【作者】 郑绍勇；

【导师】 梅晓云；

【作者基本信息】 南京中医药大学 ， 中医基础理论， 2010， 博士

【摘要】 目的：从中医古籍文献中整理挖掘肝失疏泄所致病证的治法方药以用于临床实践；探索二分类Logistic回归方法在挖掘利用中医文献资料的可行性。方法：从中医古籍文献中逐条摘录出与肝失疏泄有关的篇章、段落或条文,提取出其中的主要要素：病证名、症状、病因、病机、病位、舌象、脉象、治法、方剂、中药等,对各要素进行规范化处理；利用二分类Logistic回归统计方法对各病证的相关症状、病因、病机、病位、舌象、脉象、治法、方剂、中药等进行数据挖掘。文献整理结果：总共摘录2342个个案；经过规范化处理后,病证名共有胁痛、腹痛、胃痛、眩晕、呕吐、癥瘕、头痛、瘰疬、崩漏、乳房结核、胸痛、不寐、发热、惊悸、泄泻、热淋、腰痛等60个；症状共有胁胀、腹胀、少腹痛、食欲减退、拘挛、恶寒发热、吞酸、目赤肿痛、口苦、抽搐、脘痞、烦躁、乳房痛胀、胸闷不舒等92个；舌象共有舌黄、苔黄腻、舌红等13种；脉象有弦脉、数脉、细脉、沉脉、涩脉等19种；病位涉及肝、脾、胃、腹部、胁部、胆、肾、肺等18个；病因共有郁怒、忧思、情怀抑郁、七情所伤、肝胆郁热、肝经湿热、过劳、悲苦、肝经风热、谋虑不决、肝胆风热等18种；病机涉及肝气郁结、肝乘脾胃、肝气盛、肝火盛、肝郁化火、肝气上逆、血虚、肝气横逆、脾虚、肝火上逆、水不涵木、脾失健运等70种；治法包括疏肝理气、清肝泄火、疏肝解郁、补益脾胃、补肝养血、和中安胃、平肝抑木等20种；方剂共有逍遥散、小柴胡汤等362个；中药共白芍、当归、茯苓、柴胡等518味。数据挖掘结果：以“胁痛”为示例,挖掘出了肝失疏泄所致“胁痛”的伴随症状、病因、病机、治法、方剂、中药,具体是：胁胀、口苦、烦躁、易怒、目赤肿痛、少腹痛、恶寒发热是肝失疏泄所致“胁痛”的常见的伴随症状；郁怒、悲苦、虚劳是肝失疏泄所致“胁痛”的常见病因；肝胆气郁、肝胆实火、肝气郁结、肝气盛、肝火盛是肝失疏泄所致“胁痛”的常见病机；疏肝理气、疏肝解郁是肝失疏泄所致“胁痛”的主要治法；柴胡疏肝散是肝失疏泄所致“胁痛”的首选方剂,其次化肝煎、当归芦荟丸、逍遥散；柴胡是肝失疏泄所致“胁痛”的首选中药,其次青皮、木香、桔梗、白芍。结论：通过对中医文献的规范化处理后,利用二分类Logistic回归统计方法能比较准确地从古籍文献中挖掘出肝失疏泄所致“胁痛”的主要治法方药；从临床报道与实验研究两方面来看,挖掘结果在临床与实验研究中均取得了很好的疗效；在一定程度上证明了利用二分类Logistic回归统计方法挖掘整理中医文献资料可行性与实用性,对中医文献资料的挖掘利用方法研究具有一定的借鉴意义。更多还原

【Abstract】 Objective:the ancient Chinese literature from finishing mining liver failingto had pathogenic card to clinical practice therapies formulas, Logistic regression method to explore two classification using Chinese literature in the mining of feasibility.Methods:from the Chinese ancient literature literally excerpts from liver failingto relevant chapters, paragraphs or provision, extract the key elements of disease and syndrome: name, symptoms, the etiology and pathogenesis, disease, tongue, pulses, TCM prescriptions, alopecia, etc., all elements of standardized treatment, Logistic regression of classification of the statistical methods of disease and related symptoms, the etiology and pathogenesis, disease, tongue, pulse condition, Chinese herbs, formula and data mining, etc.Results:a total of literature 2342 excerpts from a case, After standardization, after the treatment of disease and syndrome were flank pain, abdominal pain, stomach, dizziness, nausea, headache, remove lump, LuoLi, bleeding, breast tuberculosis, chest pain, insomnia, fever, fright, diarrhea, hot shower, lumbago 60; etc. Symptoms were lurking bilges, abdominal distension, anorexia, abdominal pain, less heat, cold, evil JuLuan swallow acid, red eyes and mouth sore, convulsions, wan Pi, be agitated, breast pain, bosom is frowsty etc; not comfortable 92 Tongue were tongue yellow, yellow and red tongue seaweed bored of 13 types, Pulses are string veins, several minor veins, pulse, acerbity, pulse, etc; 19 Involving hepatic disease bits, spleen, stomach, abdomen, stalking, bravery, kidney, lung 18; etc. Cause wrath, sorrow, yu were hurt feelings of depression, seven, liver heat, liver heat, overfatigue by the wind, misery, liver heat, MouLv not definitely, treating wind-heat 18; etc. Liver diseases involving stagnation, pathogenesis, spleen, diseases by the fire, and suffered stomach, diseases and hemopenia diseases, the inverse HengNi, spleen, the inverse, water not suffered culvert wood, spleen lost as a healthy operation; 70, ShuGan including qi herbs, liver and fire XieYu discharge, liver, spleen and relatively blood and liver, stomach, or reservation during 20 species such as wood, Formula were scattered, small samples free soup 362, Total Chinese angelica, tuckahoe, officinale, etc. Was 518Results:the data mining in "flank pain" for example, excavate the liver failingto threats caused pain "with" symptoms, the etiology and pathogenesis, herbs, formula and medicine, specific threats, mouth is bitter, irritable, irritability, red eyes and less pain, sore evil cold fever is liver failingto threats caused pain "common" with symptoms. Anger and bitterness yu, xu’s liver failingto pain caused by the "common causes of threats, Yu, courage and gas stagnation, real fire, diseases and diseases are liver failingto suffered by the "common" flank pain pathogenesis, ShuGan qi and liver failingto XieYu is caused by the main threats "pain" therapies, ShuGan was scattered liver failingto is caused by the first "flank pain of second liver prescriptions, fry, angelica aloe, unfettered:Samples are liver failingto pain caused by the first "flank, secondly, the Chinese had sweet, balloonflower, officinale).Conclusion:the standardization of Chinese literature by using the binary classification, Logistic regression method can more accurately from the ancient documents in liver failingto caused by the main threats "pain" therapies formulas, Clinical reports from two aspects and experimental research, mining results in clinical and experimental study are obtained good effect, To a certain extent in using the binary classification &colleges Logistic regression statistics method of TCM literature data excavation of TCM, the feasibility and practicability of the method of using literature research has certain mining.更多还原