《名医类案》《续名医类案》从肾论治医案系统研究
|
摘要
目的：对《名医类案》《续名医类案》两部医案类书中从肾论治医案进行筛查整理,运用文献计量学、分类学、统计学、诠释学等研究方法及数据挖掘技术,对该类医案的病名、证名、体质、病因、病机、症状、治则、治法、方剂、中药、针灸、调护等内容分类系统研究,提炼出从肾论治的关联性、规律性知识,指导临床实践。探讨古代医家从肾论治临证思路,分析其对肾生理功能和病理特性的认识,丰富肾藏象理论内容,进而对揭示“肾藏精”的科学内涵提供古文献借鉴。
材料与方法：本研究以1957年人民卫生出版社出版发行的《名医类案》知不足斋影印本为底本,参照1996年中国中医药出版社出版的以潘桂娟、侯亚芬为主校的《名医类案》正续编,采用Microsoft office excel2003,将《名医类案》所载医案逐条录入,建立数据库。《续名医类案》以湖南电子音像出版社出版的大型电子图书《中华医典》升级版所收录该书内容为基础数据源,并以1957年人民卫生出版社出版发行的《续名医类案》信述堂重刊本(1885年)的影印本为底本进行校对,建立数据库。
1.《名医类案》《续名医类案》从肾论治医案筛查方法
1.1医案纳入标准(1)医案所载内容在病名、证名、体质、病因、病机、症状、治则、治法、方药、针灸、调护中的一项或多项与肾关系密切。(2)虽不是具体个案,但是医家就某一问题的医理探讨、治验心得,其内容与肾相关
1.2医案排除标准
(1)医案所载内容虽然提到肾,但实则与肾无关,更不是从肾论治。
(2)医案著录内容冗长,医家在疾病不同阶段所采用治法灵活多变,从肾论治篇幅甚少混杂其中,无法准确把握。
按以上标准运用数据库的检索功能,分别输入检索词“肾”、“命门”、“命火”“少阴”、“藏精”,在《名医类案》数据库中共检索出医案195例,对其进行人工校对,排除14例,形成从肾论治纳入医案181例。在《续名医类案》基础数据源中共检索出医案595例,对其人工校对后排除255例,形成从肾论治纳入医案340例,两部医著共计纳入医案521例(其中包括部分医家就某一问题的医理阐述)。
2.数据库的建立及记录的录入
采用Microsoft office excel2003建立《名医类案》《续名医类案》从肾论治521例医案数据库,数据库变量名分别是病名、证名、体质、病因、病机、症状、治则、治法、方剂、中药、针灸、调护,将521例医案逐条录入后进行核对。
3.数据挖掘
在建好数据库的基础上进行数据挖掘,此部分工作由沈阳航空航天大学知识工程研究中心协助完成。
4.数据标准化处理
参考《中华人民共和国国家标准——中医临床诊疗术语》、《中医方剂大辞典》《中草药异名辞典》、《中医证病名大辞典》、《中医内科学》、《中医外科学》、《中医妇科学》、《中医儿科学》、《中医五官科学》、《中医体质学》等相关内容,对数据库各变量内容进行标准化处理,统一使用规范名称,统计结果以规范名称表述。(无相应规范名称者除外)
5.结果表述,提炼结论
通过对《名医类案》《续名医类案》从肾论治医案的全面系统整理,运用数据挖掘等方法揭示医案中蕴含的潜在信息,产生各变量的相应统计结果及其结果间的置信度分析,分析结果,诠释含义,提炼结论。
结果：
1.病名统计结果
《名医类案》《续名医类案》从肾论治医案见于163种病名之中,内科疾病医案359例,外科疾病医案80例,妇科疾病医案16例,儿科疾病医案20例,五官科疾病医案46例。从肾论治医案数10例(包括10例)以上疾病名称如下：疮疡类疾病(例数32,简略为32,下同)、泄泻(24)、虚劳(23)、咳嗽(17)、遗精(16)、水肿(15)、内伤发热(15)、腰痛(14)、淋证(14)、消渴(13)、血证(13)、儿科疾病(13)、咽喉科疾病(13)、口腔科疾病(12)、喘证(11)、足癣(11)、癃闭(10)、痹证(10)、中风(10)、痿证(10)。
2.证名统计结果
《名医类案》《续名医类案》从肾论治医案载有证名医案46例,出现证名23种,其名称及其医案数如下：肾气虚(例数9,简略为9,下同)、肾阴虚(4)、肾阳虚(3)热症(3)、脾气虚(3)、阴虚阳亢(3)、脾肾两虚(2)、脾肾阳虚(2)、阴盛阳虚(2)、胃气虚(2)、少阴病(1)、少阳阳明症(1)、气脱(1)、脾气郁结(1)、肾精亏虚(1)、肝阴虚(1)、肝火犯胃(1)、心肾气虚(1)、气血两虚(1)、火证(1)、湿症(1)、足二阴虚寒症(1)、足三阴虚寒症(1)。
3.体质统计结果
《名医类案》《续名医类案》从肾论治医案载有体质内容的有33例,占全部医案的6.33%。体质划分及频次结果如下：以阴阳分类法划分,阳旺阴虚质(5)；以体态分类法(按五色分)划分,面白(2),面黑(1)；以体态分类法(按肥瘦分)划分,肥胖魁伟(13),消瘦(3)；以脏腑分类法(按脏腑机能分)划分,肾虚质(2)；以气血津液分类法划分,气虚质(7)。
4.病因统计结果
《名医类案》《续名医类案》从肾论治医案521例,其中156例医案明确了致病因素,主要病因集中在房劳(43)、情志内伤(30)、饮食不节(27)、烦劳(25)、外感六淫(18)、失治误治(11)、年老体衰(2)等。情志内伤中因怒致病14例,因惊恐致病6例,悲、思致病各5例。外感六淫中感受风邪2例,寒邪9例,风寒5例,暑邪2例。
5.病机统计结果
《名医类案》《续名医类案》从肾论治医案所记述病机是以肾的藏象理论为基础,以脏腑病机为重点的内容体系。该类医案体现病机13项,见于334例医案之中,具体病机分类及医案数如下：肾阴虚(88)、肾气虚(55)、肝肾关系失调(38)、脾肾关系失调(36)、肾阳虚(30)、心肾关系失调(19)、与肾相关形体官窍病机(17)、肾经络病机(13)、肺肾关系失调(11)、肾胃关系失调(8)、肾精亏损(8)、肾外感实证(6)、肾膀胱关系失调(5)。
6.症状统计结果
《名医类案》《续名医类案》从肾论治医案出现的症状以不可拆分症状要素统计达1500多种,包括内科、外科、儿科、妇科、五官科等各科疾病症状,其中《名医类案》从肾论治医案症状表述600多种,《续名医类案》从肾论治医案症状表述1100多种。《名医类案》《续名医类案》从肾论治医案出现症状按频次由高到低排序,位于前20位症状如下：食少(75)、口渴(54)、多痰(48)、小便涩滞(42)、发热(42)咳嗽(40)、遗精(38)、泄泻(36)、消瘦(33)、便秘(32)、腹胀(27)、倦怠(27)、自汗(25)、腰痛(24)、小便淋痛(23)、头晕(22)、胸满(20)、小便短少(19)、口干(18)、足膝痿弱(17)。
7.治则统计结果
《名医类案》《续名医类案》从肾论治医案可归纳出治则15项,见于126例医案中,治则内容及医案数如下：扶正固本(52)、虚则补之(37)、缓则治本(15)、标本兼治(11)、因人制宜(9)、扶正祛邪(6)、先补后攻(6)、调理阴阳(5)、急则治标(3)、寓补于攻(2)、攻补兼施(2)、祛邪扶正(2)、先攻后补(1)、因时制宜(1)、寒因寒用(1)。
8.治法统计结果
《名医类案》从肾论治医案出现治法52种,共计103次；《续名医类案》从肾论治医案出现治法17种,共计26次。《名医类案》《续名医类案》从肾论治医案合计出现治法58种,129次,按出现频次由高到低排序,位列前10位的治法如下：滋补肾阴(21)、补益肾气(7)、补脾益气(6)、温补脾胃(6)、补脾益肺(5)、养血清肝(5)、滋补心肾(4)、补血养肝(4)、滋补肝肾(4)、清热解毒(4)。
9.方剂统计结果
《名医类案》从肾论治医案使用方剂92条,310次；《续名医类案》从肾论治医案使用方剂127条,426次；两部医著合计在从肾论治医案中使用方剂189条,736次。《名医类案》从肾论治医案使用方剂频次出现5次以上的有：六味地黄丸(57)、金匮肾气丸(48)、补中益气汤(43)、滋肾丸(11)、四物汤(11)、十全大补汤(10)、六君子汤(8)、八珍汤(5)、二陈汤(5)、小柴胡汤(5)。《续名医类案》从肾论治医案使用方剂频次出现5次以上的有：六味地黄丸(87)、金匮肾气丸(79)、补中益气汤(53)、六君子汤(11)、十全大补汤(8)、八珍汤(7)、附子理中汤(7)、四物汤(6)、滋肾丸(6)、地黄饮子(5)。两部医著合计在从肾论治医案中使用方剂频次前十位的有：六味地黄丸(144)、金匮肾气丸(127)、补中益气汤(96)、六君子汤(19)、十全大补汤(18)、滋肾丸(17)、四物汤(17)、八珍汤(12)、四神丸(8)、附子理中汤(8)。
10.中药统计结果
中药频次的统计是遵照原著记录格式进行的,如原著中有医家的完整药物处方,则每一位药物频次均参与计算,若原著中记录格式为方剂名+药物,则只有所加药物参与了使用频次统计,并未拆方统计(因年代久远,有些方剂无法准确拆分),因此统计结果能够大体上反映古代医家从肾论治用药习惯。《名医类案》中从肾论治医案出现中药136味,共计489次,按使用频次由高到低排列前10位的中药是：黄柏(27)、五味子(26)、甘草(25)、麦冬(25)、白术(17)、知母(15)、茯苓(15)、黄连(13)、人参(12)、当归(12)、陈皮(12)。《续名医类案》中从肾论治医案出现中药164味,共计742次,按使用频次由高到低排列前10位的中药是：五味子(54)、人参(35)、麦冬(33)、茯苓(21)、肉桂(20)、甘草(19)、枸杞子(19)、熟地(18)、山药(17)、附子(17)、牛膝(17)。两部医著合计在从肾论治医案中使用中药206味,1231次,按使用频次由高到低顺序排列前20位中药使用率占所有中药使用率的49.39%,具体中药及使用频次如下：五味子(80)、麦冬(58)、人参(47)、甘草(44)、黄柏(39)、茯苓(36)、白术(28)、附子(26)、知母(26)、牛膝(24)、肉桂(24)、当归(23)、枸杞子(23)、山药(22)、熟地(21)、黄连(19)、生地(19)、陈皮(17)、栀子(17)、白芍(15)。对使用中药聚类统计后发现补虚药、清热药、收涩药、利水渗湿药四类中药使用率占所有中药使用率的四分之三还要多。
11.针灸统计结果
《名医类案》《续名医类案》从肾论治医案使用刺灸法主要包括针刺、艾灸、穴位贴敷、刺络放血、刮痧等。使用腧穴23个,共计46次,使用2次以上的腧穴有：肾俞(8)、关元(6)、照海(4)、足三里(3)、丰隆(3)、中脘(3)、阳陵泉(2)太溪(2)。
12.调护统计结果
《名医类案》《续名医类案》从肾论治医案中所包含的调护方法主要有饮食调护、精神调护、起居调护、房事调护、药物调护、按摩调护等方面,其内容散见于83条病案之中。
13.置信度分析
高频次使用中药置信度分析
五味子、麦冬、人参为使用频次位于前三位的中药,通过数据挖掘以置信度为表述形式显示其结果如下：以五味子为研究对象,与其配伍按置信度由高到低排列前三位的是麦冬(52.5%)、人参(20.0%)、牛膝(18.7%)；以麦冬为研究对象,与其配伍按置信度由高到低排列前三位的是五味子(68.9%)、黄柏(31.0%)、人参(27.5%)；以人参为研究对象,与其配伍按置信度由高到低排列前三位的是甘草(40.4%)、麦冬(36.1%)、五味子(34.0%)。高频次使用方剂加入中药置信度分析
高频次使用方剂排列前三位的是六味地黄丸、金匮肾气丸、补中益气汤,其最常加入中药通过数据挖掘以置信度为表达形式时显示如下：以六味地黄丸为研究对象,最常加入此方中药按置信度由高到低排列前三位的是五味子(100%)、麦冬(66.6%)、黄柏(46.6%)；以金匮肾气丸为研究对象,最常加入此方中药按置信度由高到低排列前三位的是麦冬(100%)、五味子(95.8%)、人参(41.6%)；以补中益气汤为研究对象,最常加入此方中药按置信度由高到低排列前三位的是五味子(100%)、麦冬(69.2%)知母(34.6%)。
结论：
1.从肾论治是古代医家临证时最为重要的治疗方法,以此为指导,涉及多学科、多系统、多器官疾病诊治,具有重要的临床应用价值。
2.《名医类案》《续名医类案》从肾论治医案的病因以内伤因素为主,包括病因种类较多,古今在病因认识上存有一定差异；病机阐释以《内经》为根基,蕴藏着丰富的古代文化知识,古代医家对肾气虚的重视及对肾气宜缓缓生发的深刻认识丰富了肾藏象理论的内涵。
3.《名医类案》《续名医类案》从肾论治医案出现的高频次症状与肾关系密切,能够体现从肾论治医案辨证要素的特点；《名医类案》与《续名医类案》从肾论治医案高频次症状之间没有显著性差异；《名医类案》《续名医类案》从肾论治医案医家更重视脉诊而忽略舌诊,在一定程度上表明从肾论治时脉象比舌象更重要；小便异常是决定从肾论治的第一要素。
4.以《名医类案》《续名医类案》从肾论治医案为代表的古医案中没有具体的治则表述,进一步验证了治则概念出现晚,抽象性高的特点。《名医类案》从肾论治医案治法表达详于《续名医类案》,与肾相关治法在医案中体现种类不多,滋补肾阴治法适应病证广,应用频率高,得到古代医家高度重视。
5.《名医类案》与《续名医类案》从肾论治医案处方特点没有显著差别,古代医家补肾同时重视培补脾胃思想在处方中得到鲜明体现。《名医类案》《续名医类案》从肾论治医案使用药物品种繁多,炮制方法丰富,用药集中度偏低,五味子、麦冬、人参等中药的高频次使用为补肾赋予了较深的寓意。
6.《名医类案》《续名医类案》从肾论治医案针灸应用不多,治疗选穴少而精,疗效显著,所用腧穴以足少阴肾经、足阳明胃经、任脉为主,温补脾肾思想在腧穴应用中得到体现。
7.《名医类案》《续名医类案》从肾论治医案所蕴含的调护方法与内容普遍适用性较强,与肾藏象特点结合的特异性较差,调护内容包含范围小,阐释深度不足。
8.《名医类案》从肾论治医案中医家的补肾重脾思想得到集中体现,《续名医类案》从肾论治医案中医家善于滋补肝肾思想得到较多表达,这与两部医著的作者学术主张实现了某种契合,两部医著作者在选案中的倾向性对从肾论治医案的研究结果具有一定影响。
