国医大师周仲瑛辨治口疮医案解构

Deconstruction of Clinical Experience in Treating Aphtha by Zhou Zhong-ying,a Master of TCM

目的:基于中医本体特色,引入文本挖掘法并改进研究模式,结合原始医案数据挖掘分析,形成医案解构,从中分析周仲瑛教授临床治疗口腔溃疡的经验。方法:对周仲瑛教授治疗口腔溃疡医案进行解构分析,并结合数据挖掘分析运用规律。结果:本次研究涉及病例65例,诊次128次,病种101种,涉及病机88条,药物258种,药物种类覆盖9大类。结论:口腔溃疡可见口腔黏膜糜烂、疼痛,常伴见疲劳、乏力、大便稀、寐差、腰酸、视物模糊、头晕、怕冷、多汗、口干等,病机总属阴虚火旺,湿热上炎,痰瘀郁阻。治疗以清热养阴生津法为主,辅以解毒、利湿、化痰散结、活血止血等,核心用药包括白残花、麦冬、肿节风、马勃、白僵蚕、黄连、玄参等。

Objective： Based on the ontological characteristics of traditional Chinese medicine,text-mining method is introduced and the research model is improved. Combining with the original medical record data-mining analysis,medical record deconstruction is formed,and the experience of Professor Zhou Zhong-ying in treating oral ulcer is analyzed. Methods： This paper deconstructed and analyzed Professor Zhou Zhong-ying＇s medical records of treating oral ulcer,and analyzed the application rules with data-mining.Results： The study involved 65 cases,128 visits,101 kinds of diseases,involving 88 pathogenesis,258 kinds of drugs,drug types covered 9 categories. Conclusion： Oral ulcer can be manifested as oral mucosal erosion,pain,often accompanied by fatigue,weakness,loose stool,poor sleep,lumbar acid,blurred vision,dizziness,fear of cold,sweating,dry mouth,etc.,pathogenesis is always yin deficiency and excessive fire,dampness and heat inflammation,phlegm-stasis stagnation. The treatment mainly focuses on heatclearing,yin-nourishing and Jin-generating therapy,supplemented by detoxification,dampness-relieving,phlegm-dispersing,bloodactivating and hemostasis. The core medicines include Baicanhua（Rosa multiflora Thunb）,Maidong（Radix Ophiopogonis）,Zhongjiefeng（Herba Sarcandrae）,Mabo（Lasiosphaera seu Calvatia）,Baijiangcan（Bombyx Batryticatus）,Huanglian（Rhizoma Coptidis）,Xuanshen（Radix Scrophulariae）,etc.