廖志峰主任医师治疗失眠用药规律:基于数据挖掘技术

目的:采用数据挖掘技术探寻全国名中医廖志峰治疗失眠的用药规律和用药的临床特点。方法:收集整理近五年(2017—2022年)廖志峰名中医工作室门诊治疗有效的失眠病案,运用Excel 2010、IBM SPSS Statistics 21.0、IBM SPSS Modeler 18.0等软件进行数据统计分析。结果:获得完整的、符合标准的处方共242首,中药177味,其中高频药物有远志(210次)、酸枣仁(164次)、柏子仁(154次)、茯苓(119次)、半夏(115次)、龙骨(115次)等;通过关联规则分析出的相关药物组合中,二项关联规则以“远志→酸枣仁”支持度及置信度排名靠前;三项关联规则以“远志→柏子仁、酸枣仁”支持度及置信度排名靠前。药物关联网络图显示柏子仁、远志、酸枣仁、茯苓、龙骨等药物与其他的高频药物之间关系紧密,用药频率比较高。高频药物可聚为5类。结论:廖志峰名中医辨治失眠用药主要脏腑为心、肝、肾,配伍多在辨证论治的基础上加入安神之品,以四君子汤、酸枣仁汤、天王补心丹、温胆汤等处方为基础方剂,加入镇静安神、宁心安神的药品,处方简练有效,辨证准确。

基于数据挖掘刘国安教授治疗老年高血压临床经验研究

目的:分析刘国安教授治疗老年高血压的用药规律和临床经验。方法:收集2020年10月1日至2021年10月1日刘国安教授诊治的58例老年高血压患者病案信息,描述性分析用药频数、性味等用药情况,对高频用药进行聚类分析、因子分析。结果:58首处方共涉及中药65味,频数≥20次的中药有10味,前3位依次为生地黄,甘草,山药、牛膝;药性多为平、寒;药味多为甘,其次苦和辛;药物归经多以肝、心、肾为主。高频药物因子分析得出4个公因子,主要涉及生龙骨、生牡蛎、柏子仁、牛膝、山药、白芍、甘草等7味中药。高频药物聚类分析得到6类:第1类为生龙骨、生牡蛎、生地黄,第2类为山药、白芍,第3类为牛膝、柏子仁;其余3类为单味药,分别是夜交藤、当归、甘草。结论:刘教授认为老年高血压多为肾阴亏虚,水不涵木,肝阳上亢,化火生风,痰瘀互结所致,用药以滋肾阴、平肝阳、疏肝风、清肝火、安心神为主,体现出寓通于补,通补兼施的治疗思想。

徐宜厚教授辨证治疗寻常型银屑病学术研究

[目的]总结徐宜厚教授治疗寻常型银屑病的学术观点和临床经验。[方法]通过跟师学习,分析研究徐宜厚老师治疗寻常型银屑病临床病案,从病因病机、辨证论治、经验用药等方面总结老师治疗寻常型银屑病的学术思想和临证经验,并举验案佐证。[结果]徐宜厚教授认为寻常型银屑病病因病机是外感六淫侵袭,肺胃气机不畅,气血运行受阻,肌肤失养;内伤七情以及饮食不节为主,日久化火,营血亏虚,外伤肌表,腠理毛窍闭塞,气滞血瘀。其将寻常型银屑病辨证分为风热证、血热证、血燥证、血瘀证,从解表祛风、凉血解毒、养阴润燥、化瘀解毒治疗用药,分别采用消风散、银花虎杖汤、养血润肤汤、黄芪丹参汤等加减。同时采用分期辨病,将寻常型银屑病分为进行期、退行期、静止期三期,病证结合,又结合外治法,药浴、软膏、针罐疗法等,临床治疗取得满意疗效。所举医案4则,体现了徐宜厚教授辨证论治寻常型银屑病,分别以祛风、凉血、养血、化瘀等方法治疗的思路,取得良好的疗效。。[结论]徐宜厚教授分期辨病,进行期宜驱邪法,退行期宜攻补兼施,静止期扶正固本或者滋阴护液。病证结合治疗寻常型银屑病有良好的临床疗效,充分体现了中医整体观念、辨证论治的精髓,其分期辨病、病证结合、辨病用药的学术观点及临床经验值得推广。

