数据挖掘陈志强教授对早中期慢性肾衰竭辨证思路

Study of syndrome differentiation thought about Professor CHEN Zhi-qiang in treating chronic renal failure of early and middle stages by data mining

[目的]运用数据挖掘技术,研究陈志强教授对早中期慢性肾衰竭(CRF)的辨证思路。[方法]收集经陈教授门诊应用中药处方诊治的早中期CRF病案,并在陈教授指导下进行辨证分析,运用计算机软件对每例病案的证候要素进行频数统计、关联规则分析,并挖掘证候与症状的对应关系。[结果]研究共录入病案信息223条,涉及证候要素11种。其中,脾肾气虚为本病最主要的本虚证候,血瘀为最重要的标实证候,其次为湿邪壅滞,在此本虚标实的基础上,半数以上均伴有脾肾阳虚。3种最常见的证候组合,均可出现乏力、畏寒、水肿、腰腿痛、寐差、舌暗红、苔腻、脉细,而其特有的重要症状则侧重辨寒热阴阳。[结论]陈志强教授对早中期CRF辨证,多从脾肾气虚为本,瘀阻、湿壅为标,并在此基础上辨寒热阴阳。

[Objective] To study the syndrome differentiation thought of Professor CHEN Zhi-qiang in treating chronic renal failure of early and middle stages by data mining. [Methods] Collect the cases of chronic renal failure in early and middle stages diagnosed and treated by Professor CHEN Zhi-qiang using Chinese medicine therapy. Analysis of syndrome differentiation was guided by Professor CHEN Zhi-qiang. The frequencies and association rules of syndrome elements of every ease, as well as the relations between syndromes and symptoms, were analyzed by multiple computer software. [Results] A total of 223 medical records were input, covering 11 syndrome elements. Spleen-kidney Qi deficiency was the primary syndrome of deficiency, and blood stasis was the excess syndrome above all, with dampness obstruction in the second place. On this basis of it, over half were accompanied by spleen-kidney yang deficiency. Symptoms of fatigue, intolerance of cold, edema, pain in waist and lower extremities, insomnia, dull-red tongue, greasy tongue coating and fine pulse could be present in all three most common syndrome combinations. However, the special vital symptoms were used to identify cold and heat as well as Yin and Yang. [Conclusion] Professor CHEN Zhi-qiang regards that chronic renal failure of early and middle stages is mostly caused by spleen-kidney Qi deficiency and blood stasis and dampness obstruction, in addition, cold heat and Yin-Yang are identified.