基于临床观察文本解析痛经辨治规律研究

Differentiation and Treatment Rule of Dysmenorrhea Based on Clinical Text Analysis

目的:研究痛经的中医药辨治规律。方法:检索国家知识基础设施数据库(CNKI)1988—2019年应用中药治疗痛经的相关文献,采用Medcase Ver3.8诊籍中医师工作室-名老中医经验传承辅助平台,运用文本解析对临床医案进行研究。结果:研究文献131篇,医案104则,涉及病例128次,332诊次,涉及症状92条,病机33条,舌象27条,脉象17条,药物249种。结论:中医药治疗痛经的特异症状为“经行腹痛”,可见症为“夹血块、月经色暗、手足冰冷、经期腰酸”,相关舌脉为“舌质暗红,苔薄白”“脉沉细弦”,核心病机为“瘀血阻滞”,常用治法为“行气化瘀,活血止痛”,常用药物为“当归、白芍、甘草、延胡索、川芎”。

Objective:To study the differentiation and treatment rule of dysmenorrhea with traditional Chinese medicine.Methods:Literature related to the treatment of dysmenorrhea with traditional Chinese medicine from 1988 to 2019 was retrieved from China National Knowledge Infrastructure(CNKI),and the medical cases were studied by text analysis using Medcasever3.8,an experience inheritance assistant platform from famous traditional Chinese medicine veterans.Results:There were 131 literature,involving 104 medical cases and 128 patients for a total of 332 consultations,and 92 symptoms,33 pathogenesis,27 tongue manifestations,17 pulse manifestations,and 249 medicinal materials were included.Conclusion:The specific symptom of dysmenorrhea in traditional Chinese medicine treatment was abdominal pain,with blood clots,dark color of menstruation,cold hands and feet,and soreness of the lower back,and having dark red tongue with thin and white coating and deep,thread and wiry pulse.The core pathogenesis was static blood obstruction,and the common treatment principles were moving qi,resolving stasis,activating blood and stopping pain using Radix Angelicae Sinensis,Radix Paeoniae Alba,Radix Glycyrrhizae,Rhizoma Corydalis and Rhizoma Ligustici Chuanxiong.