中医七情之“怒”的古代与近代医案证治规律的研究
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摘要
情绪是人生命的指挥棒,负性情绪可使人抑郁,并能诱发多种身心疾病。“怒”作为中医七情之一,是人们经历最多的情志体验。现代研究报道,因怒导致的情志病症远远比其他情志因素所致病症要多。中医医案是中医临床医师实施辨证论治过程的文字纪录,是保存、查核、考评乃至研究具体诊疗活动的档案资料。医案的信息量非常丰富,从古到今的医案中,既有丰富的医学理论,又有大量的医疗经验;既有辨证方法,又有处方用药;既有成功的经验,又有失败的教训;既有详明者令人百读不厌,又有简要者令人寻味无穷。因此,历代医案的研究对于继承中医有着极其重要的价值,要研究总结前人经验及其学术思想,要提高中医临床疗效,要创新中医理论,均有必要认真研究医案。随着科学技术的发展,多学科发展中医已经成为中医发展的一个方向,在中医医案研究领域亦是如此。统计技术、计算机技术等不断被引入医学领域,利用数理统计方法和数据挖掘技术建立相关中医医案数据库,利用数据库挖掘和分析最大的优势,通过大量数据分析,避免了个别的、人为的差异,将中医医案的经验成果科学化、定量化。
一、研究目的
本研究就是对中医七情之“怒”古、近代医案运用数理统计方法和数据挖掘技术挖掘隐藏在大量医案中的中医七情之“怒”的证治规律。
二、研究方法
本研究以古、近代与怒相关医案为研究对象,以大型电子图书《中华医典》为基础,并根据《中国医籍考》的记载,补充一些《中华医典》中未收集的重要典籍如《名医类案》等,以“怒”及其同义近义词“恚”、“忿”、“愤”、“恼”、“易怒”、“性急”、“性躁”为检索词,在原案中的原始语句中查找收集与怒相关医案,采用Microsoftoffice excel 2003建立古、近代与怒相关医案数据库。对医案原文从症状、外治法、怒在医案中的作用(病因、诱因、体质、治疗手段)、中药等多个方面进行分析。
采用excel函数对数据库的字符变量进行了数字变量的转换,根据“有”、“无”分别赋值为“1”、“0”。采用SAS8.0软件编程进行频数分析、因子分析、典型相关分析、对应分析、关联规则分析、链接图分析。
三、研究结果
(一)与怒相关医案数据库总库的病症特点及用药规律
本研究共涉及古、近代134本医籍的1490条医案,其中将怒作为治疗手段的相关医案有17条(本研究主要是针对除去怒作为治疗手段的其余1473条医案进行研究)。
1、与怒相关医案中出现症状的数理分析及数据挖掘
医案中出现症状共计219个,症状出现频次总计6939种,而常见症状(使用频次在10以上)为53个,累计出现频次为4456次,占整个医案症状出现总频次(6939)的64.22%。
研究显示,与怒相关医案的核心症状为“弦脉、数脉、纳呆、呕吐”。
2、与怒相关医案药物使用情况的数理分析与数据挖掘
与怒相关医案共使用药物382味,药物使用频次为14691味次,其中使用频数在45次以上的有60味中药,累计使用频次为11812味次,占药物使用频次的80.40%,药物使用频次在5次以下(含5次)的药物共有176味,占使用中药数的46.07%,而使用频次为403味次,仅占药物使用频次的2.74%。
研究显示,与怒相关医案中使用的核心药物群为“生姜、山栀、人参、黄芪、甘草、当归、丹皮、陈皮、柴胡、白术、白芍、半夏、茯苓”,是丹栀逍遥散、小柴胡汤及六君子汤的合方。空间分布聚类分析研究显示,六味地黄汤是一类,归脾汤是一类,而香附或是川芎则与丹栀逍遥散常配合使用。
(二)古、近代不同怒型相关医案的病症及用药规律研究
在医案中明确提到郁怒的医案共169条,大怒(暴怒、盛怒、急怒)医案共137条,劳怒医案(病因中除怒外,还有过劳)212条。
1、郁怒医案的分析
研究显示,郁怒医案的核心症状是弦脉、数脉、纳呆、倦怠,核心药物为:丹皮、柴胡、山栀、茯神、茯苓、人参、甘草、白芍、生姜、龙眼肉、酸枣仁、远志、木香、黄芪、白术、当归。
2、大怒医案的分析
研究显示,大怒医案的核心症状为胁痛、胁胀、沉脉、细脉、弦脉、数脉,核心药物为:丹皮、柴胡、山栀、茯苓、人参、甘草、白芍、生姜、陈皮、半夏、白术、当归。
3、劳怒医案的分析
研究显示,劳怒医案的核心症状是弦脉、数脉、洪脉、吐血、发热、咳嗽,核心药物为:丹反、柴胡、山栀、茯苓、人参、黄芪、白术、当归、陈皮、白芍、熟地。
(三)与怒相关妇女经、带、胎、产医案的病症特点及用药规律研究
与怒相关妇女经、带、胎、产医案共311条,占整个研究医案库总例数的21.11%。充分说明妇女容易被怒干扰,其中妇女易怒体质为51条,占整个研究医案库中易怒体质医案(215条)的23.72%,说明易怒体质对于妇女经、带、胎、产的影响较大。分别从经、带、胎、产病来看,其频次分别为月经病177例次、妊娠病77例次、产后病73例次、带下病14例次。而这充分说明妇女在月经、妊娠及产后等特殊时期易为怒所影响。
研究显示,与怒相关妇科医案中主要症状群为“弦脉、寒热往来、数脉、呕吐、纳呆、崩漏、闭经、发热、口渴”,核心药物是“生姜、陈皮、黄芪、山栀、丹皮、茯苓、白芍、白术、柴胡、甘草、当归、人参”,类似于丹栀逍遥散、小柴胡汤、六君子汤的合方。
四、研究结论
(一)研究结果表明怒作为病因、诱因、体质对机体的影响主要表现在伤肝,影响肝主疏泄的功能,引起肝气郁而化火、肝气横逆犯脾、脾虚、气滞痰凝;也可影响到肝血,引起肝血不足、肝不藏血。其核心治疗方法为清肝解郁、和畅气机、补气健脾、燥湿化痰,核心药物为丹栀逍遥散、小柴胡汤和六君子汤的合方。在治疗特点上体现了疏肝、清肝、柔肝、养肝的治肝思想,同时体现了见肝之病当先实脾的治疗理念,从气血津液角度,治法特点主要是理气、和血、化痰。
(二)本研究收集到17条怒作为治疗手段的医案,分析了怒作为治疗手段的应用规律及作用机理。应用规律主要有三个方面:一是中医情志病治疗中的按照五行相克的以情胜情的治疗方法,即怒胜思;二是中医情志病治疗中的不按照五行相克的以情胜情的治疗方法,有怒胜喜、怒胜忧的方法;三是以怒的激发之力,祛除邪气;怒作为治疗手段其作用基础主要是依赖怒的激发之力。