Purpose:All the medical cases about'treating diseases by regulating kidney function'in the two famous work Classified Case Records of Celebrated Physicians and Continued Classified Case Records of Celebrated Physicians was screened(or searched) out and taken to classification systemic research in all the aspects, like disease name, syndrome, body constitution, etiopathogenisis, pathogenesis, symptom, therapeutic principal, treatment, prescription, herbs, acupuncture therapy, nursing, etc al, by using the technique in literal metrology, systematics, statics, annotation and data mining. In this way, to approach the ancient physicians'comprehension and opinion to'kidney'and what role it plays in either physiology or pathology, which will further reveal and support the concept of'kidney stores essence'.
Material and method:For Classified Case Records of Celebrated Physicians, we picked the publication, printed in1982by People Sanitation Publisher, and also compared with the corrected Classified Case Records of Celebrated Physicians, edited by Pan Guijuan and Hou Yafen, printed by National Chinese Medicine Publisher in1996. Furthermore, we typed in all the records and build up the data bank. For Continued Classified Case Records of Celebrated Physicians, we picked China Medical Classic, produced by Hunan Electric Audiovisual Publisher, as the origin information source. It has been proofread and set up databases based on the photocopy version of Continued Classified Case Records of Celebrated Physicians which was released by peoples health press in1957.
1. How to exactly search out the records concerning'treating disease by regulating kidney function'in the two work?
1.1Conditions for'to be involved'
A. Closely related to'kidney'in at least one item of following:disease name, syndrome name, body quality, pathogen, mechanism, symptom, therapeutic principle, treatment, prescription, acupuncture and nursing.
B. Even not a complete medical case, but the content is closely related to'kidney'no matter a conclusion or discussion proposed by physicians.
1.2Conditions of'to be picked out'
A. The content is not related to kidney or'treating diseases by regulating kidney function', though mentioned of word of'kidney'.
B. Cases which changes a lot in different stages of disease development, that makes it too long and complicated to figure out its exact meaning or little related to'treating diseases by regulating kidney function'.
We used the key words,'kidney','MINGMEN','MINGHUO','SHAOYIN'and 'storing essence', to thoroughly search the data bank of the two works. In Classified Case Records of Celebrated Physicians,195cases were involved automatically, but14cases were picked out after artificial checking. The consequence of Continued Classified Case Records of Celebrated Physicians is255out of595cases. Finally, there were521cases were involved in total, including discussion and conclusion.
2. Typing in the records and building up the data bank
We typed in all the information of the521involved cases into an excel document to build up a data bank, and variates were listed as follow disease name, syndrome, body constitution, etiopathogenisis, pathogenesis, symptom, therapeutic principal, treatment, prescription, herbs, acupuncture therapy, nursing.
3. Data mining
Data mining was based on the above data bank and was executed by Knowledge Engineering Research Center of Shenyang Aerospace University.4. Control of data standard
All the terms used in our research were according to China government standard term in clinic diagnosis and treatment of TCM, Dictionary of TCMprescription, Synonym dictionary of Chinese herb, Dictionary of TCM syndrome name, Internal medicine of TCM, Surgery of TCM, Gynecology of TCM, pediatrics of TCM, etc. al.
5. Presenting results and conclusion
After overall and systemically organizing and collecting the items in the2works, we further took data mining technique to extract more information hidden in the context and concluded more by analysis in confidence level.
Results:
1. disease name
After thoroughly searching Classified Case Records of Celebrated Physicians and Continued Classified Case Records of Celebrated Physicians, we got163diseases name referring'treating diseases by regulating kidney function', referred in359internal medicine cases,80surgical cases,16gynecological cases,20pediatrics cases, and46cases in nose-ear-throat diseases. The disease names appears in the tow works over10times(including10)are listed as following, pyocutaneous disease(32), diarrhea(24), fatigue(23), coughing(17), spermatorrhoea(16), dropsy(15), fever cause by internal damage(15), low back pain(14), difficulty in micturition (14), diabetes (13), hemorrhagic disease(13)、pediatrics(13), throat disease (13), stomatology disease (12), dyspnea(11), dyspnea(11), uroschesis(10), arthromyodynia(10), stroke(10) and paralysis(10).
2. Syndrome name
23kinds of syndrome and46cases of treatment were searched out in the tow works and listed as following, kidney qi deficiency(9cases, abbreviated as9,the above are same), kidney yin deficiency (4),kidney yang deficiency (3),heat syndrome (3), spleen qi deficiency(3), yin deficiency due to exuberant yang (3),deficiency of both spleen and kidney(2),spleen-yang and kidney-yang deficiency(2),yang deficiency due to exuberant yin(2),stomach-qi deficiency(2), disorders of shao-yin meridian(1),overlap of diseases of shao-yang and yang-ming meridians(1),qi collapse(1),accumulation of spleen qi(1),shortage and deficiency of kidney essence(1),liver-yin deficiency(l),liver-fire invading stomach(1),deficiency of heart-qi and kidney-qi(1),deficiency of both qi and blood(1), fire syndrome(1),dampness syndrome(1), deficiency cold syndrome of foot jue-yin(1),deficiency cold syndrome of foot shao-yin.
3. body constitution
We found body constitution mentioned in33cases referring'treating disease by regulating kidney function', occupying6.33%in all. If classified by yin-yang,5cases described the kind of excessive yang and yin deficiency. If classified by five color, results showed whitish complexion(2), blackish complexion(1). If classified by body carriage, results showed as corpulency(13), emaciation(3). Counted by organ classification,2cases referring to type of kidney deficiency and7cases referring the type of qi deficiency, classified in qi-blood and body fluid.
