基于真实世界的当代吴门医派名老中医辨治便秘学术经验研究

Study on the Academic Experience Of The Famous Traditional Chinese Medicine Practitioners of WU Medical School in the Treatment of Constipation Based on the Real World

目的:回顾性分析当代吴门医派名老中医临证治疗便秘的病案情况,采用现代信息学技术深度挖掘其辨治便秘用药规律和学术思想。方法:根据研究诊断和纳入标准收集我院三位当代吴门医派名老中医门诊辨治便秘病例,并进行数字化采集和处理建立临床病历数据库,对病历基本信息采用描述性分析,采用频数分析法研究便秘证型、方药治法分布用药频次和药性构成情况,关联分析法挖掘病-药配伍经验,复杂网络分析治疗便秘有效药对和药组,结合人机交互方法梳理、总结当代吴门医派名老中医辨治便秘的经验。结果:便秘证型分布呈现以气虚血瘀证、脾肾阳虚证和脾虚湿热证居多的趋势,临证常用全当归、炙甘草、生白术、肉苁蓉、枳实等中药,以生白术-枳实、杏仁-槟榔、当归-肉苁蓉、升麻-枳壳、栝楼仁-杏仁为治疗便秘的5个常用的药对,元参-麦冬-火麻仁、厚朴-枳壳-大黄、生地-麦冬-玄参为治疗便秘的常用3个药组,分析核心处方发现理气健脾、辛润通络为治疗便秘主要治法。结论:当代吴门医派名老中医辨治便秘以"络病"理论为指导,用药侧重活血化瘀、辛润通络类中药;基于真实世界的临床资料数据挖掘,总结被名中医认可的诊疗规律和有效方药等信息,以利于青年医者继承名中医经验并临床推广。

Objectives：To analyze the Wumen medical school with academic experience in TCM syndrome differentiation and treatment of constipation. Methods： Select three contemporary Wumen medical school doctors treating constipation in TCM clinical case for digital acquisition and process. Frequency analysis, complex network analysis and point type mutual information analysis were used for data mining. In addition, people machine combined of method analytical data results were made in order to explore experience of famous TCM doctors of contemporary Wumen medical school on treating constipation. Results： Analysis of multidimensional data retrieval syndrome distribution, prescription treatment of constipation and association rules with constipation drug dependence as well as drug effective and drug group of complex networks. Conclusion： Famous TCM doctors of contemporary Wumen school medical were accomplished in differentiation and treatment of constipation with ＂Prolonged constipation and collaterals＂ theory, they also paid attention to herbal medicine of activating blood circulation to remove blood and activating collaterals and activating collaterals. It can be widely used in clinical diagnosis and treatment of constipation.