(三)分析了医案中郁怒、大怒、劳怒(怒与过劳因素兼挟)等不同怒型的病症及用药规律,并比较了三者病症及用药方面的差异,研究结果表明:郁怒、劳怒主要以虚性病症为主,大怒主要以气机逆乱的实性病症多见,郁怒主要特点为肝经郁热基础上出现心脾两虚为主,而劳怒主要特点为肝经郁热基础上出现脾气虚损,并表现出较明显的阴虚内热,尤其是以肺阴虚表现突出。治疗上郁怒的用药特点表现为养心安神药物的使用明显,大怒的用药特点表现为下气、破气药物的使用明显,劳怒的用药特点以养阴清热,尤其是滋补肾阴的治疗较为突出。
(四)怒易影响妇女经、带、胎、产,在病症特点上阴虚内热症状突出,血虚特征突出,进一步证实中医传统理论中“女子以肝为先天”、女子“有余于气,不足于血”。在治疗上突出了补血养血、养阴清热的治疗思想。
(五)用数据关联分析与链接图等数据挖掘方法对与怒相关病案、郁怒、大怒、劳怒、妇女经、带、胎、产的医案等的核心症状、核心药物,以及症状的组合规律和药对进行分析研究,其挖掘出来的基本方与一些经方在立法处方选药上均有着较高的吻合度。
The emotion is the master reaction of a person's life,moreover negativity emotion could cause depression and induce many kinds of physically and mentally diseases.Anger as one of the seven modes of emotions of traditional Chinese medicine(TCM)is experienced most by human being.Modern time research reported that the emotional syndrome patterns caused by anger are far more than other emotion factors.The medicine records of TCM is a script record when practitioner of Chinese medicine practicing determination of treatment based in pathogenesis obtained through differentiation of symptoms and signs.It is an archive to preserve and investigate,as well as to research the specific proceeding of diagnosis and treatment.There is plentiful information in the medicine records,which including copious theory of medicine,massive medical treatment experience,method of differentiation of symptoms and signs,to prescribe and medication, successful experience and failure lessons.It is possessing readability and practicality.Thus, the research of ancient medical record has vital value for inheritance TCM.To research the medicine records of TCM serious is good for learning the academic and thought of TCM, and to improve the clinical curative effect of TCM and to bring new ideas for TCM theory. With the development of science technology,make use of multi-subjects to develop TCM has been one of directions of the TCM development,as well as the research area of medicine records of TCM.With the statistical technique and computer technology,etc, were introduced into medical domain unceasing,make use of mathematical statistics method and data mining technology to establish correlate database of medicine records of TCM.Making use of the preponderance of database mining and analysis to avoid individual and anthropogenic disparity through mass data analysis and discover the most literal and value constituent of the medicine records in TCM scientifically and quantitatively.