4. etiopathogenisis
The etiopathogenisis, recorded in the521cases involved, among which156cases recorded clearly identified, were listed as following, excessive sexual intercourses(43),emotional damage(30),eating and drinking without temperance(27),physical strain(25), six exogenous factors(18), unfit treatment(11)and degeneration(2).among the emotional damage cases, there were14cases related to eager,6cases related to panic,5cases sadness and5cases anxiety. Result of six exogenous factors is2for wind,9for coldness,5for wind-coldness, and2for pathogenic summer-heat.
5. Pathogenesis
13kinds of pathogenesis were collected from334cases in the tow works, and which listed as following, deficiency of kidney yin(88), deficiency of kidney qi(55), disharmony between liver and kidney(38), disharmony between spleen and kidney(36), deficiency of kidney yang(30), disharmony between heart and kidney(19), structures or sencing organ relating to kidney(17), kidney meridian(13), disharmony between kidney and lung(11), disharmony between kidney and stomach(8), damage of kidney essence(8), exogenous-factor-caused sthenia syndrome in kidney(6) and dis harmony between kidney and bladder(5).
6. symptom
Looking up all the involved cases of the2works, over1500kinds of symptoms were calculated out, spreading in all kinds of disease. Calculated separately, that was600kinds of symptoms in Classified Case Records of Celebrated Physicians and1100in Continued Classified Case Records of Celebrated Physicians. Ranked by the frequency, the top20were poor appetite(75), thirsty(54), excessive phlegm(48), difficult urination(42), fever (42), coughing(40), emissions(38), diarrhea (36), emaciation(33), constipation(32), abdominal distension(27), lassitude(27), spontaneous perspiration(25), low back pain(24), odynuria(23), dizziness(22), chest distress(20), oliguresis(19), dry mouth(18) and leg debility(17).
7. therapeutical principle
15items of therapeutic principle were collected in126cases. The content and its frequency were listed as following, support healthy energy(52), asthenia requiring tonification(37), treating chronic disease aiming at the principal aspect(15), simultaneous treatment of principal and subordinate symptoms(11), individual concerned therapy(9), strengthening healthy qi to eliminate pathogens(6), tonifiction preceding purgation(6), regulating yin and yang(5), treating secondary symptoms for emergency(3), tonification involving purgation(2), simultaneous application of purging-tonifying therapy(2), eliminating pathogen to support vital qi(2), purgation preceding tonification(1), climate concerned therapy(1) and cold prescription for pseudofrigid pyrexia(l).
8. treatment
52kinds of treatments were quoted103times in total in Classified Case Records of Celebrated Physicians, and the result in Comtinued Classified Case Records of Celebrated Physicians was17kinds, quoted26times. Ranking in the quoting frequency, the top10was moisturizing kidney yin(21), tonifying kidney qi(7), promoting spleen qi(6), warming and benefiting spleen and stomach(6), benefiting spleen and lung(5), raising blood and clarifying liver(5), moisturizing heart and kidney(4), promoting blood to raise liver(4), tonifying liver and kidney(4) and cooling heat and purifying toxin(4).
9. prescription
92prescriptions were quoted310times in Classified Case Records of Celebrated Physicians, and the prescriptions quoted over5times were listed as following, sexa-Rehmaniae Bolus(57), Kidney-qi Pill (48), Decoction for Strengthening the middle warmer (43), Pill for nourishing kidney (11), Decoction of Four Drugs (11), All Nourishing Decoction (10), Decoction of sexa-gentleman (8), Decoction of Eight Ingredients (5), Double Chen Decoction(5), Bupleurum tenue Buch Decoction (5).127prescription were quoted426times in Comtinued Classified Case Records of Celebrated Physicians, and the prescriptions quoted over5times were listed as sexa-Rehmaniae Bolus (87), Kidney-qi Pill (79), Decoction for Strengthening the middle warmer (53), Decoction of sexa-gentleman (11), All Nourishing Decoction (8), Decoction of Eight Ingredients (7), aconite root-plus decoction for regulating middle Jiao(7), Decoction of Four Drugs (6), Pill for nourishing kidney (6), Rehmanniae Potion (5). Calculated together,189prescriptions were quoted736times, and top10was sexa-Rehmaniae Bolus (144), Kidney-qi Pill (127), Decoction for Strengthening the middle warmer (96), Decoction of sexa-gentleman (19), All Nourishing Decoction (18), Pill for nourishing kidney (17), Decoction of Four Drugs (17), Decoction of Eight Ingredients (12), Pill of Four Miraculous Drugs (8), aconite root-plus decoction for regulating middle Jiao (8).
10. Herbs
The calculation of herbs was according to the exact origin records in the books. As to the records like prescription plus herbs, only herbs plus were counted in, because some prescription was too old to check out the exact components. In Classified Case Records of Celebrated Physicians,136kinds of herbs were found quoted489times, and the top10were Cortex Phellodendri(27), Fructus Schisandrae(26), Radix Glycytthizae(25), Raidix Ophiopogonis(25), Rhizoma Atractylodis Macrocephalae(17), Rhizoma Anemarrhenae(15), Poria(15), Rhizoma Coptidis(13), Radix Ginseng(12), Radix Angelicae Sinensis(12) and Pericarpium Citri Reticulatae(12). In Comtinued Classified Case Records of Celebrated Physicians,164kinds of herbs were found quoted742times, and the top10herbs, ranked by frequency, were listed as Fructus Schisandrae(54), Radix Ginseng(35), Raidix Ophiopogonis(33), Poria(21), Cortex Cinnamomi(20), Radix Glycytthizae(19), Fructus Lycii(19), prepared rhizome of rehmannia(18),Rhizoma Dioscoreae(17),Radix Aconiti Lateralis Preparata(17)and Radix Acanthopanacis Bidentatae(17).Calculated together,206kinds of herbs were used1231time in total, and the top20kinds of herbs occupying49.39%in using frequency. The herbs'names and the frequency were listed a s following, Fructus Schisandrae(80), Raidix Ophiopogonis(58), Radix Ginseng(47), Radix Glycytthizae(44), Cortex Phellodendri(39), Poria(36), Rhizoma Atractylodis Macrocephalae(28), Radix Aconiti Lateralis Preparata(26), Rhizoma Anemarrhenae(26), Radix Acanthopanacis Bidentatae(24), Cortex Cinnamomi(24), Radix Angelicae Sinensis(23),Fructus Lycii(23), Rhizoma Dioscoreae(22), prepared rhizome of rehmannia(21), Rhizoma Coptidis(19), rehmannia dride rhizome(19), Pericarpium Citri Reticulatae(17), Fructus Gardeniae(17) and Raidix Paeoniae Alba(15). After clustering statistics, we found over3quarters of the herbs belong to tonifying, heat-clearing, concentrating or diuretics for eliminating dampness drugs.
11. Acupuncture points
All of acupuncture, moxibustion, point stich-on, bleeding and Guasha can be found in the2books though limited.23points was quoted46times, and over2times quoted points were listed as Shenshu(8), Guanyuan(6), Zhaohai(4), Zusanli(3),Fenglong(3), Zhongwan(3), Yanglingquan(2) and Taixi(2).
12. Nursing
According to the2works, nursing mainly related to diet, mind, daily life, sexual intercourses, drug, and massage, which scattered in83items.
13.Analysis by confidence level
13.1High-frequency used herb
The top3herbs were Fructus Schisandrae, Raidix Ophiopogonis and Radix Ginseng. Analyzed by confidence level, we got data as following. As to Fructus Schisandrae, the top3compatibility herbs were Raidix Ophiopogonis(52.5%), Radix Ginseng(20.0%) and Radix Acanthopanacis Bidentatae(18.7%). As to Raidix Ophiopogonis, the top3compatibility herbs were Fructus Schisandrae (68.9%), Cortex Phellodendri(31.0%) and Radix Ginseng(27.5%). As to Radix Ginseng, the top3compatibility herbs were Radix Glycytthizae(40.4%), Raidix Ophiopogonis(36.1%) and Fructus Schisandrae(34.0%).
13.2High-frequency used prescription
Ranked by using frequency, the top3prescriptions were sexa-Rehmaniae Bolus, Kidney-qi Pill and Decoction for strengthening the middle warmer. Analyzed by confidence level we can see which herbs show a higher confidence level in each prescription. For example, for sexa-Rehmaniae Bolus, top3herbs were Fructus Schisandrae(100%), Raidix Ophiopogonis(66.6%) and Cortex Phellodendri(46.6%). For Kidney-qi Pill, that will be Raidix Ophiopogonis(100%), Fructus Schisandrae(95.8%) and Radix Ginseng(41.6%). For Decoction for Strengthening the middle warmer, that will be Fructus Schisandrae(100%), Raidix Ophiopogonis(69.2%)and Rhizoma Anemarrhenae(34.6%).
Conclusion:
1. treating diseases by regulating kidney function is the most important methods in ancient time. Physicians applied this theory as clinical guide to diagnose and treat a large variety of diseases. It has significant clinical value.
2. The medical cases about regulating kidney to treat disease indicate that the most common pathogenic factor is internal damage.There are certain differences in the understanding of etiology between ancient and modern.
3. Summarized from the tow works, the pathogenesis of the involved cases were most demonstrated focusing on kidney-related visceral theory, and basing on Neijing. Thus the kidney-related visceral theory was enriched by the ancient physicians.
4. the high frequency shown symptoms in the involved cases were closely related to kidney function. And there wasn't significant difference between the two works. A notable thing we found was pulse-based diagnosis was applied more than glossoscopy, which indicates that pulse is more convincing and reliable than tongue in diagnosing the kidney-related disaeases. Abnormality of urination is determined from the first element of treating diseases by regulating kidney function.
5. The presentation about therapeutic principle was not found in the two works, which indicates that therapeutic principle was metaphysical and created in late time. The cases about'treating diseases by regulating kidney function', more detailed recorded in Classified Case Records of Celebrated Physicians, indicated nourishing kidney yin was widely applied in treatment, though not recorded much in disease kind.
6. The prescription implied that the ancient physician aware of tonifying spleen when invigorating kidney to cure. Abundant herbs and various methods of processing drugs were recorded in the two books. The more frequent application of Fructus Schisandrae, Raidix Ophiopogonis and Radix Ginseng indicates the thoughts of tonifying kidney.7. There were not much records about acupuncture in the2books. However, according to the limited records, we found points on kidney meradian, stomach meridian and conception vessel and Selection of acupuncture points is fewer but better, curative effect.