谢晶日相火论治溃疡性结肠炎经验浅析

溃疡性结肠炎是一种慢性非特异性炎症性疾病,病变范围主要影响大肠黏膜和黏膜下层,属于现代难治病之一,临床上以腹痛、腹泻、黏液脓血便、里急后重为其主要症状。中医并无此病名,根据症状往往将其归为泄泻、痢疾、滞下、肠癖、脏毒等范畴,病理因素多为湿、热、瘀、毒。病性为本虚标实。病位一般在肠,但可涉及多个脏器,病程较长,一旦发病往往伴随终身,迁延不愈,严重影响患者的生活质量。相火理论是中医特色理论之一,首见于《黄帝内经》,相火起于命门,寄于肝、胆、三焦等脏腑,可以温通脏腑,裨助生化之机,维持人体正常的生理功能。谢晶日教授结合丰富的临床经验,认为相火理论与溃疡性结肠炎有着密切的关系,相火离位则妄动为病,相火失位、相火过亢、相火虚衰为相火的3种病理状态,均会导致溃疡性结肠炎的发病。谢晶日教授以相火理论为基础,根据病因病程及患者体质的不同,从清化湿热、调和肝脾、益肾壮火3个方面论治本病,使相火归位,病邪去,诸证自安,临床疗效颇丰。

虞坚尔教授辨治小儿胃食管反流性咳嗽的经验浅谈

虞坚尔教授认为小儿胃食管反流性咳嗽的主要病机在于肺脾不足为本、脏腑受邪为标,痰饮、食积为重要病理因素,治疗当肺脾同调、标本兼顾,同时注重气道痉挛的病位治疗,注意顾护小儿脾胃慎用寒凉、金石等品,后附验案1则。

著名中医学家林兰教授学术经验系列之五 辟秽降浊防传变养阴生津贵润燥——治疗糖尿病乳酸性酸中毒的经验

乳酸性酸中毒属于中医“秽浊”、“神昏”、“脱症”等范畴。主要病因病机可概括为脾失健运 ,湿浊中阻 ;心火肝郁 ,痰浊蕴结 ;误治失治 ,阴脱阳亡三端。治疗上中医可分痰浊中阻型、痰浊蒙蔽型和阴脱阳亡型灵活论治 ;宜抓住治疗时机 ,中西医结合以提高疗效 ,降低死亡率。

基于信息化知识管理系统的中医拔尖人才培养模式

中医拔尖人才的培养是新时期中医院校和中医医院发展的“核心竞争力”,信息化知识管理系统是运用信息技术将名老中医的隐性知识转化为显性知识,利用网络存储、系统开发、资源共享的便捷性探索适用面更广、形式更灵活多样、可操作性更强的中医拔尖人才培养模式.

于志强运用花类药调节肝之疏泄经验

于志强教授临证配伍花类药,取其气味芬芳,质轻不燥,性善上达,理气而不伤阴,清热而不败胃,凉血而不壅滞的特点及其疏肝理气、醒脾和胃、活血化瘀、凉血清热、解郁安神的作用,用其调节肝之疏泄功能尤为适当,用于治疗情志病、皮肤疾病、妇科疾病、心血管系统、消化系统疾病,恰如其分,每获良效。

高思华教授运用血府逐瘀汤治疗不孕症经验

高思华教授认为不孕症的病机在气在血,病位在肝,可涉及脾脏,临床多以气滞血瘀为主要病机。高思华教授治疗不孕症擅长用血府逐瘀汤,以标本同治,调理气血为诊疗思路,充分体现了高思华教授谨守病机,审时度势,随证施治的治疗思想。

Professor Zhang Yu-zhen's medication rule in treating metrorrhagia and bleeding based on data mining