Objective
The research aimed at mining of the rule of syndrome and treatment of anger in seven modes of emotions of TCM which concealed from the medicine records of TCM in ancient times and modern times through apply mathematical statistics method and data mining technology.
Methods
The research object is the medicine records of TCM in ancient times and modem times which related with anger.By using the Zhong Hua Yi Dian as the elementary reference,and according with record of Zhong Guo Yi Ji Kao to supplement some reference which didn't assemble in the Zhong Hua Yi Dian.Using all kinds of keywords which related with anger as docuterm to search and collect the medicine records of TCM.Apply Microsoft office excel 2003 software to establish the medicine records database which related with anger in ancient times and modern times.
Results
Part one
The disease characteristic and medication rule of medical record in the total database which related with anger.
This study refer to 1490 medical records in 134 medical books,which including 17 medical records to take anger as therapeutic tool.The major research aspect of this study is all this medical records except for those 17 items.
Firstly,to handle the symptom in medical records that related with anger by using mathematics analysis and data mining.There are 219 symptoms in all in the medical record, which occurrence 6939 times all together.Moreover,there are 53 common symptoms, which occurrence more than 10 times,occurrence 4456 times accumulative total.The percentage of common symptoms is 64.22%.The major symptoms in the medical record that related with anger are wiry pulse,frequent pulse,anorexia and emesis.
Secondly,to handle the medication in medical records that related with anger by using mathematics analysis and data mining.
There are 382 species Chinese medicinal materials were applied in the medical records related with anger.All of these medicines were applied 14691 in all.Moreover, there are 60 kinds' medicines were applied more than 45 times,and were applied 11812 times accumulative total which account 80.40%of the medicines usage.Meanwhile,there are 176 kinds' medicines were applied less than 5 times which account 46.07%of all medicinal materials.These 176 kinds' medicines were applied 403 times accumulative total which account 2.74%of the medicines usage.
The major medicinal materials in the medical record that related with anger are rhizoma zingiberis recens,Cape jasmine,ginseng,radix astragali,licorice root,angelica, cortex moutan,aurantii nobilis pericarpium,radix bupleuri,atractylodes macrocephala, paeoniae radix,pinelliae tuber and hoelen.All of these medicines could constitute the compound recipe including Dan Zhi Xiao Yao powder,Xiao Chai Hu prescription and Liu Jun Zi prescription.To think the spatial distribution cluster,there are two kinds compound recipes including Rehmanniae Decoction of Six Ingredients and Decoction for Invigorating the Spleen.However,nutgrass galingale rhizome or szechwan lovage rhizome together with Dan Zhi Xiao Yao powder as common use.
Part two
The study of difference kinds of anger and its medication rule research of medical record in ancient times and modern times.There are 169 cases gloomy anger,137 cases intense anger and 212 cases exhaustion anger were clear-cut recorded in medical records.
Firstly,the analyses of gloomy anger cases.The major symptoms of gloomy anger cases are wiry pulse,frequent pulse,anorexia lassitude.Moreover,the major medicinal materials are cortex moutan,radix bupleuri,Cape jasmine,Indian bread with hostwood, hoelen,ginseng,licorice root,paeoniae radix,rhizoma zingiberis recens,arillus longan, jujube seed,Polygala,costustroot,radix astragali,atractylodes macrocephala and angelica. Secondly,the analyses of intense anger cases.