8. There is not much detailed, profundity or extended records about nursing in the2works. All the content about nursing was common and unspecific.
9. Tonifying kidney more than spleen was more presented or indicated in Classified Case Records of Celebrated Physicians, while tonifying kidney and liver together shown more in Comtinued Classified Case Records of Celebrated Physicians.
材料与方法：本研究以1957年人民卫生出版社出版发行的《名医类案》知不足斋影印本为底本,参照1996年中国中医药出版社出版的以潘桂娟、侯亚芬为主校的《名医类案》正续编,采用Microsoft office excel2003,将《名医类案》所载医案逐条录入,建立数据库。《续名医类案》以湖南电子音像出版社出版的大型电子图书《中华医典》升级版所收录该书内容为基础数据源,并以1957年人民卫生出版社出版发行的《续名医类案》信述堂重刊本(1885年)的影印本为底本进行校对,建立数据库。
1.《名医类案》《续名医类案》从肾论治医案筛查方法
1.1医案纳入标准(1)医案所载内容在病名、证名、体质、病因、病机、症状、治则、治法、方药、针灸、调护中的一项或多项与肾关系密切。(2)虽不是具体个案,但是医家就某一问题的医理探讨、治验心得,其内容与肾相关
1.2医案排除标准
(1)医案所载内容虽然提到肾,但实则与肾无关,更不是从肾论治。
(2)医案著录内容冗长,医家在疾病不同阶段所采用治法灵活多变,从肾论治篇幅甚少混杂其中,无法准确把握。
按以上标准运用数据库的检索功能,分别输入检索词“肾”、“命门”、“命火”“少阴”、“藏精”,在《名医类案》数据库中共检索出医案195例,对其进行人工校对,排除14例,形成从肾论治纳入医案181例。在《续名医类案》基础数据源中共检索出医案595例,对其人工校对后排除255例,形成从肾论治纳入医案340例,两部医著共计纳入医案521例(其中包括部分医家就某一问题的医理阐述)。
2.数据库的建立及记录的录入
采用Microsoft office excel2003建立《名医类案》《续名医类案》从肾论治521例医案数据库,数据库变量名分别是病名、证名、体质、病因、病机、症状、治则、治法、方剂、中药、针灸、调护,将521例医案逐条录入后进行核对。
3.数据挖掘
在建好数据库的基础上进行数据挖掘,此部分工作由沈阳航空航天大学知识工程研究中心协助完成。
4.数据标准化处理
参考《中华人民共和国国家标准——中医临床诊疗术语》、《中医方剂大辞典》《中草药异名辞典》、《中医证病名大辞典》、《中医内科学》、《中医外科学》、《中医妇科学》、《中医儿科学》、《中医五官科学》、《中医体质学》等相关内容,对数据库各变量内容进行标准化处理,统一使用规范名称,统计结果以规范名称表述。(无相应规范名称者除外)
5.结果表述,提炼结论
通过对《名医类案》《续名医类案》从肾论治医案的全面系统整理,运用数据挖掘等方法揭示医案中蕴含的潜在信息,产生各变量的相应统计结果及其结果间的置信度分析,分析结果,诠释含义,提炼结论。
结果：
1.病名统计结果
《名医类案》《续名医类案》从肾论治医案见于163种病名之中,内科疾病医案359例,外科疾病医案80例,妇科疾病医案16例,儿科疾病医案20例,五官科疾病医案46例。从肾论治医案数10例(包括10例)以上疾病名称如下：疮疡类疾病(例数32,简略为32,下同)、泄泻(24)、虚劳(23)、咳嗽(17)、遗精(16)、水肿(15)、内伤发热(15)、腰痛(14)、淋证(14)、消渴(13)、血证(13)、儿科疾病(13)、咽喉科疾病(13)、口腔科疾病(12)、喘证(11)、足癣(11)、癃闭(10)、痹证(10)、中风(10)、痿证(10)。
2.证名统计结果
《名医类案》《续名医类案》从肾论治医案载有证名医案46例,出现证名23种,其名称及其医案数如下：肾气虚(例数9,简略为9,下同)、肾阴虚(4)、肾阳虚(3)热症(3)、脾气虚(3)、阴虚阳亢(3)、脾肾两虚(2)、脾肾阳虚(2)、阴盛阳虚(2)、胃气虚(2)、少阴病(1)、少阳阳明症(1)、气脱(1)、脾气郁结(1)、肾精亏虚(1)、肝阴虚(1)、肝火犯胃(1)、心肾气虚(1)、气血两虚(1)、火证(1)、湿症(1)、足二阴虚寒症(1)、足三阴虚寒症(1)。
3.体质统计结果
《名医类案》《续名医类案》从肾论治医案载有体质内容的有33例,占全部医案的6.33%。体质划分及频次结果如下：以阴阳分类法划分,阳旺阴虚质(5)；以体态分类法(按五色分)划分,面白(2),面黑(1)；以体态分类法(按肥瘦分)划分,肥胖魁伟(13),消瘦(3)；以脏腑分类法(按脏腑机能分)划分,肾虚质(2)；以气血津液分类法划分,气虚质(7)。
4.病因统计结果
《名医类案》《续名医类案》从肾论治医案521例,其中156例医案明确了致病因素,主要病因集中在房劳(43)、情志内伤(30)、饮食不节(27)、烦劳(25)、外感六淫(18)、失治误治(11)、年老体衰(2)等。情志内伤中因怒致病14例,因惊恐致病6例,悲、思致病各5例。外感六淫中感受风邪2例,寒邪9例,风寒5例,暑邪2例。
5.病机统计结果
《名医类案》《续名医类案》从肾论治医案所记述病机是以肾的藏象理论为基础,以脏腑病机为重点的内容体系。该类医案体现病机13项,见于334例医案之中,具体病机分类及医案数如下：肾阴虚(88)、肾气虚(55)、肝肾关系失调(38)、脾肾关系失调(36)、肾阳虚(30)、心肾关系失调(19)、与肾相关形体官窍病机(17)、肾经络病机(13)、肺肾关系失调(11)、肾胃关系失调(8)、肾精亏损(8)、肾外感实证(6)、肾膀胱关系失调(5)。
6.症状统计结果
《名医类案》《续名医类案》从肾论治医案出现的症状以不可拆分症状要素统计达1500多种,包括内科、外科、儿科、妇科、五官科等各科疾病症状,其中《名医类案》从肾论治医案症状表述600多种,《续名医类案》从肾论治医案症状表述1100多种。《名医类案》《续名医类案》从肾论治医案出现症状按频次由高到低排序,位于前20位症状如下：食少(75)、口渴(54)、多痰(48)、小便涩滞(42)、发热(42)咳嗽(40)、遗精(38)、泄泻(36)、消瘦(33)、便秘(32)、腹胀(27)、倦怠(27)、自汗(25)、腰痛(24)、小便淋痛(23)、头晕(22)、胸满(20)、小便短少(19)、口干(18)、足膝痿弱(17)。
7.治则统计结果
《名医类案》《续名医类案》从肾论治医案可归纳出治则15项,见于126例医案中,治则内容及医案数如下：扶正固本(52)、虚则补之(37)、缓则治本(15)、标本兼治(11)、因人制宜(9)、扶正祛邪(6)、先补后攻(6)、调理阴阳(5)、急则治标(3)、寓补于攻(2)、攻补兼施(2)、祛邪扶正(2)、先攻后补(1)、因时制宜(1)、寒因寒用(1)。
8.治法统计结果
《名医类案》从肾论治医案出现治法52种,共计103次；《续名医类案》从肾论治医案出现治法17种,共计26次。《名医类案》《续名医类案》从肾论治医案合计出现治法58种,129次,按出现频次由高到低排序,位列前10位的治法如下：滋补肾阴(21)、补益肾气(7)、补脾益气(6)、温补脾胃(6)、补脾益肺(5)、养血清肝(5)、滋补心肾(4)、补血养肝(4)、滋补肝肾(4)、清热解毒(4)。
9.方剂统计结果
《名医类案》从肾论治医案使用方剂92条,310次；《续名医类案》从肾论治医案使用方剂127条,426次；两部医著合计在从肾论治医案中使用方剂189条,736次。《名医类案》从肾论治医案使用方剂频次出现5次以上的有：六味地黄丸(57)、金匮肾气丸(48)、补中益气汤(43)、滋肾丸(11)、四物汤(11)、十全大补汤(10)、六君子汤(8)、八珍汤(5)、二陈汤(5)、小柴胡汤(5)。《续名医类案》从肾论治医案使用方剂频次出现5次以上的有：六味地黄丸(87)、金匮肾气丸(79)、补中益气汤(53)、六君子汤(11)、十全大补汤(8)、八珍汤(7)、附子理中汤(7)、四物汤(6)、滋肾丸(6)、地黄饮子(5)。两部医著合计在从肾论治医案中使用方剂频次前十位的有：六味地黄丸(144)、金匮肾气丸(127)、补中益气汤(96)、六君子汤(19)、十全大补汤(18)、滋肾丸(17)、四物汤(17)、八珍汤(12)、四神丸(8)、附子理中汤(8)。
10.中药统计结果
中药频次的统计是遵照原著记录格式进行的,如原著中有医家的完整药物处方,则每一位药物频次均参与计算,若原著中记录格式为方剂名+药物,则只有所加药物参与了使用频次统计,并未拆方统计(因年代久远,有些方剂无法准确拆分),因此统计结果能够大体上反映古代医家从肾论治用药习惯。《名医类案》中从肾论治医案出现中药136味,共计489次,按使用频次由高到低排列前10位的中药是：黄柏(27)、五味子(26)、甘草(25)、麦冬(25)、白术(17)、知母(15)、茯苓(15)、黄连(13)、人参(12)、当归(12)、陈皮(12)。《续名医类案》中从肾论治医案出现中药164味,共计742次,按使用频次由高到低排列前10位的中药是：五味子(54)、人参(35)、麦冬(33)、茯苓(21)、肉桂(20)、甘草(19)、枸杞子(19)、熟地(18)、山药(17)、附子(17)、牛膝(17)。两部医著合计在从肾论治医案中使用中药206味,1231次,按使用频次由高到低顺序排列前20位中药使用率占所有中药使用率的49.39%,具体中药及使用频次如下：五味子(80)、麦冬(58)、人参(47)、甘草(44)、黄柏(39)、茯苓(36)、白术(28)、附子(26)、知母(26)、牛膝(24)、肉桂(24)、当归(23)、枸杞子(23)、山药(22)、熟地(21)、黄连(19)、生地(19)、陈皮(17)、栀子(17)、白芍(15)。对使用中药聚类统计后发现补虚药、清热药、收涩药、利水渗湿药四类中药使用率占所有中药使用率的四分之三还要多。
11.针灸统计结果
《名医类案》《续名医类案》从肾论治医案使用刺灸法主要包括针刺、艾灸、穴位贴敷、刺络放血、刮痧等。使用腧穴23个,共计46次,使用2次以上的腧穴有：肾俞(8)、关元(6)、照海(4)、足三里(3)、丰隆(3)、中脘(3)、阳陵泉(2)太溪(2)。
12.调护统计结果
《名医类案》《续名医类案》从肾论治医案中所包含的调护方法主要有饮食调护、精神调护、起居调护、房事调护、药物调护、按摩调护等方面,其内容散见于83条病案之中。
13.置信度分析
高频次使用中药置信度分析
五味子、麦冬、人参为使用频次位于前三位的中药,通过数据挖掘以置信度为表述形式显示其结果如下：以五味子为研究对象,与其配伍按置信度由高到低排列前三位的是麦冬(52.5%)、人参(20.0%)、牛膝(18.7%)；以麦冬为研究对象,与其配伍按置信度由高到低排列前三位的是五味子(68.9%)、黄柏(31.0%)、人参(27.5%)；以人参为研究对象,与其配伍按置信度由高到低排列前三位的是甘草(40.4%)、麦冬(36.1%)、五味子(34.0%)。高频次使用方剂加入中药置信度分析
高频次使用方剂排列前三位的是六味地黄丸、金匮肾气丸、补中益气汤,其最常加入中药通过数据挖掘以置信度为表达形式时显示如下：以六味地黄丸为研究对象,最常加入此方中药按置信度由高到低排列前三位的是五味子(100%)、麦冬(66.6%)、黄柏(46.6%)；以金匮肾气丸为研究对象,最常加入此方中药按置信度由高到低排列前三位的是麦冬(100%)、五味子(95.8%)、人参(41.6%)；以补中益气汤为研究对象,最常加入此方中药按置信度由高到低排列前三位的是五味子(100%)、麦冬(69.2%)知母(34.6%)。
结论：
1.从肾论治是古代医家临证时最为重要的治疗方法,以此为指导,涉及多学科、多系统、多器官疾病诊治,具有重要的临床应用价值。
2.《名医类案》《续名医类案》从肾论治医案的病因以内伤因素为主,包括病因种类较多,古今在病因认识上存有一定差异；病机阐释以《内经》为根基,蕴藏着丰富的古代文化知识,古代医家对肾气虚的重视及对肾气宜缓缓生发的深刻认识丰富了肾藏象理论的内涵。
3.《名医类案》《续名医类案》从肾论治医案出现的高频次症状与肾关系密切,能够体现从肾论治医案辨证要素的特点；《名医类案》与《续名医类案》从肾论治医案高频次症状之间没有显著性差异；《名医类案》《续名医类案》从肾论治医案医家更重视脉诊而忽略舌诊,在一定程度上表明从肾论治时脉象比舌象更重要；小便异常是决定从肾论治的第一要素。
4.以《名医类案》《续名医类案》从肾论治医案为代表的古医案中没有具体的治则表述,进一步验证了治则概念出现晚,抽象性高的特点。《名医类案》从肾论治医案治法表达详于《续名医类案》,与肾相关治法在医案中体现种类不多,滋补肾阴治法适应病证广,应用频率高,得到古代医家高度重视。
5.《名医类案》与《续名医类案》从肾论治医案处方特点没有显著差别,古代医家补肾同时重视培补脾胃思想在处方中得到鲜明体现。《名医类案》《续名医类案》从肾论治医案使用药物品种繁多,炮制方法丰富,用药集中度偏低,五味子、麦冬、人参等中药的高频次使用为补肾赋予了较深的寓意。
6.《名医类案》《续名医类案》从肾论治医案针灸应用不多,治疗选穴少而精,疗效显著,所用腧穴以足少阴肾经、足阳明胃经、任脉为主,温补脾肾思想在腧穴应用中得到体现。
7.《名医类案》《续名医类案》从肾论治医案所蕴含的调护方法与内容普遍适用性较强,与肾藏象特点结合的特异性较差,调护内容包含范围小,阐释深度不足。
8.《名医类案》从肾论治医案中医家的补肾重脾思想得到集中体现,《续名医类案》从肾论治医案中医家善于滋补肝肾思想得到较多表达,这与两部医著的作者学术主张实现了某种契合,两部医著作者在选案中的倾向性对从肾论治医案的研究结果具有一定影响。
