基于数据挖掘的张炳秀教授诊治胃脘痛临床经验研究
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摘要
[目的]以全国名老中医张炳秀教授临床实践为基础,结合现代先进的数据挖掘技术及科学的检验方法,研究、继承、发扬张炳秀教授丰富而独特的临床经验,提高中医药在胃脘痛诊治中的临床疗效。发挥老中医药专家在中医药学术传承中的特定作用。
[方法]收集张炳秀教授临证多年来的治疗胃脘痛的验案,按纳入标准、排除标准筛选,将符合标准的640例755诊次的临床资料依次输入电脑,将所有数据进行归类、统计分析,建立最佳的病案数据挖掘的模型。针对各软件的特点和优势具体选用SPSS15.0统计软件进行频数分析、聚类分析、主成分分析与因子分析；选用Excel数据挖掘外接程序进行Logistic回归分析、关联规则分析。频数分析涉及证型、四诊信息、病机、中药、病程、特殊症状与病史等多方面。系统聚类、主成分及因子分析主要用于进一步剖析四诊信息。Logistic回归分析主要用于剖析证型与药物之间的关系。关联规则分析主要用于剖析胃脘痛各证型与胃镜下表现的关联,病机与药物的关联,主要症状与药物的关联。将上述方法有机结合对病案信息进行有效挖掘,系统诠释证、症和方、药的对应规律。最终通过对数据挖掘结果的分析,并结合张炳秀教授的治疗经验探讨其辨证思路与组方用药规律。
[结果]数据挖掘得出以下结果：共使用中药227种,频数大于20次的仅有77种。中药用药方法较多,共有475种,频数大于20次的有88种。说明治疗中对中药种类的选择以及对中药剂量的选择相对固定,重点突出。研究中大多数胃脘痛病例的病史时间较长。共有219种体现四诊信息的征象,能体现证候要素的征象在60个左右。不少病例选用自拟方治疗,据对应的证型可知这些病例以实邪病况为主。胃脘痛与胃、脾、肝、胆、肾等五脏腑密切相关,与气、虚、热、湿、寒、郁等病理因素密切相关；聚类及因子分析的结果使证候征象不仅有分类,而且有主次之分,有利于对四诊要点的分析,从而在辨证中准确把握病机与证型。得出胃脘痛证候初步诊断方案：脾胃虚寒证主要依据冷痛、畏寒怕冷、喜温喜按、脉沉、薄苔、舌质淡红、白苔,次要依据嘈杂、泛酸、嗳气、脉细、神疲；肝气犯胃证主要依据心烦、失眠、喜叹息、胸闷、窜痛、情志诱因、连及胁肋、胀痛,次要依据胀痛连乳、头晕；湿热中阻证主要依据口苦、口干、黄苔、脉弦、舌质红、大便不畅、大便干燥、脉滑,次要依据恶心、尿黄、灼痛、烧心；脾胃气虚证主要依据舌质嫩、舌质齿痕、脉弱、面色少华、纳差、脉缓、乏力,次要依据少苔、隐痛、食后腹胀；痰湿内蕴证主要依据嗜睡、身困重、腻苔、口粘、重坠感、便溏、食后加重,次要依据脉濡、厚苔；瘀血停胃证主要依据刺痛、部位固定、舌质紫暗、脉涩、瘀斑,次要依据腹胀、按之硬满。胃脘痛各证型与胃镜下表现的关联规则研究结果证实了导师提出“脏腑望诊”、“诊察入微”等观点的实用性；将治法规范以后健脾、清热、益气、理气、化湿、降逆、温中、滋阴、化瘀、化痰、利胆、解毒12法得到凸显；排名前20位的方剂为胃爱汤、自拟方、旋复代赭汤、理中汤、逍遥散、柴芩温胆汤、柴胡疏肝散、温胆汤、平胃散、玉女煎、左金丸、附子理中汤、泻黄散、大柴胡汤、正胆汤、苓桂术甘汤、芍药甘草汤、失笑散、玄麦桔甘汤、一贯煎；Logistic回归分析显示了与各证型密切相关的药物排序。并藉此总结出相关的经验方。脾胃气虚的治疗可以选参、芪、枣、山药、木香为经验方；肝气犯胃的治疗可以选柴胡、香附、炒白芍、当归、青皮、木蝴蝶、薄荷为经验方;湿热中阻的治疗可以选川黄连、黄芩、栀子、茵陈、土茯苓、蒲公英、竹茹为经验方：脾胃虚寒的治疗可以选红参、炮姜炭/干姜、川桂枝、黄芪、熟薏苡仁、木香为经验方；胃阴亏耗的治疗可以选北沙参、麦冬、太子参、生地、丹皮、枸杞、五味子为经验方；瘀血停胃的治疗可以选蒲黄、五灵脂、鸡血藤、赤芍、丹参、黄芪为经验方；痰湿内蕴的治疗可以选苍术、生薏苡仁、莲肉、石菖蒲、藿香、制半夏、生姜为经验方；胃热内盛的治疗可以选丹皮、生石膏、升麻、知母、生地、栀子、麦冬为经验方；饮食伤胃的治疗可以选山楂、麦芽、熟薏苡仁、茯苓、连翘、九香虫为经验方；寒邪客胃的治疗可以选苍术、生姜、藿香、九香虫、大腹皮为经验方。
总结其主要临床经验与学术思想如下：认为脾胃虚弱是主要病因；认为相关脏腑失和,气机升降失常是发病主要病机；审证求因时强调对核心证候特点的把握；将脾胃气虚从各证型中剥离出来,单拟一型,此点与东垣重补土一脉相承；衷中参西提出脏腑望诊；寓补于通强后天,提出胃脘痛的治疗应该以补虚为主,同时要注重腑气的通利；方药独特能兼容古今,变通古方创制胃爱汤,用于临床,疗效突出。
[结论]本数据挖掘所得结果总体上可以反映张炳秀教授临床诊疗胃脘痛的规律。使张炳秀教授诊治胃脘痛的特色和经验得到了凸显和数据支持,丰富了名老中医辨治胃脘痛的临证经验和学术思想,为临床实践提供了客观的依据。是数据挖掘运用在名老中医经验采集方面的新突破与新进展。