The major symptoms of intense anger cases are flank painful and distend sunken pulse,small pulse,wiry pulse,and pulsus frequens.Moreover,the major medicinal materials are cortex moutan,radix bupleuri,Cape jasmine,hoelen,ginseng,licorice root, paeoniae radix,rhizoma zingiberis recens,aurantii nobilis pericarpium,pinelliae tuber, atractylodes macrocephala,and angelica.
Thirdly,the analyses of exhaustion anger cases.
The major symptoms of exhaustion anger cases are wiry pulse,pulsus frequens, bounding pulse,haematemesis,fervescence,and cough.Moreover,the major medicinal materials are cortex moutan,radix bupleuri,Cape jasmine,hoelen,ginseng,radix astragali, atractylodes macrocephala,angelica,aurantii nobilis,paeoniae radix,and prepared rhizome of rehmannia.
Part three
The study of disease characteristic and medication rule of Gynecological diseases related with anger.
There are 311 Gynecological diseases cases related with anger which account 21.11%. And there are 51 cases femme tantrum constitution in all which account 23.72%in tantrum constitution.These indicate that femme is attack by anger and emerge tantrum constitution easily.The frequency of each Gynecological disease is menopathy 177 times,pregnancy disease 77 times,puerperal disease 73 times and fluor disease 14 times.It indicates that femme is attack by anger easier while during their menstrual period,gestation period and after parturition.
The major symptoms of Gynecological diseases cases related with anger are wiry pulse,alternate attack of chill and fever,pulsus frequens,emesis,anorexia,massive or incessant extramenstral vaginal bleeding,amenorrhea,fervescence,and hydrodipsia. Moreover,the major medicinal materials are rhizoma zingiberis recens,aurantii nobilis pericarpium,radix astragali,Cape jasmine,cortex moutan,hoelen,radix bupleuri,Cape jasmine,paeoniae radix,atractylodes macrocephala,radix bupleuri,licorice root,angelica and ginseng.All these medicinal materials are similar with the ingredient of compound recipe including Dan Zhi Xiao Yao powder,Xiao Chai Hu prescription and Liu Jun Zi prescription.
Conclusion
Part one
The findings indicate that the major effect of anger as etiopathogenisis,remote cause and constitution are to be harmful to hepar and liver controlling dispersion.These effects provoke depression of liver-QI and jpyretic generation,transverse invasion of hyperactiver liver-QI to offend spleen,splenic asthenia and QI- stagnant cause sputum form.Moreover, it could cause deficiency of liver-blood and liver loss storing blood.The primary treatments are to disperse the depression of liver-QI,smooth the activities of qi,invigorate vital energy and invigorate the spleen,and drying dampness to eliminate phlegm.And the primary medicinal materials are the ingredient of compound recipe including Dan Zhi Xiao Yao powder,Xiao Chai Hu prescription and Liu Jun Zi prescription.The treatment characteristics are dispersing the depressed liver-energy,nourishing the liver,regulating vital energy,dissipate phlegm,etc.
Part two
This study including 17 cases using anger as therapeutic tool analyze which application rule and mechanism of action.There are three major application rules as follow. First,the treatment according to restriction among five elements and apply emotion to treat emotional disease.For example,make use of anger prevailing over anxiety.Second,the treatment doesn't according to restriction among five elements and applies emotion to treat emotional disease.For example,make use of anger prevailing over happiness and worry. Third,make use anger as suscitate action to treat disease.The effective foundation of apply anger as therapeutic tool is depend on the anger's suscitate action.
Part three
This study analyzes different kinds of anger and its medication and compares their difference.The findings indicate that the major syndrome of both gloomy anger and exhaustion anger are asthenia syndrome.And the intense anger's major syndrome is asthenia syndrome caused by the inverse and disorder of activities of qi.The major characteristic of gloomy anger is cardiosplenic asthenia which basic on the liver meridian heat accumulation.Meanwhile,the major characteristic of exhaustion anger is damage of spleen-QI which caused by liver meridian heat accumulation,and display conspicuous yin asthenia generating intrinsic heat syndrome,especially asthenia of pulmonary yin.The medication characteristic of gloomy anger treatment is tranquilizing by nourishing the heart, and the intense anger one is descending qi and dissipating stagnant qi.Moreover,the exhaustion anger is applying eliminating heat by nourishing yin as its medication characteristic.
