糖尿病肾病论文：糖尿病肾病数据挖掘周仲瑛

糖尿病肾病论文：糖尿病肾病数据挖掘周仲瑛

【中文摘要】以国医大师周仲瑛教授长期积累的治疗糖尿病肾病(DN)的验案为基础,以现代最新信息技术为手段,采用数据挖掘方法

对周仲瑛教授辨治DN的临证经验及学术思想进行传承研究,使其源

于临床,高于临床,又能回归、指导临床。通过研究生期间跟随周仲瑛教授临证抄方学习,对周仲瑛教授近20年来积累的所有DN病案进行全面收集、整理,按照诊断标准、纳入标准、排除标准进行筛选,将符合条件的92例病案共162诊次的全部临床资料利用SQL-Server2005软件建立病案采集、存贮数据库,运用频数分布、聚类分析、关联规则挖掘、分析其中的核心处方及症状、病机、药物之间的关联性,并对挖掘结果进行分析、归纳、总结。92例患者中男性46例,女性46例,年龄最大81岁,最小28岁,平均年龄59.48岁。频数在15次以上的症状为：肢体麻木,口干,尿频多,大便干,四肢浮肿,疲劳乏力,小便有沫,寐差,小便黄,头昏头晕,易汗,腰膝酸重,便溏,面目浮肿,脘腹胀,怕冷,视物模糊等,舌苔黄薄腻,舌质暗红,常见裂纹,脉细滑。病机方面,与肾相关病机频率为73.46%,虚、瘀、热、湿、痰、燥病理因素分别为137.65%、80.25%、78.40%、48.77%、21.60%、14.20%。所用药物中,频数>50次的有：生地黄、鬼箭羽、地骨皮、知母、玄参、僵蚕、玉米须、泽兰、太子参、麦冬、黄连、山萸肉、泽泻、桑白皮(炙)、茯苓、天花粉、桑叶。运用聚类方法获得3类核心方：①生地黄、山萸肉、丹皮、泽泻、茯苓、黄柏、知母、玉米须、土茯苓；②水牛角片、生地黄、赤芍、丹皮、玄参、僵蚕、天花粉、桑叶；③太

子参、生黄芪、山萸肉、生地黄、丹皮、泽泻、地骨皮。1.糖尿病肾病病位在肾,涉及肝、胃、脾、肺及心,久病入络。2.病理因素以虚、瘀、热、湿、痰、燥为主,贯穿于糖尿病肾病病理演变的始终,是糖尿病肾病加重的关键因素。3.糖尿病肾病证机总属本虚标实,本虚包括肝肾不足和气阴两虚,标实包括燥热、湿热、瘀热、痰热。4.周仲瑛教授治疗糖尿病肾病的常用药物类别为滋补肝肾药、益气养阴药、凉血化瘀药、清热药、化湿药、化痰药。

【英文摘要】[] Base on proven cases, accumulated under a long-term treatment of diabetic nephropathy (DN) by Professor Zhou zhongying -- also known as a national medical master, using modern latest information technology as a means of data mining methods to study his clinical experience and academic thoughts of treatment for DN. In hope to return to improve the clinical treatment for DN and expand TCM knowledge.[Methods] By closely following Professor Zhouzhongying in a long term clinical practice, collect all the DN related cases during the past 20 years. The accumulation data are rescreening to meet the standard criteria. The results are 92 cases with 162 clinical follow up. All the clinical data are using SOL-server 2005 software to establish clinical case collections and database storage; moreover, using comprehend frequency distribution, cluster analysis,associated condition to focus on defining and

analyzing the core prescription and the association with symptoms and pathogenesis, in the end sum up the result and draw a conclusion.[Results] Totally 92 patients, male 46 cases, female 46 cases, too. The oldest is 81 years old while the youngest is 28 years old, with an average age of 59.48 years. Frequency of symptoms in 15 appearances above for:numbness, dry mouth, frequent urination, defecate dry, limb swelling, fatigue, urinary foam, insomnia, yellow urine, dizziness, much sweat, waist knees acid heavy, loose stools, face and eye dropsy, abdominal distension, afraid of the cold, inspect content fuzzy, tongue coating yellow thin greasy, tongue is dark red usually with crack fine and smoothing pulse etc. Pathogenesis aspects, renal related is 73.46%, pathogenesis uequency for asthenia, blood stasis, heat, dampness, sputum and dry pathological factors respectively is

137.65%,80.25%,78.40%,48.77%,21.60%,14.20%; The herbs used more than 50 times are: Shengdihuang, Guijianyu, Digupi, Zhimu, Xuanshen, Jiangcan, Yumixu, Zelan, Taizishen, Maidong, Huanglian, Shanyurou, Zexie, Sangbaipi(roast), Fuling, Tianhuafen, Sangye. With clustering methods of obtaining 3 class core prescription:(1) Shengdi, Shanyurou, Danpi, Zexie, Fuling, Huangbai, Zhimu, Yumixu and Tufuling; (2) Shuiniujiao,