[Objective] Based on the TCM theory and clinical practices specialized by Professor Zhang Bingxiu who is one of the National old TCM, combined with modern advanced data mining technology and scientific testing methods, we study、heritage and develop the clinical experience and academic ideas accumulated by Professor Zhang Bingxiu treating epigastric pain. Improve the diagnosis and treatment of Chinese medicine in epigastric pain the clinical curative effect. Play old Chinese medicine experts in traditional Chinese medicine academic inheritance of specific role.
[Methods]Has collected Professor Zhang Bing Xiu over the years of experience in the treatment of epigastric pain case, according to inclusion criteria, exclusion criteria screening will meet the standards of the640cases755times the clinical diagnosis in turn entered into the computer data, all data are classified, statistical analysis, establish the best medical record data mining models. For each specific software features and advantages of statistical software used SPSS15.0frequency analysis, cluster analysis, principal component analysis and factor analysis; use Microsoft SQL Server2005Data Mining Add-Ins for Office Excel2007Logistic regression analysis, association rules analysis.Frequency analysis involves syndromes, the four diagnostic information, pathogenesis, Chinese traditional medicine, course of disease, specific symptoms and medical history and other aspects.Hierarchical clustering, principal components and factor analysis is mainly used for further analysis of four diagnostic information.Logistic regression analysis is mainly used for analysis of syndromes and the relationship between traditional Chinese medicines.Association rules analysis is mainly used for the analysis of epigastric pain syndromes associated with the performance of endoscopic, pathogenesis associated with traditional Chinese medicine, the main symptoms associated with the traditional Chinese medicine.Organic combine the above methods for effective mining of medical record information and make a systemic interpretation of the corresponding laws of disease、syndrome、 symptoms and prescription and drugs. Finally we explore the syndrome differentiation thinking and law of prescription drugs which is based on the analysis of the mining results and combined with clinical experience of Professor Zhang Bingxiu.