Purpose:All the medical cases about'treating diseases by regulating kidney function'in the two famous work Classified Case Records of Celebrated Physicians and Continued Classified Case Records of Celebrated Physicians was screened(or searched) out and taken to classification systemic research in all the aspects, like disease name, syndrome, body constitution, etiopathogenisis, pathogenesis, symptom, therapeutic principal, treatment, prescription, herbs, acupuncture therapy, nursing, etc al, by using the technique in literal metrology, systematics, statics, annotation and data mining. In this way, to approach the ancient physicians'comprehension and opinion to'kidney'and what role it plays in either physiology or pathology, which will further reveal and support the concept of'kidney stores essence'.
Material and method:For Classified Case Records of Celebrated Physicians, we picked the publication, printed in1982by People Sanitation Publisher, and also compared with the corrected Classified Case Records of Celebrated Physicians, edited by Pan Guijuan and Hou Yafen, printed by National Chinese Medicine Publisher in1996. Furthermore, we typed in all the records and build up the data bank. For Continued Classified Case Records of Celebrated Physicians, we picked China Medical Classic, produced by Hunan Electric Audiovisual Publisher, as the origin information source. It has been proofread and set up databases based on the photocopy version of Continued Classified Case Records of Celebrated Physicians which was released by peoples health press in1957.
1. How to exactly search out the records concerning'treating disease by regulating kidney function'in the two work?
1.1Conditions for'to be involved'
A. Closely related to'kidney'in at least one item of following:disease name, syndrome name, body quality, pathogen, mechanism, symptom, therapeutic principle, treatment, prescription, acupuncture and nursing.
B. Even not a complete medical case, but the content is closely related to'kidney'no matter a conclusion or discussion proposed by physicians.
1.2Conditions of'to be picked out'
A. The content is not related to kidney or'treating diseases by regulating kidney function', though mentioned of word of'kidney'.
B. Cases which changes a lot in different stages of disease development, that makes it too long and complicated to figure out its exact meaning or little related to'treating diseases by regulating kidney function'.
We used the key words,'kidney','MINGMEN','MINGHUO','SHAOYIN'and 'storing essence', to thoroughly search the data bank of the two works. In Classified Case Records of Celebrated Physicians,195cases were involved automatically, but14cases were picked out after artificial checking. The consequence of Continued Classified Case Records of Celebrated Physicians is255out of595cases. Finally, there were521cases were involved in total, including discussion and conclusion.
2. Typing in the records and building up the data bank
We typed in all the information of the521involved cases into an excel document to build up a data bank, and variates were listed as follow disease name, syndrome, body constitution, etiopathogenisis, pathogenesis, symptom, therapeutic principal, treatment, prescription, herbs, acupuncture therapy, nursing.
3. Data mining
Data mining was based on the above data bank and was executed by Knowledge Engineering Research Center of Shenyang Aerospace University.4. Control of data standard
All the terms used in our research were according to China government standard term in clinic diagnosis and treatment of TCM, Dictionary of TCMprescription, Synonym dictionary of Chinese herb, Dictionary of TCM syndrome name, Internal medicine of TCM, Surgery of TCM, Gynecology of TCM, pediatrics of TCM, etc. al.
5. Presenting results and conclusion
After overall and systemically organizing and collecting the items in the2works, we further took data mining technique to extract more information hidden in the context and concluded more by analysis in confidence level.
Results:
1. disease name
After thoroughly searching Classified Case Records of Celebrated Physicians and Continued Classified Case Records of Celebrated Physicians, we got163diseases name referring'treating diseases by regulating kidney function', referred in359internal medicine cases,80surgical cases,16gynecological cases,20pediatrics cases, and46cases in nose-ear-throat diseases. The disease names appears in the tow works over10times(including10)are listed as following, pyocutaneous disease(32), diarrhea(24), fatigue(23), coughing(17), spermatorrhoea(16), dropsy(15), fever cause by internal damage(15), low back pain(14), difficulty in micturition (14), diabetes (13), hemorrhagic disease(13)、pediatrics(13), throat disease (13), stomatology disease (12), dyspnea(11), dyspnea(11), uroschesis(10), arthromyodynia(10), stroke(10) and paralysis(10).
2. Syndrome name
23kinds of syndrome and46cases of treatment were searched out in the tow works and listed as following, kidney qi deficiency(9cases, abbreviated as9,the above are same), kidney yin deficiency (4),kidney yang deficiency (3),heat syndrome (3), spleen qi deficiency(3), yin deficiency due to exuberant yang (3),deficiency of both spleen and kidney(2),spleen-yang and kidney-yang deficiency(2),yang deficiency due to exuberant yin(2),stomach-qi deficiency(2), disorders of shao-yin meridian(1),overlap of diseases of shao-yang and yang-ming meridians(1),qi collapse(1),accumulation of spleen qi(1),shortage and deficiency of kidney essence(1),liver-yin deficiency(l),liver-fire invading stomach(1),deficiency of heart-qi and kidney-qi(1),deficiency of both qi and blood(1), fire syndrome(1),dampness syndrome(1), deficiency cold syndrome of foot jue-yin(1),deficiency cold syndrome of foot shao-yin.
3. body constitution
We found body constitution mentioned in33cases referring'treating disease by regulating kidney function', occupying6.33%in all. If classified by yin-yang,5cases described the kind of excessive yang and yin deficiency. If classified by five color, results showed whitish complexion(2), blackish complexion(1). If classified by body carriage, results showed as corpulency(13), emaciation(3). Counted by organ classification,2cases referring to type of kidney deficiency and7cases referring the type of qi deficiency, classified in qi-blood and body fluid.
