基于医案数据分析的半夏泻心汤治疗消化性溃疡的方证关系研究

Study on Relationship between Classical Prescriptions and Syndromes of Banxia Xiexin Decoction Treating Peptic Ulcer Based on Medical Records Data Analysis

目的基于医案分析的半夏泻心汤治疗消化性溃疡的临床研究。方法检索选取1970-2018年半夏泻心汤治疗消化性溃疡的典型临床医案60例进行分析。将医案中的症状及体征进行术语规范化等处理,抽取医案信息建立EXCEL表,应用数据分析软件包R×643.5.0对数据进行频数分析及关联规则分析。结果60例半夏泻心汤治疗消化性溃疡医案中,发现频数较高的症状及体征为胃脘痛、脘胀、食欲减退、口苦、嗳气、口中泛酸等;通过关联规则分析可知,以支持度>=0.1,置信度>=0.6为参数进行分析,27个症状(包括体征)之间的关联规则共有100项,其中提升度大于1.500的关联规则有16项,分别为肠鸣-滑脉、肠鸣-大便稀溏、厚苔-小便短少黄赤、腹胀-嗳气等关联项集,从中分析可知半夏泻心汤治疗消化性溃疡的基本病机为寒热错杂、湿热中阻、脾胃虚弱等。结论基于医案整理半夏泻心汤治疗消化性溃疡的方证研究对消化性溃疡临床治疗提供参考依据,对提高临床疗效具有积极意义。

Objective To study the relationship between classical prescriptions and syndromes of Banxia Xiexin Decoction treating peptic ulcer based on medicalrecords data analysis.Methods A total of 60 clinical cases of peptic ulcer treated with Banxia Xiexin Decoction from 1970 to 2018 were selected.The symptoms and signs in the medical cases were standardized.We extracted the medical informationto establish the excel table and used the analysis of frequency and association rulesof software package R×643.5.0 to analyze the data.Results We can find the high frequency of the symptoms and signs werestomach cramps,bloating,loss of appetite,bitterness,belching and pantothenic acid ina total of 60 clinical cases of peptic ulcer treated with Banxia Xiexin Decoction.According to the analysis of association rules,with support>=0.1 and confidence>=0.6 as parameters,a total of100 rules in the association between 27 symptoms and signs,the correlation between item sets which were greater than 1.500 were16 rules,which werebowel sounds-smooth pulse,bowel sounds-loose stool,thick tongue coating-short yellowurination,abdominal distension-belching,etc.From the analysis,it can be seen that the basic pathogenesis of Banxia Xiexin Decoction in the treatment of peptic ulcer is mixed cold and heat,dampness and heat resistance,deficiency of spleen and stomach,etc.Conclusion Study on the relationship between classical prescriptions and syndromes of Banxia Xiexin Decoction treating peptic ulcer based on medical records data analysis provides reference for clinical treatment of peptic ulcer and makes a positive significance for improving clinical efficacy.