明清时期骨质疏松症证素特征及治法研究

Osteoporosis in the Ming and Qing Dynasties Study on its Characteristics and Treatment

目的:基于数据挖掘分析明清医案中骨质疏松症证素特征及治法。方法:收集明清时期医案,筛选明确诊断为骨质疏松症的医案并进行整理,应用“古今医案云平台(V2.2.1)”对病位、病性等信息进行分析。结果:骨质疏松症发病病位证素由高到低排序依次为肾、肝、脾、胃;骨质疏松症病性证素由高到低排序依次为阴虚、气虚、阳虚、血瘀、气滞,病性多见于本虚标实;统计出常见证型7个,其中肝肾阴虚证、脾胃虚弱证、肾阳虚证、脾肾阳虚证、气滞血瘀证频次居前5位;常见治法8个,其中滋补肝肾、填精壮骨,益气健脾、补益脾胃,补肾壮阳、强筋健骨,补益脾肾、强筋壮骨居前4位。结论:明清时期骨质疏松症的辨证分型比较繁杂,缺乏统一,运用证素辨证能够进一步深入揭示骨质疏松症辨证的实质及规律,再结合对该病的治法,可为临床提供新借鉴。

Objective:Study on the characteristics and treatment of osteoporosis in Ming and Qing Dynasties.Methods:Medical records of Ming and Qing dynasties were collected,medical records clearly diagnosed as osteoporosis were screened and sorted out,and the information of disease location and severity was analyzed by using“ancient and modern medical record cloud platform”.Results:Kidney,liver,spleen and stomach were the most important factors in the pathogenesis of osteoporosis.The order of the syndrome elements of osteoporosis from high to low was Yin deficiency,qi deficiency,Yang deficiency,blood stasis and qi stagnation.There were 7common syndromes,among which liver-kidney Yin deficiency syndrome,spleen-stomach weakness syndrome,kidney-yang deficiency syndrome,spleen-kidney Yang deficiency syndrome,qi stagnation and blood stasis syndrome ranked the first 5.There are 8common treatment methods,including nourishing liver and kidney,filling essence and strengthening bones;Invigorating qi and spleen,tonifying spleen and stomach;Tonifying kidney,strengthening muscles and bones;Tonifying spleen and kidney,strengthening tendons and bones in the top 4.Conclusion:The syndrome differentiation of osteoporosis in Ming and Qing dynasties was complicated and lacked unity.The application of syndrome differentiation of syndrome elements could further reveal the ess ence and law of syndrome differentiation of osteoporosis,and provide a new direction for the standardization of syndrome differentiation of osteoporosis.