Part four
Anger is affecting Gynecological diseases easily.The characteristic of these diseases are to show up conspicuous yin asthenia generating intrinsic heat and hemopenia.This confirmed some traditional theory in TCM,such as nv zi yi gan wei xian tian and nv zi you yu qi,bu zu yu xue.The treatment is outstanding the thought of enrich the blood to nourish the blood and eliminating heat by nourishing yin.
Part five
The data mining methods,such as data association analysis and link chart,were applied to research the combination rule and medicine relationship of medical record which related with anger.The research content including the major symptoms and medicinal materials of gloomy anger,intense anger,and exhaustion anger and Gynecological diseases. This research found some basic prescriptions which accord with some classical prescriptions to high degree in such aspects as prescription,treatment methods and medicine selections.
一、研究目的
本研究就是对中医七情之“怒”古、近代医案运用数理统计方法和数据挖掘技术挖掘隐藏在大量医案中的中医七情之“怒”的证治规律。
二、研究方法
本研究以古、近代与怒相关医案为研究对象,以大型电子图书《中华医典》为基础,并根据《中国医籍考》的记载,补充一些《中华医典》中未收集的重要典籍如《名医类案》等,以“怒”及其同义近义词“恚”、“忿”、“愤”、“恼”、“易怒”、“性急”、“性躁”为检索词,在原案中的原始语句中查找收集与怒相关医案,采用Microsoftoffice excel 2003建立古、近代与怒相关医案数据库。对医案原文从症状、外治法、怒在医案中的作用(病因、诱因、体质、治疗手段)、中药等多个方面进行分析。
采用excel函数对数据库的字符变量进行了数字变量的转换,根据“有”、“无”分别赋值为“1”、“0”。采用SAS8.0软件编程进行频数分析、因子分析、典型相关分析、对应分析、关联规则分析、链接图分析。
三、研究结果
(一)与怒相关医案数据库总库的病症特点及用药规律
本研究共涉及古、近代134本医籍的1490条医案,其中将怒作为治疗手段的相关医案有17条(本研究主要是针对除去怒作为治疗手段的其余1473条医案进行研究)。
1、与怒相关医案中出现症状的数理分析及数据挖掘
医案中出现症状共计219个,症状出现频次总计6939种,而常见症状(使用频次在10以上)为53个,累计出现频次为4456次,占整个医案症状出现总频次(6939)的64.22%。
研究显示,与怒相关医案的核心症状为“弦脉、数脉、纳呆、呕吐”。
2、与怒相关医案药物使用情况的数理分析与数据挖掘
与怒相关医案共使用药物382味,药物使用频次为14691味次,其中使用频数在45次以上的有60味中药,累计使用频次为11812味次,占药物使用频次的80.40%,药物使用频次在5次以下(含5次)的药物共有176味,占使用中药数的46.07%,而使用频次为403味次,仅占药物使用频次的2.74%。
研究显示,与怒相关医案中使用的核心药物群为“生姜、山栀、人参、黄芪、甘草、当归、丹皮、陈皮、柴胡、白术、白芍、半夏、茯苓”,是丹栀逍遥散、小柴胡汤及六君子汤的合方。空间分布聚类分析研究显示,六味地黄汤是一类,归脾汤是一类,而香附或是川芎则与丹栀逍遥散常配合使用。
(二)古、近代不同怒型相关医案的病症及用药规律研究
在医案中明确提到郁怒的医案共169条,大怒(暴怒、盛怒、急怒)医案共137条,劳怒医案(病因中除怒外,还有过劳)212条。
1、郁怒医案的分析
研究显示,郁怒医案的核心症状是弦脉、数脉、纳呆、倦怠,核心药物为:丹皮、柴胡、山栀、茯神、茯苓、人参、甘草、白芍、生姜、龙眼肉、酸枣仁、远志、木香、黄芪、白术、当归。
2、大怒医案的分析
研究显示,大怒医案的核心症状为胁痛、胁胀、沉脉、细脉、弦脉、数脉,核心药物为:丹皮、柴胡、山栀、茯苓、人参、甘草、白芍、生姜、陈皮、半夏、白术、当归。
3、劳怒医案的分析
研究显示,劳怒医案的核心症状是弦脉、数脉、洪脉、吐血、发热、咳嗽,核心药物为:丹反、柴胡、山栀、茯苓、人参、黄芪、白术、当归、陈皮、白芍、熟地。
(三)与怒相关妇女经、带、胎、产医案的病症特点及用药规律研究
与怒相关妇女经、带、胎、产医案共311条,占整个研究医案库总例数的21.11%。充分说明妇女容易被怒干扰,其中妇女易怒体质为51条,占整个研究医案库中易怒体质医案(215条)的23.72%,说明易怒体质对于妇女经、带、胎、产的影响较大。分别从经、带、胎、产病来看,其频次分别为月经病177例次、妊娠病77例次、产后病73例次、带下病14例次。而这充分说明妇女在月经、妊娠及产后等特殊时期易为怒所影响。
研究显示,与怒相关妇科医案中主要症状群为“弦脉、寒热往来、数脉、呕吐、纳呆、崩漏、闭经、发热、口渴”,核心药物是“生姜、陈皮、黄芪、山栀、丹皮、茯苓、白芍、白术、柴胡、甘草、当归、人参”,类似于丹栀逍遥散、小柴胡汤、六君子汤的合方。
四、研究结论