[Results]Data mining results are as follows:A total of227kinds of traditional Chinese medicine use. frequency of greater than20times only77species. Chinese medicine treatment methods are more, a total of475kinds, frequency20times greater than88species.Describes the treatment of choice of types of traditional Chinese medicine and Chinese medicine dose selection for a relatively fixed and focused.Most cases of a history of epigastric pain longer.There are219kinds of signs reflect the four diagnostic information, to reflect the elements of the signs of the syndrome in about60.Many patients choose zi ni decoction treatment, according to the corresponding syndrome shows the excessive pathogenic factors of these cases to the main condition.Epigastric pain with stomach, spleen, liver, gallbladder, kidney and other organs is closely related to five, with qi. deficiency, heat, dampness, cold, constraint and other pathological factors closely related; cluster and factor analysis resulting classification is not only signs of the syndrome, but also primary and secondary points, it is beneficial for the analysis of four diagnostic points to accurately grasp the dialectical Pathogenesis and syndromes:Come to the preliminary diagnostic programs of epigastric pain syndromes:syndrome of spleen-stomach deficiency cold based primarily on the cold pain,cold chills, thermophilic hi. deep pulse, thin tongue fur, pale red tongue, white tongue fur, a secondary basis epigastric upset, acid upflow, belching, fine pulse, fatigued spirit; syndrome of liver-QI invading the stomach based primarily on vexation, insomnia, like sighing, chest tightness, scurrying pain. emotional incentives, With and rib-side, distending pain, a secondary basis for distending pain with Breasts, dizziness;syndrome of damp-heat obstructing in zhong jiao based primarily on bitterness of mouth, dry mouth, yellow tongue fur, stringlike pulse, red tongue, inhibited defecation,dry stool, slippery pulse, a secondary basis for nausea, yellow urine, scorching pain heartburn;syndrome of deficiency of spleen-QI and stomach-QI based primarily on the pale tender-soft tongue, tongue bearing dental impressions, weak pulse, looking Shaohua. anorexia, moderate pulse,lack of strength, according to a small secondary little Moss, dull pain abdominal distention after eating;syndrome of phlegm-damp retention based primarily on somnolence, heavy cumbersome body, slimy tongue fur, mouth sticky, heavy sense of falling, loose stools, increased after eating, according to the secondary soggy pulse, thick fur:syndrome of retention of blood stasis based primarily on tingling pain, site fixed, dark purple tongue, rough pulse, stasis macule, secondary basis abdominal distention, press hard.Under epigastric pain various syndromes associated with the performance of endoscopic the connection rule findings confirmed Professor Zhang Bing Xiu proposed "the internal organs observation of patient's complexion","examines into micro" and so on viewpoint usability; Will govern the law standard later fortify the spleen, clear heat, supplement qi. rectify qi,remove dampness, direct counter flow downward, warm the center, supplement yin,dissolve stasis, dissolve phlegm, promote gallbladder function, detoxification12methods are highlighted; Top20of the following prescription wei ai decoction,zi ni decoction.xuan fu dai zhe decoction,li zhong decoction.xiao yao powder,chai qin wen dan decoction,chai hu shu gan powder, wen dan decoction,pin wei powder.yu nv decoction,zuojin pill,fu zi li zhong decoction,xie huang powder,da chai hu decoction.zheng dan decoction,lin gui zhu gan decoction,shao yao gan cao decoction,shi xiao powder,xuan mai jie gan decoction, yi guan decoction;Logistic regression analysis showed that the syndrome is closely related with the drug order. And takes advantage of this summarizes related after the proven prescription.Treatment of syndrome of deficiency of spleen-QI and stomach-QI can choose Taizishen/Dangshen、Huangqi、Dazao、Muxiang for the experience; Treatment of syndrome of liver-QI invading the stomach can choose Chaihu、Xiangfu、Baishao、 Danggui、Qingpi、Muhudie、Bohe for the experience; Treatment of syndrome of damp-heat obstructing in zhong jiao can choose Huanglian、Huangqin、Zhizi、Yinchen、Tufuling、 Pugongying or the experience; Treatment of syndrome of spleen-stomach deficiency cold can choose Renshen、Paojiang/Ganjiang、Guizhi、Huangqi、mature Yiyiren、Muxiang for the experience; Treatment of syndrome of stomach yin deficiency can choose Beishashen、Maidong、 Taizishen、Shengdi、Mudanpi、Gouqizi、Wuweizi for the experience; Treatment of syndrome of retention of blood stasis can choose Puhuang、Wulingzhi、Jixueteng、Chishao、Danshen、 Huangqi for the experience; Treatment of syndrome of phlegm-damp retention can choose Cangzhu、raw Yiyiren、Lianzi、Shichangpu、Huoxiang、Banxia、Shengjiang for the experience; Treatment of syndrome of intense stomach-heat can choose Mudanpi、raw Shigao、Shengma、 Zhimu、Shengdi、Zhizi、Maidong for the experience; Treatment of syndrome of retention of food in stomach can choose Shanzha、Maiya、mature Yiyiren、Fuling、Lianqiao、Jiuxiangchaong for the experience; Treatment of syndrome of cold pathogen attacking stomach can choose Cangzhu、Shengjiang、Huoxiang、Jiuxiangchong、Dafupi for the experience.
