基于古今医案数据挖掘的“酒伤”湿病证治规律探究

Study on the Rule of Syndrome and Treatment of "Alcoholic Injury" Damp Disease Based On Data Mining of Ancient and Modern Medical Records

目的:探索"酒伤"所致内伤湿病的证治规律。方法:搜集并整理中华医典(5.0)、中国知网(CNKI)、大医医学搜索、维普数据库(VIP)、万方数据库及中国生物医学文献数据库(CBM)中"酒伤"相关医案,将医案进行规范处理后,建立"酒伤"内伤湿病数据库,将医案录入中医传承辅助平台(V2.5)软件,借助软件分析系统,剖析"酒伤"内伤湿病医案中的常见疾病、主要证型、治则治法、常用药物、常用药物组合。结果:纳入医案共101则,涉及证型30种,82种症状,11种舌象,治则治法63种,中药212味;常见疾病为泄泻(16)、呕吐(9)、咳嗽(7)、黄疸(6)、胃痛(5)、呕血(5)等;症状以大便次数多(19)、大便稀(19)、呕吐(17)、食少(16)、咳嗽(12)、头昏(11)、发热(11)为主;舌象中舌质以淡白舌(34)、红舌(30)、淡红舌(12)为主,舌苔以白腻苔(21)、黄腻苔(16)、薄白苔(12)为主;证型以湿浊内盛(29)、脾胃阳虚(21)、痰湿蕴肺(19)、湿郁化热(11)、肝失疏泄(8)、脾肾阳虚(7)为主;常见药物为茯苓(56)、白术(32)、甘草(31)、半夏(27)、陈皮(22)等;关联分析得出频数较高的药物组合为"白术-茯苓"(24)、"半夏-茯苓"(22)、"甘草-茯苓"(20)、"陈皮-茯苓"(17)、"半夏-陈皮"(14)。结论:关于"酒伤"所致内伤湿病,历代医家立足中焦气机升降,囊括三焦祛湿基本治法,尤以温阳祛湿、清热利湿、淡渗利湿、理气化湿、降逆止呕、芳香化湿、健脾益肾等为主。

Objective: With the help of data mining software, to explore the rule of syndrome and treatment of internal injuries caused by alcohol injury. Methods: The relevant medical records of "alcoholic injury" in Chinese Medical Dictionary(5.0), China National Knowledge Network(CNKI), Big Medical Search, VIP Database(VIP), Wan fang Database and Chinese Biomedical Literature Database(CBM) were collected and sorted out. After standardized treatment of medical records, the database of "alcoholic injury" was established, and the medical records were input into the traditional Chinese medicine inheritance support platform(V2.5) software. With the help of software analysis system, the common diseases, main syndromes, therapeutic principles and methods,common drug frequency and common drug combinations in the medical records of "alcoholic injury" were analyzed.Results: A total of 101 medical records were included, involving 30 kinds of syndromes, 82 kinds of symptoms,11 kinds of tongue images, 63 kinds of treatment principles and methods, 212 kinds of traditional Chinese medicine. The most common diseases were diarrhea(16), vomiting(9), cough(7), jaundice(6), stomachache(5),hematemesis(5), etc. The main symptoms were stool frequency(19), thin stool(19), vomiting(17), eating less(16),cough(12), dizziness(11), etc. The highest frequency of tongue appearance were pale tongue(34), red tongue(30)and pale red tongue(12). The highest frequency of tongue coating were white greasy coating(21), yellow greasy coating(16) and thin white coating(12). The highest frequency of syndromes were wet turbidity(29), spleen and stomach yang deficiency(21), phlegm retention lung(19), damp heat(11), liver dysfunction(8), spleen and kidney yang deficiency(7). The common drugs were Fuling(Poria)(56), Baizhu(Atractylodis macrocephalae rhizoma)(32),Gancao(Glycyrrhizae radix et rhizoma)(31), Banxia(Pinelliae rhizoma praeparatum)(27), Chenpi(Citri reticulatae pericarpium)(22), etc. Correlation analysis showed that the drug combinations with high frequency were Baizhu(Atractylodis macrocephalae rhizoma)-Fuling(Poria)(24), Banxia(Pinelliae rhizoma praeparatum)-Fuling(Poria)(22),Gancao(Glycyrrhizae radix et rhizoma)-Fuling(Poria)(20), Chenpi(Citri reticulatae pericarpium)-Fuling(Poria)(17),Banxia(Pinelliae rhizoma praeparatum)-Chenpi(Citri reticulatae pericarpium)(14). Conclusion: With regard to the internal injury and dampness caused by "alcohol injury", doctors of previous dynasties based on the rise and fall of the medium coke Qi machine, and the treatment methods are mainly warming yang and removing dampness,clearing heat and dampness, light infiltration and dampness, regulating qi and removing dampness, reducing inversion and stopping vomiting, aromatizing dampness, strengthening spleen and kidney, etc.