4. etiopathogenisis
The etiopathogenisis, recorded in the521cases involved, among which156cases recorded clearly identified, were listed as following, excessive sexual intercourses(43),emotional damage(30),eating and drinking without temperance(27),physical strain(25), six exogenous factors(18), unfit treatment(11)and degeneration(2).among the emotional damage cases, there were14cases related to eager,6cases related to panic,5cases sadness and5cases anxiety. Result of six exogenous factors is2for wind,9for coldness,5for wind-coldness, and2for pathogenic summer-heat.
5. Pathogenesis
13kinds of pathogenesis were collected from334cases in the tow works, and which listed as following, deficiency of kidney yin(88), deficiency of kidney qi(55), disharmony between liver and kidney(38), disharmony between spleen and kidney(36), deficiency of kidney yang(30), disharmony between heart and kidney(19), structures or sencing organ relating to kidney(17), kidney meridian(13), disharmony between kidney and lung(11), disharmony between kidney and stomach(8), damage of kidney essence(8), exogenous-factor-caused sthenia syndrome in kidney(6) and dis harmony between kidney and bladder(5).
6. symptom
Looking up all the involved cases of the2works, over1500kinds of symptoms were calculated out, spreading in all kinds of disease. Calculated separately, that was600kinds of symptoms in Classified Case Records of Celebrated Physicians and1100in Continued Classified Case Records of Celebrated Physicians. Ranked by the frequency, the top20were poor appetite(75), thirsty(54), excessive phlegm(48), difficult urination(42), fever (42), coughing(40), emissions(38), diarrhea (36), emaciation(33), constipation(32), abdominal distension(27), lassitude(27), spontaneous perspiration(25), low back pain(24), odynuria(23), dizziness(22), chest distress(20), oliguresis(19), dry mouth(18) and leg debility(17).
7. therapeutical principle
15items of therapeutic principle were collected in126cases. The content and its frequency were listed as following, support healthy energy(52), asthenia requiring tonification(37), treating chronic disease aiming at the principal aspect(15), simultaneous treatment of principal and subordinate symptoms(11), individual concerned therapy(9), strengthening healthy qi to eliminate pathogens(6), tonifiction preceding purgation(6), regulating yin and yang(5), treating secondary symptoms for emergency(3), tonification involving purgation(2), simultaneous application of purging-tonifying therapy(2), eliminating pathogen to support vital qi(2), purgation preceding tonification(1), climate concerned therapy(1) and cold prescription for pseudofrigid pyrexia(l).
8. treatment
52kinds of treatments were quoted103times in total in Classified Case Records of Celebrated Physicians, and the result in Comtinued Classified Case Records of Celebrated Physicians was17kinds, quoted26times. Ranking in the quoting frequency, the top10was moisturizing kidney yin(21), tonifying kidney qi(7), promoting spleen qi(6), warming and benefiting spleen and stomach(6), benefiting spleen and lung(5), raising blood and clarifying liver(5), moisturizing heart and kidney(4), promoting blood to raise liver(4), tonifying liver and kidney(4) and cooling heat and purifying toxin(4).
9. prescription
92prescriptions were quoted310times in Classified Case Records of Celebrated Physicians, and the prescriptions quoted over5times were listed as following, sexa-Rehmaniae Bolus(57), Kidney-qi Pill (48), Decoction for Strengthening the middle warmer (43), Pill for nourishing kidney (11), Decoction of Four Drugs (11), All Nourishing Decoction (10), Decoction of sexa-gentleman (8), Decoction of Eight Ingredients (5), Double Chen Decoction(5), Bupleurum tenue Buch Decoction (5).127prescription were quoted426times in Comtinued Classified Case Records of Celebrated Physicians, and the prescriptions quoted over5times were listed as sexa-Rehmaniae Bolus (87), Kidney-qi Pill (79), Decoction for Strengthening the middle warmer (53), Decoction of sexa-gentleman (11), All Nourishing Decoction (8), Decoction of Eight Ingredients (7), aconite root-plus decoction for regulating middle Jiao(7), Decoction of Four Drugs (6), Pill for nourishing kidney (6), Rehmanniae Potion (5). Calculated together,189prescriptions were quoted736times, and top10was sexa-Rehmaniae Bolus (144), Kidney-qi Pill (127), Decoction for Strengthening the middle warmer (96), Decoction of sexa-gentleman (19), All Nourishing Decoction (18), Pill for nourishing kidney (17), Decoction of Four Drugs (17), Decoction of Eight Ingredients (12), Pill of Four Miraculous Drugs (8), aconite root-plus decoction for regulating middle Jiao (8).
10. Herbs
The calculation of herbs was according to the exact origin records in the books. As to the records like prescription plus herbs, only herbs plus were counted in, because some prescription was too old to check out the exact components. In Classified Case Records of Celebrated Physicians,136kinds of herbs were found quoted489times, and the top10were Cortex Phellodendri(27), Fructus Schisandrae(26), Radix Glycytthizae(25), Raidix Ophiopogonis(25), Rhizoma Atractylodis Macrocephalae(17), Rhizoma Anemarrhenae(15), Poria(15), Rhizoma Coptidis(13), Radix Ginseng(12), Radix Angelicae Sinensis(12) and Pericarpium Citri Reticulatae(12). In Comtinued Classified Case Records of Celebrated Physicians,164kinds of herbs were found quoted742times, and the top10herbs, ranked by frequency, were listed as Fructus Schisandrae(54), Radix Ginseng(35), Raidix Ophiopogonis(33), Poria(21), Cortex Cinnamomi(20), Radix Glycytthizae(19), Fructus Lycii(19), prepared rhizome of rehmannia(18),Rhizoma Dioscoreae(17),Radix Aconiti Lateralis Preparata(17)and Radix Acanthopanacis Bidentatae(17).Calculated together,206kinds of herbs were used1231time in total, and the top20kinds of herbs occupying49.39%in using frequency. The herbs'names and the frequency were listed a s following, Fructus Schisandrae(80), Raidix Ophiopogonis(58), Radix Ginseng(47), Radix Glycytthizae(44), Cortex Phellodendri(39), Poria(36), Rhizoma Atractylodis Macrocephalae(28), Radix Aconiti Lateralis Preparata(26), Rhizoma Anemarrhenae(26), Radix Acanthopanacis Bidentatae(24), Cortex Cinnamomi(24), Radix Angelicae Sinensis(23),Fructus Lycii(23), Rhizoma Dioscoreae(22), prepared rhizome of rehmannia(21), Rhizoma Coptidis(19), rehmannia dride rhizome(19), Pericarpium Citri Reticulatae(17), Fructus Gardeniae(17) and Raidix Paeoniae Alba(15). After clustering statistics, we found over3quarters of the herbs belong to tonifying, heat-clearing, concentrating or diuretics for eliminating dampness drugs.
11. Acupuncture points
All of acupuncture, moxibustion, point stich-on, bleeding and Guasha can be found in the2books though limited.23points was quoted46times, and over2times quoted points were listed as Shenshu(8), Guanyuan(6), Zhaohai(4), Zusanli(3),Fenglong(3), Zhongwan(3), Yanglingquan(2) and Taixi(2).
12. Nursing
According to the2works, nursing mainly related to diet, mind, daily life, sexual intercourses, drug, and massage, which scattered in83items.
13.Analysis by confidence level
13.1High-frequency used herb
The top3herbs were Fructus Schisandrae, Raidix Ophiopogonis and Radix Ginseng. Analyzed by confidence level, we got data as following. As to Fructus Schisandrae, the top3compatibility herbs were Raidix Ophiopogonis(52.5%), Radix Ginseng(20.0%) and Radix Acanthopanacis Bidentatae(18.7%). As to Raidix Ophiopogonis, the top3compatibility herbs were Fructus Schisandrae (68.9%), Cortex Phellodendri(31.0%) and Radix Ginseng(27.5%). As to Radix Ginseng, the top3compatibility herbs were Radix Glycytthizae(40.4%), Raidix Ophiopogonis(36.1%) and Fructus Schisandrae(34.0%).
13.2High-frequency used prescription
Ranked by using frequency, the top3prescriptions were sexa-Rehmaniae Bolus, Kidney-qi Pill and Decoction for strengthening the middle warmer. Analyzed by confidence level we can see which herbs show a higher confidence level in each prescription. For example, for sexa-Rehmaniae Bolus, top3herbs were Fructus Schisandrae(100%), Raidix Ophiopogonis(66.6%) and Cortex Phellodendri(46.6%). For Kidney-qi Pill, that will be Raidix Ophiopogonis(100%), Fructus Schisandrae(95.8%) and Radix Ginseng(41.6%). For Decoction for Strengthening the middle warmer, that will be Fructus Schisandrae(100%), Raidix Ophiopogonis(69.2%)and Rhizoma Anemarrhenae(34.6%).
Conclusion:
1. treating diseases by regulating kidney function is the most important methods in ancient time. Physicians applied this theory as clinical guide to diagnose and treat a large variety of diseases. It has significant clinical value.
2. The medical cases about regulating kidney to treat disease indicate that the most common pathogenic factor is internal damage.There are certain differences in the understanding of etiology between ancient and modern.
3. Summarized from the tow works, the pathogenesis of the involved cases were most demonstrated focusing on kidney-related visceral theory, and basing on Neijing. Thus the kidney-related visceral theory was enriched by the ancient physicians.
4. the high frequency shown symptoms in the involved cases were closely related to kidney function. And there wasn't significant difference between the two works. A notable thing we found was pulse-based diagnosis was applied more than glossoscopy, which indicates that pulse is more convincing and reliable than tongue in diagnosing the kidney-related disaeases. Abnormality of urination is determined from the first element of treating diseases by regulating kidney function.
5. The presentation about therapeutic principle was not found in the two works, which indicates that therapeutic principle was metaphysical and created in late time. The cases about'treating diseases by regulating kidney function', more detailed recorded in Classified Case Records of Celebrated Physicians, indicated nourishing kidney yin was widely applied in treatment, though not recorded much in disease kind.
6. The prescription implied that the ancient physician aware of tonifying spleen when invigorating kidney to cure. Abundant herbs and various methods of processing drugs were recorded in the two books. The more frequent application of Fructus Schisandrae, Raidix Ophiopogonis and Radix Ginseng indicates the thoughts of tonifying kidney.7. There were not much records about acupuncture in the2books. However, according to the limited records, we found points on kidney meradian, stomach meridian and conception vessel and Selection of acupuncture points is fewer but better, curative effect.
8. There is not much detailed, profundity or extended records about nursing in the2works. All the content about nursing was common and unspecific.