(一)研究结果表明怒作为病因、诱因、体质对机体的影响主要表现在伤肝,影响肝主疏泄的功能,引起肝气郁而化火、肝气横逆犯脾、脾虚、气滞痰凝;也可影响到肝血,引起肝血不足、肝不藏血。其核心治疗方法为清肝解郁、和畅气机、补气健脾、燥湿化痰,核心药物为丹栀逍遥散、小柴胡汤和六君子汤的合方。在治疗特点上体现了疏肝、清肝、柔肝、养肝的治肝思想,同时体现了见肝之病当先实脾的治疗理念,从气血津液角度,治法特点主要是理气、和血、化痰。
(二)本研究收集到17条怒作为治疗手段的医案,分析了怒作为治疗手段的应用规律及作用机理。应用规律主要有三个方面:一是中医情志病治疗中的按照五行相克的以情胜情的治疗方法,即怒胜思;二是中医情志病治疗中的不按照五行相克的以情胜情的治疗方法,有怒胜喜、怒胜忧的方法;三是以怒的激发之力,祛除邪气;怒作为治疗手段其作用基础主要是依赖怒的激发之力。
(三)分析了医案中郁怒、大怒、劳怒(怒与过劳因素兼挟)等不同怒型的病症及用药规律,并比较了三者病症及用药方面的差异,研究结果表明:郁怒、劳怒主要以虚性病症为主,大怒主要以气机逆乱的实性病症多见,郁怒主要特点为肝经郁热基础上出现心脾两虚为主,而劳怒主要特点为肝经郁热基础上出现脾气虚损,并表现出较明显的阴虚内热,尤其是以肺阴虚表现突出。治疗上郁怒的用药特点表现为养心安神药物的使用明显,大怒的用药特点表现为下气、破气药物的使用明显,劳怒的用药特点以养阴清热,尤其是滋补肾阴的治疗较为突出。
(四)怒易影响妇女经、带、胎、产,在病症特点上阴虚内热症状突出,血虚特征突出,进一步证实中医传统理论中“女子以肝为先天”、女子“有余于气,不足于血”。在治疗上突出了补血养血、养阴清热的治疗思想。
(五)用数据关联分析与链接图等数据挖掘方法对与怒相关病案、郁怒、大怒、劳怒、妇女经、带、胎、产的医案等的核心症状、核心药物,以及症状的组合规律和药对进行分析研究,其挖掘出来的基本方与一些经方在立法处方选药上均有着较高的吻合度。
The emotion is the master reaction of a person's life,moreover negativity emotion could cause depression and induce many kinds of physically and mentally diseases.Anger as one of the seven modes of emotions of traditional Chinese medicine(TCM)is experienced most by human being.Modern time research reported that the emotional syndrome patterns caused by anger are far more than other emotion factors.The medicine records of TCM is a script record when practitioner of Chinese medicine practicing determination of treatment based in pathogenesis obtained through differentiation of symptoms and signs.It is an archive to preserve and investigate,as well as to research the specific proceeding of diagnosis and treatment.There is plentiful information in the medicine records,which including copious theory of medicine,massive medical treatment experience,method of differentiation of symptoms and signs,to prescribe and medication, successful experience and failure lessons.It is possessing readability and practicality.Thus, the research of ancient medical record has vital value for inheritance TCM.To research the medicine records of TCM serious is good for learning the academic and thought of TCM, and to improve the clinical curative effect of TCM and to bring new ideas for TCM theory. With the development of science technology,make use of multi-subjects to develop TCM has been one of directions of the TCM development,as well as the research area of medicine records of TCM.With the statistical technique and computer technology,etc, were introduced into medical domain unceasing,make use of mathematical statistics method and data mining technology to establish correlate database of medicine records of TCM.Making use of the preponderance of database mining and analysis to avoid individual and anthropogenic disparity through mass data analysis and discover the most literal and value constituent of the medicine records in TCM scientifically and quantitatively.