Summarizes the main clinical experience and academic thought as follows:That the spleen-stomach vacuity is a major cause of epigastric pain; That the relevant organs falling out, air-lift disorders are the main disease pathogenesis; Careful card for stressed because of the characteristics of the core syndrome grasp; Syndrome of deficiency of spleen-QI and stomach-QI be splitting up single intended to be a type, this point of view with the same strain Li Dongyuan attention to the spleen;Combined TCM and West Medicine proposed "the internal organs observation of patient's complexion"; Embedded in the tonifying method in the method of free the bowels, so that the spleen-stomach enhancements;Epigastric pain treatment should be made mainly supplement vacuity, while focusing on free the bowels; Recipe unique can be compatible with ancient and modern, flexible ancient prescription created wei ai decoction, for clinical efficacy outstanding.
[Conclusion]The results of data mining in general, reflect Professor Zhang Bingxiu the laws of the clinical treatment of epigastric pain. Diagnosis and treatment of epigastric pain that Professor Zhang Bingxiu characteristics and experience are the highlights and data support.Enrich the old Famous TCM experts' Diagnosis and Treatment of epigastric pain of clinical experience and academic thinking for clinical practice to provide an objective basis. Data mining is used in Famous TCM experts'clinical experience collection to the new breakthroughs and new development.
[方法]收集张炳秀教授临证多年来的治疗胃脘痛的验案,按纳入标准、排除标准筛选,将符合标准的640例755诊次的临床资料依次输入电脑,将所有数据进行归类、统计分析,建立最佳的病案数据挖掘的模型。针对各软件的特点和优势具体选用SPSS15.0统计软件进行频数分析、聚类分析、主成分分析与因子分析；选用Excel数据挖掘外接程序进行Logistic回归分析、关联规则分析。频数分析涉及证型、四诊信息、病机、中药、病程、特殊症状与病史等多方面。系统聚类、主成分及因子分析主要用于进一步剖析四诊信息。Logistic回归分析主要用于剖析证型与药物之间的关系。关联规则分析主要用于剖析胃脘痛各证型与胃镜下表现的关联,病机与药物的关联,主要症状与药物的关联。将上述方法有机结合对病案信息进行有效挖掘,系统诠释证、症和方、药的对应规律。最终通过对数据挖掘结果的分析,并结合张炳秀教授的治疗经验探讨其辨证思路与组方用药规律。
