摘要
目的：采用数据挖掘方式,对周仲瑛教授辨治慢性乙型肝炎的独到临证经验及学术思想进行数据挖掘,传承研究。
方法：对周仲瑛教授近10余年来积累的慢性乙型肝炎病案进行收集与整理,严格按照纳入标准、排除标准进行筛选,将符合标准的124例首诊病案的全部临床资料利用SQL-Server2005软件建立病案采集、存贮数据库,运用频数分布与关联规则分析其中的症状、病机、处方、用药之间的相关性,对挖掘结果进行分析、归纳、总结、讨论。
结果：124例患者以男性为主,男性87例,女性37例,平均年龄34.56岁。慢性乙型肝炎多发于青壮年男性,其中以31-41年龄段发病人数最多。本病以烦躁易怒、面色偏黯、口干苦、胃纳差、肝区疼痛、皮肤痉痒等主要症状,脉象多弦,舌苔黄腻,舌质暗红,患者的临床表现与其病机有一定的对应关系。主要病机为湿热瘀毒、湿热郁滞、肝脾两伤、肝胆湿热与肝肾阴虚。周老运用的主要药物,即分布频率>60%分别为茵陈、柴胡、广郁金、炒黄芩、炒苍术、厚朴、蒲公英、法半夏、甘草、赤芍、茯苓、垂盆草、藿香与佩兰。
结论：1.慢性乙型肝炎以烦躁易怒、面色偏黯、口干苦、胃纳差、肝区疼痛、皮肤瘙痒、疲劳乏力、腰膝酸痛、尿黄量少、寐差为主要症状,脉象多弦,舌苔黄腻,舌质暗红；2.慢性乙型肝炎的主要病机证型为湿热瘀毒、湿热郁滞、肝脾两伤、肝胆湿热与肝肾阴虚；3.周仲瑛教授治疗慢性乙型肝炎以清热解毒利湿药为主；4.周仲瑛教授针对不同证型组方有规律可循,加减灵活。
Objective:To research on Professor Zhou Zhongying's treatment experience and academic thoughts on Chronic Hepatitis B by mining dates in cases of this field.
Methods:First, collected and organized Professor Zhou Zhongying's medical records on Chronic Hepatitis B in nearly 10 years. Second, established the medical records database by SQL-Server2005 software with the 124 qualified first visit patients journal, which was according to the strict inclusion criteria and exclusion criteria. Third, analyzed the correlation in symptoms, pathogenesis, prescriptions and drugs by the methods of frequency distribution and association rules, then summary and discuss the mining results.
Results:124 Chronic Hepatitis B patients,87 are males and 37 are females, with average age as 34.56 years old. It happened mainly in young men, which the incidence of the largest number of age is ranged from 31 to 41. Chronic Hepatitis B's main symptoms are irritable, dark complextion, dry and bitter mouth, bad appetite, pain in liver area, itch shin, string pulse, yellow greasy tongue coating and dark red tongue body. Patients symptoms correlate to its pathogenesis. Chronic Hepatitis B's main pathogenesis are damp and heat toxic stagnation, damp stasis and heat stagnation, liver and spleen injury, dampness and heat in liver and gallbladder, liver and kidney yin difficiency. The mainly drugs Professor Zhou Zhongying used with distribution frequency>>60%are yinchen, chaihu, guangyujin, baked huangqin, baked cangzhu, houpu, pugongying, prepared banxia, gancao, chishao, fuling, chuipengcao, huoxiang and peilan.
Conclusions:1. Chronic Hepatitis B's main symptoms are irritable, dark complextion, dry and bitter mouth, bad appetite, pain in liver area, itch shin, fatigue, waist and knee pain, dark and less urine, poor sleep, string pulse, yellow greasy tongue coating and dark red tongue body. 2.Chronic Hepatitis B's main pathogenesis are damp and heat toxic stagnation, damp stasis and heat stagnation, liver and spleen injury, dampness and heat in liver and gallbladder, liver and kidney yin difficiency.3. The mainly drugs Professor Zhou Zhongying used for Chronic Hepatitis B herbals can clear heat, remove dampness and detoxification.4. Professor Zhou Zhongying's formulations for different Chronic Hepatitis B's syndromes are regular with flexible addition and subtraction.
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