Objective
The research aimed at mining of the rule of syndrome and treatment of anger in seven modes of emotions of TCM which concealed from the medicine records of TCM in ancient times and modern times through apply mathematical statistics method and data mining technology.
Methods
The research object is the medicine records of TCM in ancient times and modem times which related with anger.By using the Zhong Hua Yi Dian as the elementary reference,and according with record of Zhong Guo Yi Ji Kao to supplement some reference which didn't assemble in the Zhong Hua Yi Dian.Using all kinds of keywords which related with anger as docuterm to search and collect the medicine records of TCM.Apply Microsoft office excel 2003 software to establish the medicine records database which related with anger in ancient times and modern times.
Results
Part one
The disease characteristic and medication rule of medical record in the total database which related with anger.
This study refer to 1490 medical records in 134 medical books,which including 17 medical records to take anger as therapeutic tool.The major research aspect of this study is all this medical records except for those 17 items.
Firstly,to handle the symptom in medical records that related with anger by using mathematics analysis and data mining.There are 219 symptoms in all in the medical record, which occurrence 6939 times all together.Moreover,there are 53 common symptoms, which occurrence more than 10 times,occurrence 4456 times accumulative total.The percentage of common symptoms is 64.22%.The major symptoms in the medical record that related with anger are wiry pulse,frequent pulse,anorexia and emesis.
Secondly,to handle the medication in medical records that related with anger by using mathematics analysis and data mining.
There are 382 species Chinese medicinal materials were applied in the medical records related with anger.All of these medicines were applied 14691 in all.Moreover, there are 60 kinds' medicines were applied more than 45 times,and were applied 11812 times accumulative total which account 80.40%of the medicines usage.Meanwhile,there are 176 kinds' medicines were applied less than 5 times which account 46.07%of all medicinal materials.These 176 kinds' medicines were applied 403 times accumulative total which account 2.74%of the medicines usage.
The major medicinal materials in the medical record that related with anger are rhizoma zingiberis recens,Cape jasmine,ginseng,radix astragali,licorice root,angelica, cortex moutan,aurantii nobilis pericarpium,radix bupleuri,atractylodes macrocephala, paeoniae radix,pinelliae tuber and hoelen.All of these medicines could constitute the compound recipe including Dan Zhi Xiao Yao powder,Xiao Chai Hu prescription and Liu Jun Zi prescription.To think the spatial distribution cluster,there are two kinds compound recipes including Rehmanniae Decoction of Six Ingredients and Decoction for Invigorating the Spleen.However,nutgrass galingale rhizome or szechwan lovage rhizome together with Dan Zhi Xiao Yao powder as common use.
Part two
The study of difference kinds of anger and its medication rule research of medical record in ancient times and modern times.There are 169 cases gloomy anger,137 cases intense anger and 212 cases exhaustion anger were clear-cut recorded in medical records.
Firstly,the analyses of gloomy anger cases.The major symptoms of gloomy anger cases are wiry pulse,frequent pulse,anorexia lassitude.Moreover,the major medicinal materials are cortex moutan,radix bupleuri,Cape jasmine,Indian bread with hostwood, hoelen,ginseng,licorice root,paeoniae radix,rhizoma zingiberis recens,arillus longan, jujube seed,Polygala,costustroot,radix astragali,atractylodes macrocephala and angelica. Secondly,the analyses of intense anger cases.
The major symptoms of intense anger cases are flank painful and distend sunken pulse,small pulse,wiry pulse,and pulsus frequens.Moreover,the major medicinal materials are cortex moutan,radix bupleuri,Cape jasmine,hoelen,ginseng,licorice root, paeoniae radix,rhizoma zingiberis recens,aurantii nobilis pericarpium,pinelliae tuber, atractylodes macrocephala,and angelica.
Thirdly,the analyses of exhaustion anger cases.
The major symptoms of exhaustion anger cases are wiry pulse,pulsus frequens, bounding pulse,haematemesis,fervescence,and cough.Moreover,the major medicinal materials are cortex moutan,radix bupleuri,Cape jasmine,hoelen,ginseng,radix astragali, atractylodes macrocephala,angelica,aurantii nobilis,paeoniae radix,and prepared rhizome of rehmannia.