[结果]数据挖掘得出以下结果：共使用中药227种,频数大于20次的仅有77种。中药用药方法较多,共有475种,频数大于20次的有88种。说明治疗中对中药种类的选择以及对中药剂量的选择相对固定,重点突出。研究中大多数胃脘痛病例的病史时间较长。共有219种体现四诊信息的征象,能体现证候要素的征象在60个左右。不少病例选用自拟方治疗,据对应的证型可知这些病例以实邪病况为主。胃脘痛与胃、脾、肝、胆、肾等五脏腑密切相关,与气、虚、热、湿、寒、郁等病理因素密切相关；聚类及因子分析的结果使证候征象不仅有分类,而且有主次之分,有利于对四诊要点的分析,从而在辨证中准确把握病机与证型。得出胃脘痛证候初步诊断方案：脾胃虚寒证主要依据冷痛、畏寒怕冷、喜温喜按、脉沉、薄苔、舌质淡红、白苔,次要依据嘈杂、泛酸、嗳气、脉细、神疲；肝气犯胃证主要依据心烦、失眠、喜叹息、胸闷、窜痛、情志诱因、连及胁肋、胀痛,次要依据胀痛连乳、头晕；湿热中阻证主要依据口苦、口干、黄苔、脉弦、舌质红、大便不畅、大便干燥、脉滑,次要依据恶心、尿黄、灼痛、烧心；脾胃气虚证主要依据舌质嫩、舌质齿痕、脉弱、面色少华、纳差、脉缓、乏力,次要依据少苔、隐痛、食后腹胀；痰湿内蕴证主要依据嗜睡、身困重、腻苔、口粘、重坠感、便溏、食后加重,次要依据脉濡、厚苔；瘀血停胃证主要依据刺痛、部位固定、舌质紫暗、脉涩、瘀斑,次要依据腹胀、按之硬满。胃脘痛各证型与胃镜下表现的关联规则研究结果证实了导师提出“脏腑望诊”、“诊察入微”等观点的实用性；将治法规范以后健脾、清热、益气、理气、化湿、降逆、温中、滋阴、化瘀、化痰、利胆、解毒12法得到凸显；排名前20位的方剂为胃爱汤、自拟方、旋复代赭汤、理中汤、逍遥散、柴芩温胆汤、柴胡疏肝散、温胆汤、平胃散、玉女煎、左金丸、附子理中汤、泻黄散、大柴胡汤、正胆汤、苓桂术甘汤、芍药甘草汤、失笑散、玄麦桔甘汤、一贯煎；Logistic回归分析显示了与各证型密切相关的药物排序。并藉此总结出相关的经验方。脾胃气虚的治疗可以选参、芪、枣、山药、木香为经验方；肝气犯胃的治疗可以选柴胡、香附、炒白芍、当归、青皮、木蝴蝶、薄荷为经验方;湿热中阻的治疗可以选川黄连、黄芩、栀子、茵陈、土茯苓、蒲公英、竹茹为经验方：脾胃虚寒的治疗可以选红参、炮姜炭/干姜、川桂枝、黄芪、熟薏苡仁、木香为经验方；胃阴亏耗的治疗可以选北沙参、麦冬、太子参、生地、丹皮、枸杞、五味子为经验方；瘀血停胃的治疗可以选蒲黄、五灵脂、鸡血藤、赤芍、丹参、黄芪为经验方；痰湿内蕴的治疗可以选苍术、生薏苡仁、莲肉、石菖蒲、藿香、制半夏、生姜为经验方；胃热内盛的治疗可以选丹皮、生石膏、升麻、知母、生地、栀子、麦冬为经验方；饮食伤胃的治疗可以选山楂、麦芽、熟薏苡仁、茯苓、连翘、九香虫为经验方；寒邪客胃的治疗可以选苍术、生姜、藿香、九香虫、大腹皮为经验方。
总结其主要临床经验与学术思想如下：认为脾胃虚弱是主要病因；认为相关脏腑失和,气机升降失常是发病主要病机；审证求因时强调对核心证候特点的把握；将脾胃气虚从各证型中剥离出来,单拟一型,此点与东垣重补土一脉相承；衷中参西提出脏腑望诊；寓补于通强后天,提出胃脘痛的治疗应该以补虚为主,同时要注重腑气的通利；方药独特能兼容古今,变通古方创制胃爱汤,用于临床,疗效突出。
[结论]本数据挖掘所得结果总体上可以反映张炳秀教授临床诊疗胃脘痛的规律。使张炳秀教授诊治胃脘痛的特色和经验得到了凸显和数据支持,丰富了名老中医辨治胃脘痛的临证经验和学术思想,为临床实践提供了客观的依据。是数据挖掘运用在名老中医经验采集方面的新突破与新进展。
[Objective] Based on the TCM theory and clinical practices specialized by Professor Zhang Bingxiu who is one of the National old TCM, combined with modern advanced data mining technology and scientific testing methods, we study、heritage and develop the clinical experience and academic ideas accumulated by Professor Zhang Bingxiu treating epigastric pain. Improve the diagnosis and treatment of Chinese medicine in epigastric pain the clinical curative effect. Play old Chinese medicine experts in traditional Chinese medicine academic inheritance of specific role.