9. Tonifying kidney more than spleen was more presented or indicated in Classified Case Records of Celebrated Physicians, while tonifying kidney and liver together shown more in Comtinued Classified Case Records of Celebrated Physicians.
引文
[1]洪燕珠,周昌乐,张志枫,等.中医医案的研究进展.中医药通报.2008,7(3)：62-65。
[2]李经纬,余瀛鳌.中医大辞典.北京：人民卫生出版社,2006：682。
[3]苏礼.《名医类案》导读.中医文献杂志.2005,23(2)：10-11。
[4]潘桂娟,侯亚芬.名医类案(正续编).北京：中国中医药出版社,1996：1。
[5]甄学燕.《续名医类案》述要.北京中医药.2010,29(12)：914-916。
[6]焦振廉.江瓘生平事迹评述.安徽中医学院学报.2009,28(1)：10-12。
[7]茅晓.略论《名医类案》的医史文献学成就.山西中医.2005,21(1)：37-38。
[8]俞中元.魏玉横临床的主要特色.中华医史杂志.2006,36(2)：79-82。
[9]许文忠.魏玉横组方思想再探.北京中医药大学学报.2003,26(5)：7-8。
[10]孟庆云.宣明往范,昭示来学：论中医医案的价值、特点和研究方法.中医杂志.2006,47(8)：568-570。
[11]茅晓.略论《名医类案》的医史文献学成就.山西中医.2005,21(1)：37-38。
[12]茅晓.略论《名医类案》的医史文献学成就.山西中医.2005,21(2)：46-48。
[13]茅晓.略论《名医类案》的医史文献学成就.山西中医.2005,21(3)：53-55。
[14]于凌,李其忠.从《续名医类案》看古代医案的临床价值.上海中医药杂志.2006,40(10)：46-47。
[15]茅晓.博稽精采,昭示来学：《名医类案·中风》学术成就评析.浙江中医学院学报.2001,25(5)：8-10。
[16]黄健,郭丽娃.《名医类案》中医心身医学成就初探.中国中医基础医学杂志.2007,13(4)：261-262。
[17]鲍健欣.浅析《名医类案·痰》.江苏中医药.2009,41(7)：75-76。
[18]陈贵华,李振彬,杨静,等.《名医类案》痛风篇探析.河北中医.2010,32(1)：117-118。
[19]曹竞超,许敬生.《名医类案》头痛治法探析.辽宁中医药大学学报.2008,10(10)：22-23。
[20]戴月笙.《名医类案》血证急重症案选析.福建中医药.1985(2)：55-57。
[21]鲍健欣.《名医类案》误诊医案初探.上海中医药杂志.2010,44(3)：54-55。
[22]凌芳,李成文.《续名医类案》中产后惊悸医案浅析.光明中医.2008,23(7)：915-917。
[23]杨杰,王米渠,孙洋,等.《续名医类案》关于双胞胎孕产辨证论治的探讨.现代中 西医结合杂志.2006,15(1)：3-4。
[24]许文忠.《名医类案》《续名医类案》补肝法初探.北京中医药大学学报.2006,29(6)：377-380。
[25]刘惠玲,童光东.试析《名医类案》外治法之运用.中医外治杂志.1998,7(2)：6,42。
[26]袁宜勤.《名医类案》之刺血验案评析.中国民间疗法.2009,17(8)：8。
[27]袁宜勤.《名医类案》之灸法验案探析.湖南中医药大学学报.2010,30(1)：4-5,72。
[28]茅晓.《名医类案》附子运用例析.山西中医.2001,17(5)：45-46。
[29]郑虎占,侯新楠,张敏.《名医类案》与《续名医类案》的中药特殊用法探讨.中医文献杂志.2007,25(3)：12-14。
[30]茅晓.《名医类案》研究的方法学探讨.南京中医药大学学报：社会科学版.2002,3(1)：34-36。
[31]孙燕,臧佳新,任廷革.基于数据挖掘技术的医案整理方法探讨.中国中医药信息杂志.2006,13(11)：106-107。
[32]黄利兴,周小青.数据挖掘技术在中医医案领域的应用进展.江西中医学院学报.2010,22(1)：92-94。
[33]孙艳秋,刘建平,刘世芳.基于数据挖掘技术名老中医经验传承的研究.辽宁中医药大学学报.2010,12(1)：223-224。
[1]焦振廉.试论中医文献研究的性质与范畴.山西中医学院学报.2007,8(4)：2。
[2]Han J M, Kamber M.数据挖掘：概念与技术(影印版).北京：高等教育出版社.2001：256-258。
[3]于长春,贺佳,范思昌,等.数据挖掘技术在医学领域中的应用.第二军医大学学报.2003,24：1250-1252。
[4]孙燕,臧佳新,任廷革.基于数据挖掘技术的医案整理方法探讨.中国中医药信息杂志.2006,13(11)：106-107。
[5]张文彤,姜庆五,赵耐青,等.数据挖掘技术在生物信息学基因变异规律研究的应用.中国卫生统计.2005,22(1)：5-8。
[6]徐天朝,苏晶.现代数理统计方法在中医方药文献研究中的应用.中国中医基础医学杂志.2011,17(4)：386-388。
[7]黄粤,高颖.数据挖掘技术在中医证候研究中的应用概述.上海中医药大学学报.2010,24(1)：85-87。
[8]曹洪欣,刘寨华,张华敏,等.基于聚类分析的病毒性心肌炎证候分类研究及证候特征研究.中医杂志.2007,48(7)：629-632。
[9]佘侃侃.方剂数据挖掘现状及存在问题的探讨.中医药导报.2009,15(5)：113-115。
[10]张林,梁茂新,宫俊,等.基于数据挖掘技术的方剂配伍规律研究述评.现代生物医学进展.2010,10(20)：3945-3947。
[11]姚美村,艾路,袁月梅,等.消渴病复方配伍规律的关联规则分析.北京中医药大学学报.2002,25(6)：48-50。
[12]苏奎国,付先军.基于数据挖掘方法的治疗变应性鼻炎经典方剂用药及配伍规律分析.中医杂志.2011,52(1)：57。
[13]庄力,周雪忠,贾彩燕,等.基于Biclustering的中医药症关系分析.计算机工程.2010,36(11)：241。
[14]李卫民,李卫红.方剂中生地黄配伍规律的研究.中华中医药杂志.2011,26(3)：483。
[15]司富春,李山霞.近30年临床子宫肌瘤中医证型和用药规律分析.世界中西医结合杂志.2009,4(01)：45-47,49。
[16]任玉兰,梁繁荣.基于数据挖掘的经穴效应特性性文献评价思路.针刺研究.2009,34(3)：199-201。
[17]赵凌,任玉兰,余毓如,等.有效整理古代针灸文献的研究方法与要求.成都中医药大学学报.2007,30(4)：1-2。
[18]任玉兰,赵凌,陈勤,等.数据挖掘技术在经穴选用及其特异性研究中的应用.中医杂志.2010,51(1)：47。
[19]张笑平.中医病案学.北京：中国中医药出版社.1995：1。
[20]郭军.基于数据挖掘分析前名老中医病案整理的思路与方法.中医药信息.2011,28(2)：49-50。
[21]谭定英,老膺荣,古求知,等.面向循证传承的名老中医个人医案数据挖掘研究思路初探.新中医.2011,43(8)：162-164。
[22]黄利兴,周小青.数据挖掘技术在中医医案领域的应用进展.江西中医学院学报.2010,22(1)：92-94。
[23]彭平,孙立新,郑玉光,等.数据挖掘及其在中医药领域的应用.河北中医.2009,31(7)：1072-1073。
[1]中医药学名词审定委员会.中医药学名词·2004.北京：科学出版社,2005：3。
[2]洪燕珠,周昌乐,张志枫,等.中医医案的研究进展.中医药通报.2008,7(3)：62-65。
[3]甄学燕.《续名医类案》述要.北京中医药.2010,29(12)：914-916。
[4]焦振廉.江瓘生平事迹评述.安徽中医学院学报.2009,28(1)：10-12。
[5]李经纬,余瀛鳌.中医大辞典.北京：人民卫生出版社,2006：682。
[6]苏礼.《名医类案》导读.中医文献杂志.2005,23(2)：10-11。
[7]潘桂娟,侯亚芬.名医类案(正续编).北京：中国中医药出版社,1996：1。
[8]茅晓.江瓘父子医案特色.浙江中医杂志,2001,3：93-95。
[9]李德新.中医基础理论.北京：人民卫生出版社,2001：199。
[10]王新华.中医基础理论.北京：人民卫生出版社,2001：705-726。
[11]中医药学名词审定委员会.中医药学名词·2004.北京：科学出版社,2005：81。
[12]GB/T20348—2006,中医基础理论术语.北京：中国标准出版社,2006：41。
[13]灵枢经.北京：人民卫生出版社,1963：114。
[14]王琦.中医体质学.北京：人民卫生出版社,2009：147。
[15]王新华.中医基础理论.北京：人民卫生出版社,2001：425-431。
[16]王新华.中医基础理论.北京：人民卫生出版社,2001：435。
[17]中医药学名词审定委员会.中医药学名词·2004.北京：科学出版社,2005：37。
[18]GB/T20348—2006,中医基础理论术语.北京：中国标准出版社,2006：44。
[19]中医药学名词审定委员会.中医药学名词·2004.北京：科学出版社,2005：42。
[20]中医药学名词审定委员会.中医药学名词·2004.北京：科学出版社,2005：58。
[21]GB/T20348—2006,中医基础理论术语.北京：中国标准出版社,2006：78。
[22]王新华.中医基础理论.北京：人民卫生出版社,2001：730。
[23]中医药学名词审定委员会.中医药学名词·2004.北京：科学出版社,2005：110。
[24]初杰.再论治则与治法.辽宁中医杂志.2002,29(7)：385。
[25]孟庆云.治则与治法.中国中医基础医学杂志.1995,1(3)：23。
[26]王新华.中医基础理论[M].北京：人民卫生出版社,2001：731。
[27]于长春,贺佳,范思昌,等.数据挖掘技术在医学领域中的应用.第二军医大学学报.2003,24：1250-1252。
[28]Han J M, Kamber M.数据挖掘：概念与技术(影印版).北京：高等教育出版社.2001：256-258。
[29]任玉兰,梁繁荣.基于数据挖掘的经穴效应特性性文献评价思路.针刺研究.2009,34(3)：199-201。
[30]Neyman, J. (1937) "Outline of a Theory of Statistical Estimation Based on the Classical Theory of Probability", Philosophical Transactions of the Royal Society of London A,236, 333-380.
