基于古今医案数据分析的血证证治规律研究
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摘要
本课题旨在通过文献研究与现代统计学分析相结合的方法,探求血证病的证治规律,期望能够为临床治疗血证病提供更多借鉴和辨证的新思路。
     第一部分为运用文献学的方法,收集整理古代文献,从历史发展的角度,对历代医家关于血证病的论述进行了全面总结和回顾。系统的分析了血证的病名、病因、病机、治疗等诸多方面问题,力求从整体上认识血证证治的发展规律,为今后的研究奠定文献基础。
     第二部分为血证古今医案数据统计与结果。对文献中的1885例血证医案及临床报道进行系统整理,将医案中的症状、用药分别建立数据库,利用“SAS System for Windows V9.1”统计软件分别对其进行频数、因子、聚类等数理统计分析。并对病例中如年龄、性别等基本资料;以及用药种类、归经、性味、各时期用药特点等做出整理。
     第三部分,可分为三个小部分。(一)根据统计结果总结了各种血证(鼻衄、咳血、吐血、尿血、便秘、紫癜)的证侯规律:包括各自的辨证分型以及传变规律。(二)根据药物统计分析的结果总结出六种出血疾病的治疗规律。创立了基础方、辨证用方、随症加减方三步治疗法。可直接用于指导临床治疗。(三)总结了血证治疗的用药规律。包括补益药的使用规律、止血药的使用规律,以及矿石类、炭类药物的使用规律,并提出通用炭的假说。此外还总结了血证治疗药物种类的规律、归经的规律的规律以及各时期用药不同特点的规律。
This issue through literature research and analysis of modern statistical methods,and explore Blood Symptom Complex treatment laws,look forward to evidence for clinical treatment of Blood Symptom Complex and to provide more diagnosis from the new ideas.
     The first part was to use bibliography to learn methods of collection of ancient literature,from the perspective of historical development of ancient medicine on the Blood Symptom Complex on the disease to carry out a comprehensive summary and review.Systematic analysis of the blood evidence of disease,etiology,pathogenesis,treatment,and many other aspects to the overall understanding of blood from the forensic evidence of the development of the law of governance for future research to lay the basis of the literature.
     The second part is the data analysis of medical cases.It conducted systematic compiling of the medical records and clinical reports of 1885 cases on Blood Symptom Complex from the literatures,it set up the database of symptoms and prescriptions related with the treatment of Blood Symptom Complex in both ancient and modern time.And then it made mathematical statistics analysis like frequencies,factors,clustering etc.Using SAS System for Windows V9.1 statistical software,it summed up high-frequency symptoms and medicines and analyzed the type of syndrome,causes, pathogenesis,medication characteristics and principles.
     The third part,can be divided into three parts.(1) summarizes the statistical results based on Blood Symptom Complex(epistaxis,hemoptysis, hematemesis,urinating blood,hematochezia,purpura) the law of the syndrome:the syndrome,including their type,as well as the law of mass change.(2) According to the results of statistical analysis of the herb summarized the laws of hemorrhagic diseases.Creating three-stpeps therapy method:foundation prescription,BianZheng prescription and symptom prescription.Can be directly used to guide clinical treatment.(3) summed up the Blood Symptom Complex of the herb treatment law permits.Including the use of tonic,the use of hemostatic law,as well as the ore type,carbon type of drug use laws,and made general charcoal hypothesis.In addition,summed up Channel-Tropism character's of the Blood Symptom Complex and the period of administration of the laws of the different characteristics.
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