基于数据挖掘的李秋艳治疗失眠271例病案分析

Analysis on 271 Cases of Insomnia Treated by Li Qiuyan on the Basis of Data Mining

目的总结归纳李秋艳教授治疗失眠的辨治思路、临证组方、用药特点及其用药规律。方法采用传统师承门诊抄方和电子病历采集分析相结合的研究方法,选取2014年9月-2016年4月以"失眠"为主诉于李秋艳教授门诊就诊,符合中西医诊断标准,且服用汤剂后疗效显著者。使用中医学术思想挖掘平台电子病历采集系统V1.0进行数据挖掘。结果共纳入95例患者,分析处方271张;其中女性患者203例,占74.9%,辨证属阴虚、肝郁者居多,川芎的使用频率最高,四气以寒性者最多,五味以苦味药为多,归经以心、肝经为主。结论李秋艳教授治疗失眠坚持辨病与辨证相结合,审因论治;明晰现代药理,灵活应用活血化瘀法;重视从心、肝论治;深谙四气五味归经功效,药物剂量小而专。

Objective To summarize Prof. Li Qiuyan's thought of syndrome differentiation and treatment,Chinese herbal prescriptions and the characteristics and law of drug use in the treatment of insomnia.Methods The clinical herbal formula transcription and collection of digital medical record were adopted. Insomnia as the chief complaint in the treatment by Prof. Li Qiuyuan from September 2014 to April 2016,which was in accordance with the diagnostic criteria of Chinese medicine and western medicine and had achieved the significant efficacy treated with herbal decoction. The data mining was done with medical file collection system V1. 0 of mining platform of TCM academic thought. Results Totally 95 patients were included,with271 formulas involved. Of the cases,203 cases were females,accounting to 74. 9%,differentiated as yin deficiency and liver stagnation. Lugusticum wallichii was used in the highest frequency. Regarding the four properties,the herbs of cold nature was the most commonly used and regarding the five flavors,the herb of bitter taste was commonly use. The herbs were mainly acting on the heart and liver meridians. Conclusion In Prof. Li Qiuyan's treatment of insomnia,the disease identification and syndrome differentiation are well coordinated to detect the causative factor and determine the treatment. Prof. Li is clear in modern pharmacology and flexibly applies the therapy for activating blood circulation and resolving stasis. The treatment focuses on the regulation of heart and liver functions and considers greatly the actions of four properties,five flavors and meridian relationship of herbs,with small dose and specific herb selected.