[2]李经纬,余瀛鳌.中医大辞典.北京：人民卫生出版社,2006：682。
[3]苏礼.《名医类案》导读.中医文献杂志.2005,23(2)：10-11。
[4]潘桂娟,侯亚芬.名医类案(正续编).北京：中国中医药出版社,1996：1。
[5]甄学燕.《续名医类案》述要.北京中医药.2010,29(12)：914-916。
[6]焦振廉.江瓘生平事迹评述.安徽中医学院学报.2009,28(1)：10-12。
[7]茅晓.略论《名医类案》的医史文献学成就.山西中医.2005,21(1)：37-38。
[8]俞中元.魏玉横临床的主要特色.中华医史杂志.2006,36(2)：79-82。
[9]许文忠.魏玉横组方思想再探.北京中医药大学学报.2003,26(5)：7-8。
[10]孟庆云.宣明往范,昭示来学：论中医医案的价值、特点和研究方法.中医杂志.2006,47(8)：568-570。
[11]茅晓.略论《名医类案》的医史文献学成就.山西中医.2005,21(1)：37-38。
[12]茅晓.略论《名医类案》的医史文献学成就.山西中医.2005,21(2)：46-48。
[13]茅晓.略论《名医类案》的医史文献学成就.山西中医.2005,21(3)：53-55。
[14]于凌,李其忠.从《续名医类案》看古代医案的临床价值.上海中医药杂志.2006,40(10)：46-47。
[15]茅晓.博稽精采,昭示来学：《名医类案·中风》学术成就评析.浙江中医学院学报.2001,25(5)：8-10。
[16]黄健,郭丽娃.《名医类案》中医心身医学成就初探.中国中医基础医学杂志.2007,13(4)：261-262。
[17]鲍健欣.浅析《名医类案·痰》.江苏中医药.2009,41(7)：75-76。
[18]陈贵华,李振彬,杨静,等.《名医类案》痛风篇探析.河北中医.2010,32(1)：117-118。
[19]曹竞超,许敬生.《名医类案》头痛治法探析.辽宁中医药大学学报.2008,10(10)：22-23。
[20]戴月笙.《名医类案》血证急重症案选析.福建中医药.1985(2)：55-57。
[21]鲍健欣.《名医类案》误诊医案初探.上海中医药杂志.2010,44(3)：54-55。
[22]凌芳,李成文.《续名医类案》中产后惊悸医案浅析.光明中医.2008,23(7)：915-917。
[23]杨杰,王米渠,孙洋,等.《续名医类案》关于双胞胎孕产辨证论治的探讨.现代中 西医结合杂志.2006,15(1)：3-4。
[24]许文忠.《名医类案》《续名医类案》补肝法初探.北京中医药大学学报.2006,29(6)：377-380。
[25]刘惠玲,童光东.试析《名医类案》外治法之运用.中医外治杂志.1998,7(2)：6,42。
[26]袁宜勤.《名医类案》之刺血验案评析.中国民间疗法.2009,17(8)：8。
[27]袁宜勤.《名医类案》之灸法验案探析.湖南中医药大学学报.2010,30(1)：4-5,72。
[28]茅晓.《名医类案》附子运用例析.山西中医.2001,17(5)：45-46。
[29]郑虎占,侯新楠,张敏.《名医类案》与《续名医类案》的中药特殊用法探讨.中医文献杂志.2007,25(3)：12-14。
[30]茅晓.《名医类案》研究的方法学探讨.南京中医药大学学报：社会科学版.2002,3(1)：34-36。
[31]孙燕,臧佳新,任廷革.基于数据挖掘技术的医案整理方法探讨.中国中医药信息杂志.2006,13(11)：106-107。
[32]黄利兴,周小青.数据挖掘技术在中医医案领域的应用进展.江西中医学院学报.2010,22(1)：92-94。
[33]孙艳秋,刘建平,刘世芳.基于数据挖掘技术名老中医经验传承的研究.辽宁中医药大学学报.2010,12(1)：223-224。
[1]焦振廉.试论中医文献研究的性质与范畴.山西中医学院学报.2007,8(4)：2。
[2]Han J M, Kamber M.数据挖掘：概念与技术(影印版).北京：高等教育出版社.2001：256-258。
[3]于长春,贺佳,范思昌,等.数据挖掘技术在医学领域中的应用.第二军医大学学报.2003,24：1250-1252。
[4]孙燕,臧佳新,任廷革.基于数据挖掘技术的医案整理方法探讨.中国中医药信息杂志.2006,13(11)：106-107。
[5]张文彤,姜庆五,赵耐青,等.数据挖掘技术在生物信息学基因变异规律研究的应用.中国卫生统计.2005,22(1)：5-8。
[6]徐天朝,苏晶.现代数理统计方法在中医方药文献研究中的应用.中国中医基础医学杂志.2011,17(4)：386-388。
[7]黄粤,高颖.数据挖掘技术在中医证候研究中的应用概述.上海中医药大学学报.2010,24(1)：85-87。
[8]曹洪欣,刘寨华,张华敏,等.基于聚类分析的病毒性心肌炎证候分类研究及证候特征研究.中医杂志.2007,48(7)：629-632。
[9]佘侃侃.方剂数据挖掘现状及存在问题的探讨.中医药导报.2009,15(5)：113-115。
[10]张林,梁茂新,宫俊,等.基于数据挖掘技术的方剂配伍规律研究述评.现代生物医学进展.2010,10(20)：3945-3947。
[11]姚美村,艾路,袁月梅,等.消渴病复方配伍规律的关联规则分析.北京中医药大学学报.2002,25(6)：48-50。
[12]苏奎国,付先军.基于数据挖掘方法的治疗变应性鼻炎经典方剂用药及配伍规律分析.中医杂志.2011,52(1)：57。
[13]庄力,周雪忠,贾彩燕,等.基于Biclustering的中医药症关系分析.计算机工程.2010,36(11)：241。
[14]李卫民,李卫红.方剂中生地黄配伍规律的研究.中华中医药杂志.2011,26(3)：483。
[15]司富春,李山霞.近30年临床子宫肌瘤中医证型和用药规律分析.世界中西医结合杂志.2009,4(01)：45-47,49。
[16]任玉兰,梁繁荣.基于数据挖掘的经穴效应特性性文献评价思路.针刺研究.2009,34(3)：199-201。
[17]赵凌,任玉兰,余毓如,等.有效整理古代针灸文献的研究方法与要求.成都中医药大学学报.2007,30(4)：1-2。
[18]任玉兰,赵凌,陈勤,等.数据挖掘技术在经穴选用及其特异性研究中的应用.中医杂志.2010,51(1)：47。
[19]张笑平.中医病案学.北京：中国中医药出版社.1995：1。
[20]郭军.基于数据挖掘分析前名老中医病案整理的思路与方法.中医药信息.2011,28(2)：49-50。
[21]谭定英,老膺荣,古求知,等.面向循证传承的名老中医个人医案数据挖掘研究思路初探.新中医.2011,43(8)：162-164。
[22]黄利兴,周小青.数据挖掘技术在中医医案领域的应用进展.江西中医学院学报.2010,22(1)：92-94。
[23]彭平,孙立新,郑玉光,等.数据挖掘及其在中医药领域的应用.河北中医.2009,31(7)：1072-1073。
[1]中医药学名词审定委员会.中医药学名词·2004.北京：科学出版社,2005：3。
[2]洪燕珠,周昌乐,张志枫,等.中医医案的研究进展.中医药通报.2008,7(3)：62-65。
[3]甄学燕.《续名医类案》述要.北京中医药.2010,29(12)：914-916。
[4]焦振廉.江瓘生平事迹评述.安徽中医学院学报.2009,28(1)：10-12。
[5]李经纬,余瀛鳌.中医大辞典.北京：人民卫生出版社,2006：682。
[6]苏礼.《名医类案》导读.中医文献杂志.2005,23(2)：10-11。
[7]潘桂娟,侯亚芬.名医类案(正续编).北京：中国中医药出版社,1996：1。
[8]茅晓.江瓘父子医案特色.浙江中医杂志,2001,3：93-95。
[9]李德新.中医基础理论.北京：人民卫生出版社,2001：199。
[10]王新华.中医基础理论.北京：人民卫生出版社,2001：705-726。
[11]中医药学名词审定委员会.中医药学名词·2004.北京：科学出版社,2005：81。
[12]GB/T20348—2006,中医基础理论术语.北京：中国标准出版社,2006：41。
[13]灵枢经.北京：人民卫生出版社,1963：114。
[14]王琦.中医体质学.北京：人民卫生出版社,2009：147。
[15]王新华.中医基础理论.北京：人民卫生出版社,2001：425-431。
[16]王新华.中医基础理论.北京：人民卫生出版社,2001：435。
[17]中医药学名词审定委员会.中医药学名词·2004.北京：科学出版社,2005：37。
[18]GB/T20348—2006,中医基础理论术语.北京：中国标准出版社,2006：44。
[19]中医药学名词审定委员会.中医药学名词·2004.北京：科学出版社,2005：42。
[20]中医药学名词审定委员会.中医药学名词·2004.北京：科学出版社,2005：58。
[21]GB/T20348—2006,中医基础理论术语.北京：中国标准出版社,2006：78。
[22]王新华.中医基础理论.北京：人民卫生出版社,2001：730。
[23]中医药学名词审定委员会.中医药学名词·2004.北京：科学出版社,2005：110。
[24]初杰.再论治则与治法.辽宁中医杂志.2002,29(7)：385。
[25]孟庆云.治则与治法.中国中医基础医学杂志.1995,1(3)：23。
[26]王新华.中医基础理论[M].北京：人民卫生出版社,2001：731。
[27]于长春,贺佳,范思昌,等.数据挖掘技术在医学领域中的应用.第二军医大学学报.2003,24：1250-1252。
[28]Han J M, Kamber M.数据挖掘：概念与技术(影印版).北京：高等教育出版社.2001：256-258。
[29]任玉兰,梁繁荣.基于数据挖掘的经穴效应特性性文献评价思路.针刺研究.2009,34(3)：199-201。
[30]Neyman, J. (1937) "Outline of a Theory of Statistical Estimation Based on the Classical Theory of Probability", Philosophical Transactions of the Royal Society of London A,236, 333-380.