[Methods]Has collected Professor Zhang Bing Xiu over the years of experience in the treatment of epigastric pain case, according to inclusion criteria, exclusion criteria screening will meet the standards of the640cases755times the clinical diagnosis in turn entered into the computer data, all data are classified, statistical analysis, establish the best medical record data mining models. For each specific software features and advantages of statistical software used SPSS15.0frequency analysis, cluster analysis, principal component analysis and factor analysis; use Microsoft SQL Server2005Data Mining Add-Ins for Office Excel2007Logistic regression analysis, association rules analysis.Frequency analysis involves syndromes, the four diagnostic information, pathogenesis, Chinese traditional medicine, course of disease, specific symptoms and medical history and other aspects.Hierarchical clustering, principal components and factor analysis is mainly used for further analysis of four diagnostic information.Logistic regression analysis is mainly used for analysis of syndromes and the relationship between traditional Chinese medicines.Association rules analysis is mainly used for the analysis of epigastric pain syndromes associated with the performance of endoscopic, pathogenesis associated with traditional Chinese medicine, the main symptoms associated with the traditional Chinese medicine.Organic combine the above methods for effective mining of medical record information and make a systemic interpretation of the corresponding laws of disease、syndrome、 symptoms and prescription and drugs. Finally we explore the syndrome differentiation thinking and law of prescription drugs which is based on the analysis of the mining results and combined with clinical experience of Professor Zhang Bingxiu.
[Results]Data mining results are as follows:A total of227kinds of traditional Chinese medicine use. frequency of greater than20times only77species. Chinese medicine treatment methods are more, a total of475kinds, frequency20times greater than88species.Describes the treatment of choice of types of traditional Chinese medicine and Chinese medicine dose selection for a relatively fixed and focused.Most cases of a history of epigastric pain longer.There are219kinds of signs reflect the four diagnostic information, to reflect the elements of the signs of the syndrome in about60.Many patients choose zi ni decoction treatment, according to the corresponding syndrome shows the excessive pathogenic factors of these cases to the main condition.Epigastric pain with stomach, spleen, liver, gallbladder, kidney and other organs is closely related to five, with qi. deficiency, heat, dampness, cold, constraint and other pathological factors closely related; cluster and factor analysis resulting classification is not only signs of the syndrome, but also primary and secondary points, it is beneficial for the analysis of four diagnostic points to accurately grasp the dialectical Pathogenesis and syndromes:Come to the preliminary diagnostic programs of epigastric pain syndromes:syndrome of spleen-stomach deficiency cold based primarily on the cold pain,cold chills, thermophilic hi. deep pulse, thin tongue fur, pale red tongue, white tongue fur, a secondary basis epigastric upset, acid upflow, belching, fine pulse, fatigued spirit; syndrome of liver-QI invading the stomach based primarily on vexation, insomnia, like sighing, chest tightness, scurrying pain. emotional incentives, With and rib-side, distending pain, a secondary basis for distending pain with Breasts, dizziness;syndrome of damp-heat obstructing in zhong jiao based primarily on bitterness of mouth, dry mouth, yellow tongue fur, stringlike pulse, red tongue, inhibited defecation,dry stool, slippery pulse, a secondary basis for nausea, yellow urine, scorching pain heartburn;syndrome of deficiency of spleen-QI and stomach-QI based primarily on the pale tender-soft tongue, tongue bearing dental impressions, weak pulse, looking Shaohua. anorexia, moderate pulse,lack of strength, according to a small secondary little Moss, dull pain abdominal distention after eating;syndrome of phlegm-damp retention based primarily on somnolence, heavy cumbersome body, slimy tongue fur, mouth sticky, heavy sense of falling, loose stools, increased after eating, according to