated with the corresponding addition and subtraction of Chinese herbs in the formula according to the syndromes differentiation.
Objective To explore the clinical characteristics of concussion patients,traditional Chinese medicine( TCM) syndrome type distribution and prescription regularity. Methods The clinical characteristics and syndrome types of 54 patients with concussion were analyzed with the method of case analysis,and the prescription regularity of TCM for concussion were analyzed based on association rules and complex system entropy clustering algorithm. Results The ratio of male to female in 54 concussion patients was 1. 5∶ 1. The average age of the enrolled patients was( 39. 69 ± 16. 34) years old. Young crowd aged between 20-50 years old were in majority.Traffic accident injury was the first cause of mild traumatic brain injury. The main clinical symptoms were dizziness,headache,insomnia,forgetfulness,irritability,depression,poor appetite,nausea,and so on. Phlegm stasis obstruction was the core pathogenesis of concussion. The main TCM syndrome type included qi deficiency and phlegm stasis,heart-kidney imbalance and stasis,liver depression and phlegm stasis,and kidney deficiency and phlegm stasis. Qi deficiency and phlegm stasis was the most important syndrome type.Semen Persicae,Acorus Tatarinowii,Poria Cocos,Ligusticum Chuanxiong,Rhizoma Pinelliae( processed with alum) were the basic herbs for concussion treatment. Conclusion TCM syndrome differentiation was the key point to the concussion treatment. Phlegm stasis obstruction was the core pathogenesis of concussion. Qi deficiency and phlegm stasis was the most important syndrome type. The basic prescription was Semen Persicae,Acorus Tatarinowii,Poria Cocos,Ligusticum Chuanxiong,Rhizoma Pinelliae( processed with alum).The patients with different syndrome type were treated with the corresponding addition and subtraction of Chinese herbs in the formula according to the syndromes differentiation.
引文
[1]王忠诚.王忠诚神经外科学[M]. 2版.武汉:湖北科学技术出版社,2015:301-304.
[2]唐仕欢,陈建新,杨洪军,等.基于复杂系统熵聚类方法的中药新药处方发现研究思路[J].世界科学技术(中医药现代化),2009,11(2):225-228.
[3]卢笑晖,单崎玮.基于中医传承辅助系统分析卢尚岭教授治疗头风病用药经验[J].中国实验方剂学杂志,2012,18(9):5-9.
[4]唐仕欢,申丹,卢朋,等.中医传承辅助平台应用评述[J].中华中医药杂志,2015,30(2):329-331.
[5]江涛,鄢泽然,疏欣扬,等.脑外伤后综合征的中医治疗探讨[J].实用中医内科杂志,2012,26(6):1-2,4.
[6]吴学勤.大成汤加减治疗脑震荡65例临床观察[J].宁夏医学杂志,2000,22(1):42.
[7]高磊,王健,高淑珍,等.天麻枸杞汤加减治疗脑震荡后综合征(肝肾亏损型)的疗效观察[J].中医临床研究,2014,6(33):96-98.
[8]阎奇.加味通窍活血汤治疗脑外伤后癫痫72例疗效观察[J].中国中医药信息杂志,2007,14(8):62.
[9]李燕子.加味通窍活血汤治疗脑外伤后癫痫疗效观察[J].中国实用神经疾病杂志,2014,17(14):114-115.
[10]张文华.改良逐瘀汤结合西医疗法治疗脑外伤后精神抑郁症患者的疗效分析[J].医学理论与实践,2016,29(24):3350-3351.
[11]樊永平.国医大师王绵之治疗脑病用药特点[J].中华中医药杂志,2013,28(7):2020-2022.
[12]朱迎君,王永强,王少卿,等.王绵之教授治疗中医脑病遣药用方规律分析[J].中医药学报,2017,45(6):10-13.
[2]唐仕欢,陈建新,杨洪军,等.基于复杂系统熵聚类方法的中药新药处方发现研究思路[J].世界科学技术(中医药现代化),2009,11(2):225-228.
[3]卢笑晖,单崎玮.基于中医传承辅助系统分析卢尚岭教授治疗头风病用药经验[J].中国实验方剂学杂志,2012,18(9):5-9.
[4]唐仕欢,申丹,卢朋,等.中医传承辅助平台应用评述[J].中华中医药杂志,2015,30(2):329-331.
[5]江涛,鄢泽然,疏欣扬,等.脑外伤后综合征的中医治疗探讨[J].实用中医内科杂志,2012,26(6):1-2,4.
[6]吴学勤.大成汤加减治疗脑震荡65例临床观察[J].宁夏医学杂志,2000,22(1):42.
[7]高磊,王健,高淑珍,等.天麻枸杞汤加减治疗脑震荡后综合征(肝肾亏损型)的疗效观察[J].中医临床研究,2014,6(33):96-98.
[8]阎奇.加味通窍活血汤治疗脑外伤后癫痫72例疗效观察[J].中国中医药信息杂志,2007,14(8):62.
[9]李燕子.加味通窍活血汤治疗脑外伤后癫痫疗效观察[J].中国实用神经疾病杂志,2014,17(14):114-115.
[10]张文华.改良逐瘀汤结合西医疗法治疗脑外伤后精神抑郁症患者的疗效分析[J].医学理论与实践,2016,29(24):3350-3351.
[11]樊永平.国医大师王绵之治疗脑病用药特点[J].中华中医药杂志,2013,28(7):2020-2022.
[12]朱迎君,王永强,王少卿,等.王绵之教授治疗中医脑病遣药用方规律分析[J].中医药学报,2017,45(6):10-13.