Objective:To explore the medication rules of Professor Zhang Yuzhen in treating the bleeding period of metrorrhagia and metrostaxisthe,and to explore the treatment of the disease.Methods:Collected 520 prescriptions of Professor Zhang Yuzhen in the treatment of patients with the bleeding period of metrorrhagia and metrostaxis,and analyzed the regularity of medication by using"TCM inheritance assist platform(V2.5)".Results:According to the analysis,the top 30 most frequently used herbs for treating the bleeding period of metrorrhagia and metrostaxisthe were Codonopsis pilosula,Trogopterus dung,Cattail pollen,Motherwort,Cornus,Ophiopogon japonicas,Schisandra,Tortoiseshell,Panax notoginseng,Radix Paeoniae Alba,etc.Core combination 35 In the group,the core prescription has 1 hemostasis,followed by 2 hemostasis,and evolves to get 3 new prescriptions.Conclusion:Professor Zhang Yuzhen's medication for the treatment of metrorrhagia and metrostaxisthe is mostly Gan Wen's product.The treatment is based on the three organs of the liver,spleen,and kidney,and the disease is treated with"tonifying the kidney and benefiting qi,reducing blood stasis and stopping bleeding".

Research Progress on Refractory Hypertension in Traditional Chinese Medicine

At present,the mortality rate and disability rate caused by cardiovascular and cerebrovascular diseases are very high in China.Individuals with refractory hypertension are at a greater risk of developing chronic kidney disease,heart failure,stroke and myocardial infarction.Therefore,how to effectively control blood pressure and identify the cause of refractory hypertension is a problem that medical workers need to solve,and it is also the key to prevent cardiovascular disease.In recent years,the government actively supports the development of traditional Chinese medicine.Since the curative effect of traditional Chinese medicine is recognized by the public,the prospect of traditional Chinese medicine in the prevention and treatment of refractory hypertension is considerable,and it is expected to become the main key research direction in the future.

Experience inheritance from famous specialists based on real- world clinical research paradigm of traditional Chinese medicine

The current modes of experience inheritance from famous specialists in traditional Chinese medicine （TCM） include master and disciple, literature review, clinical-epidemiology-based clinical research observation, and analysis and data mining via computer and database technologies. Each mode has its advantages and disadvantages. However, a scientific and instructive experience inheritance mode has not been developed. The advent of the big data era as well as the formation and practice accumulation of the TCM clinical research paradigm in the real world have provided new perspectives, techniques, and methods for inheriting experience from famous TCM specialists. Through continuous exploration and practice, the research group proposes the innovation research mode based on the real-world TCM clinical research paradigm, which involves the inheritance and innovation of the existing modes. This mode is formulated in line with its own development regularity of TCM and is expected to become the main mode of experience inheritance in the clinical field.

庄礼兴“调神针法”治疗双心疾病经验撷要

This study summarizes Prof. Li-xing ZHUANG's experience in treating psycho-cardiological disease, which is characterized by cardiovascular somatic symptoms and emotional abnormalities. Psycho-cardiological disease is mainly caused by disorders of the brain and heart shen-mind, and related to the dysfunction of zangfu functions. In acupuncture treatment, attention should be paid to “regulation of the heart and brain, and taking zangfu organs in to account at the same time.” Sìshénzhēn (四神针) of JIN’s three-needle, Shéntíng (神庭GV 24) and Yìntáng (印堂GV29) are adopted to regulate the brain, Shénmén (神门HT7) or Nèiguān (内关PC6) are used to regulate the heart shen-mind, Hégǔ (合谷LI4), Tàichōng (太冲LR3), and Sānyīnjiāo (三阴交SP6) are used to regulate zangfu, and the Daoqi Tongjing method is applied to regulate the qi and blood, achieving good effects in the clinical setting.

Study on the Drug Selection Law for Treatment of Chronic Gastritis with Spleen Deficiency and Stomach Dryness by Complex System Entropy Cluster

Objective:To study on Prof. GAO Zhong-ying’s drug selection law for treatment of chronic gastritis with data mining technique. Methods: The 407 medical records of chronic gastritis treated by Prof. GAO Zhong-ying were collected and the study on these drugs in the recipes was carried out with data mining method. Among them, the recipe composed of one drug was studied with frequency statistical method, correlativity between drug pairs with improved mutual information, correlativity among multi-drugs with complex system entropy cluster technique. Results: In treatment of chronic gastritis by Prof. GAO Zhong-ying there were 30 drugs with a higher use frequency of over 38 times, 94 commonly-used drug pairs with correlation coefficient of over 0.05, 11 commonly-used drug core combinations. Conclusion: The results attained with data mining technique for studying experience of famous and old TCM physicians conform to the clinical practice and the method is of an important significance for summarization of famous and old TCM physicians’ experiences.