Part three
The study of disease characteristic and medication rule of Gynecological diseases related with anger.
There are 311 Gynecological diseases cases related with anger which account 21.11%. And there are 51 cases femme tantrum constitution in all which account 23.72%in tantrum constitution.These indicate that femme is attack by anger and emerge tantrum constitution easily.The frequency of each Gynecological disease is menopathy 177 times,pregnancy disease 77 times,puerperal disease 73 times and fluor disease 14 times.It indicates that femme is attack by anger easier while during their menstrual period,gestation period and after parturition.
The major symptoms of Gynecological diseases cases related with anger are wiry pulse,alternate attack of chill and fever,pulsus frequens,emesis,anorexia,massive or incessant extramenstral vaginal bleeding,amenorrhea,fervescence,and hydrodipsia. Moreover,the major medicinal materials are rhizoma zingiberis recens,aurantii nobilis pericarpium,radix astragali,Cape jasmine,cortex moutan,hoelen,radix bupleuri,Cape jasmine,paeoniae radix,atractylodes macrocephala,radix bupleuri,licorice root,angelica and ginseng.All these medicinal materials are similar with the ingredient of compound recipe including Dan Zhi Xiao Yao powder,Xiao Chai Hu prescription and Liu Jun Zi prescription.
Conclusion
Part one
The findings indicate that the major effect of anger as etiopathogenisis,remote cause and constitution are to be harmful to hepar and liver controlling dispersion.These effects provoke depression of liver-QI and jpyretic generation,transverse invasion of hyperactiver liver-QI to offend spleen,splenic asthenia and QI- stagnant cause sputum form.Moreover, it could cause deficiency of liver-blood and liver loss storing blood.The primary treatments are to disperse the depression of liver-QI,smooth the activities of qi,invigorate vital energy and invigorate the spleen,and drying dampness to eliminate phlegm.And the primary medicinal materials are the ingredient of compound recipe including Dan Zhi Xiao Yao powder,Xiao Chai Hu prescription and Liu Jun Zi prescription.The treatment characteristics are dispersing the depressed liver-energy,nourishing the liver,regulating vital energy,dissipate phlegm,etc.
Part two
This study including 17 cases using anger as therapeutic tool analyze which application rule and mechanism of action.There are three major application rules as follow. First,the treatment according to restriction among five elements and apply emotion to treat emotional disease.For example,make use of anger prevailing over anxiety.Second,the treatment doesn't according to restriction among five elements and applies emotion to treat emotional disease.For example,make use of anger prevailing over happiness and worry. Third,make use anger as suscitate action to treat disease.The effective foundation of apply anger as therapeutic tool is depend on the anger's suscitate action.
Part three
This study analyzes different kinds of anger and its medication and compares their difference.The findings indicate that the major syndrome of both gloomy anger and exhaustion anger are asthenia syndrome.And the intense anger's major syndrome is asthenia syndrome caused by the inverse and disorder of activities of qi.The major characteristic of gloomy anger is cardiosplenic asthenia which basic on the liver meridian heat accumulation.Meanwhile,the major characteristic of exhaustion anger is damage of spleen-QI which caused by liver meridian heat accumulation,and display conspicuous yin asthenia generating intrinsic heat syndrome,especially asthenia of pulmonary yin.The medication characteristic of gloomy anger treatment is tranquilizing by nourishing the heart, and the intense anger one is descending qi and dissipating stagnant qi.Moreover,the exhaustion anger is applying eliminating heat by nourishing yin as its medication characteristic.
Part four
Anger is affecting Gynecological diseases easily.The characteristic of these diseases are to show up conspicuous yin asthenia generating intrinsic heat and hemopenia.This confirmed some traditional theory in TCM,such as nv zi yi gan wei xian tian and nv zi you yu qi,bu zu yu xue.The treatment is outstanding the thought of enrich the blood to nourish the blood and eliminating heat by nourishing yin.
Part five
The data mining methods,such as data association analysis and link chart,were applied to research the combination rule and medicine relationship of medical record which related with anger.The research content including the major symptoms and medicinal materials of gloomy anger,intense anger,and exhaustion anger and Gynecological diseases. This research found some basic prescriptions which accord with some classical prescriptions to high degree in such aspects as prescription,treatment methods and medicine selections.
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