the secondary soggy pulse, thick fur:syndrome of retention of blood stasis based primarily on tingling pain, site fixed, dark purple tongue, rough pulse, stasis macule, secondary basis abdominal distention, press hard.Under epigastric pain various syndromes associated with the performance of endoscopic the connection rule findings confirmed Professor Zhang Bing Xiu proposed "the internal organs observation of patient's complexion","examines into micro" and so on viewpoint usability; Will govern the law standard later fortify the spleen, clear heat, supplement qi. rectify qi,remove dampness, direct counter flow downward, warm the center, supplement yin,dissolve stasis, dissolve phlegm, promote gallbladder function, detoxification12methods are highlighted; Top20of the following prescription wei ai decoction,zi ni decoction.xuan fu dai zhe decoction,li zhong decoction.xiao yao powder,chai qin wen dan decoction,chai hu shu gan powder, wen dan decoction,pin wei powder.yu nv decoction,zuojin pill,fu zi li zhong decoction,xie huang powder,da chai hu decoction.zheng dan decoction,lin gui zhu gan decoction,shao yao gan cao decoction,shi xiao powder,xuan mai jie gan decoction, yi guan decoction;Logistic regression analysis showed that the syndrome is closely related with the drug order. And takes advantage of this summarizes related after the proven prescription.Treatment of syndrome of deficiency of spleen-QI and stomach-QI can choose Taizishen/Dangshen、Huangqi、Dazao、Muxiang for the experience; Treatment of syndrome of liver-QI invading the stomach can choose Chaihu、Xiangfu、Baishao、 Danggui、Qingpi、Muhudie、Bohe for the experience; Treatment of syndrome of damp-heat obstructing in zhong jiao can choose Huanglian、Huangqin、Zhizi、Yinchen、Tufuling、 Pugongying or the experience; Treatment of syndrome of spleen-stomach deficiency cold can choose Renshen、Paojiang/Ganjiang、Guizhi、Huangqi、mature Yiyiren、Muxiang for the experience; Treatment of syndrome of stomach yin deficiency can choose Beishashen、Maidong、 Taizishen、Shengdi、Mudanpi、Gouqizi、Wuweizi for the experience; Treatment of syndrome of retention of blood stasis can choose Puhuang、Wulingzhi、Jixueteng、Chishao、Danshen、 Huangqi for the experience; Treatment of syndrome of phlegm-damp retention can choose Cangzhu、raw Yiyiren、Lianzi、Shichangpu、Huoxiang、Banxia、Shengjiang for the experience; Treatment of syndrome of intense stomach-heat can choose Mudanpi、raw Shigao、Shengma、 Zhimu、Shengdi、Zhizi、Maidong for the experience; Treatment of syndrome of retention of food in stomach can choose Shanzha、Maiya、mature Yiyiren、Fuling、Lianqiao、Jiuxiangchaong for the experience; Treatment of syndrome of cold pathogen attacking stomach can choose Cangzhu、Shengjiang、Huoxiang、Jiuxiangchong、Dafupi for the experience.
Summarizes the main clinical experience and academic thought as follows:That the spleen-stomach vacuity is a major cause of epigastric pain; That the relevant organs falling out, air-lift disorders are the main disease pathogenesis; Careful card for stressed because of the characteristics of the core syndrome grasp; Syndrome of deficiency of spleen-QI and stomach-QI be splitting up single intended to be a type, this point of view with the same strain Li Dongyuan attention to the spleen;Combined TCM and West Medicine proposed "the internal organs observation of patient's complexion"; Embedded in the tonifying method in the method of free the bowels, so that the spleen-stomach enhancements;Epigastric pain treatment should be made mainly supplement vacuity, while focusing on free the bowels; Recipe unique can be compatible with ancient and modern, flexible ancient prescription created wei ai decoction, for clinical efficacy outstanding.
[Conclusion]The results of data mining in general, reflect Professor Zhang Bingxiu the laws of the clinical treatment of epigastric pain. Diagnosis and treatment of epigastric pain that Professor Zhang Bingxiu characteristics and experience are the highlights and data support.Enrich the old Famous TCM experts' Diagnosis and Treatment of epigastric pain of clinical experience and academic thinking for clinical practice to provide an objective basis. Data mining is used in Famous TCM experts'clinical experience collection to the new breakthroughs and new development.
引文
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