【作者】 刘强；

【导师】 朱文锋；

【作者基本信息】 湖南中医学院 ， 中医诊断学， 2003， 博士

【摘要】 目的：发掘心气虚证辨证论治规律的新知识或被忽视的内容，构建心气虚证的网络结构。 方法：本研究运用数据挖掘技术，对心气虚证古代文献资料、临床信息和科研进展等方面的数据进行聚类挖掘，发掘心气虚证辨证论治规律的新知识或被忽视的内容。结合挖掘结果，运用网络结构可视化思想构建心气虚证网络结构图，并运用逆转录聚合酶链反应(RT-PCR)探索心气虚证基因网络结构。 结果：1 心气虚证的数据挖掘结果表明：常见病因或诱因为思虑劳倦、七情过激、久病体虚受邪、年高脏弱；常见主诉为胸闷、气促、胸痛、心悸、头晕和下肢肿；常见症状有胸闷胸痛、心悸气短、神疲乏力、活动后加重、易惊善忘、汗出异常、卧欠安；常见体征有口唇紫绀、心律失常、颈静脉充盈、肺部湿罗音、心界左下扩大；常见舌象为舌暗红或淡暗，苔薄白；常见脉象为弦细或细弱而虚；常见实验室检查结果为心律失常和心肌缺血改变；常见科研指标为心功能、血液流变学和心电生理改变；常见鉴别诊断有肺气虚证、心肺气虚证、心血虚证、心阳虚证、心阳暴脱证、心脾两虚证、心胆气虚证；常见西医病种有冠心病、高血压，心脏瓣膜病和心肌病；临床常用方剂有生脉散、瓜篓薤白半夏汤和归脾汤；常用中药有人参、茯苓、麦冬、黄芪、丹参、瓜篓、薤白、远志、桂枝、菖蒲和朱砂；常用针灸疗法为艾灸心腧穴；常用养生方法有省咸增苦、导引“呵字诀”、少思虑和侧卧屈膝;常规禁忌有思虑和服食生冷、猪肉。 2心气虚证的网络结构研究表明:网络思想在中医学的应用最早可以追溯到战国秦汉时期，主要标志为五行学说与中医的结合;心气虚证存在不同层次的网络调控机制;口受体、内皮素(ET)和一氧化氮合酶(NOS)三者为，讼气虚证微观网络结构的关键节点，它们的基因表达情况可以部分阐释，二气虚证的基因网络调控机制;单味中药中人参对三者干预作用优于水蛙、丹参，而益气活血复方心复康效果优于单味中药。 结论:1数据挖掘技术有助于中医学发现新知识或被忽视的内容。 2思虑劳倦和七情过激为心气虚证的常见病因。 3肺气虚证为，二气虚证的常见鉴别诊断。 4中医古代比较重视心气虚证神志改变的诊治，现代则更重视其血脉改变的诊治。 5五行学说是网络思想在中医学最早应用的主要标志。 6心气虚证存在不同层次的网络调控机制。 7日AR、ET和NO加05为心气虚证微观网络结构的关键节点，它们的基因表达情况可部分阐释，。气虚证的基因网络结构。 8中药治疗心气虚证的机理可能与心气虚证的基因网络调控有关，单味益气中药疗效优于单味补血和活血药，益气活血复方效果优于单味中药。更多还原

【Abstract】 Objective: To find out some new or neglected knowledge of the Heart-Qi Deficiency Syndrome(HQDS),and build the network construct of HQDS. Method: The investigation clustering the ancient literature, clinical Information and scientific research about HQDS by clustering data mining for find out some new or neglected knowledge. To integrate the results of clustering data mining and based on visual model requirement, network structure diagram of HQDS would be drawn, gene network structure be study with RT-PCR.Result: 1 The results of clustering data mining show that: excessive consideration overworked, emotional stress, macronosia, body asthenia and senium are common causes; sense of suppression in the chest, panting, chest pain palpitation dizziness and oedema of lower limb are common chief complaints; sense of suppression in the chest, panting, chest pain palpitation, tiredness, inertia, hyperarousal, Forgetfulness abnormal diaphoresis and agrypnia are common symptoms; cyanosis of lips, arrhythmia, engorged cervical vein moist rales of lung, the left side enlarged cardiac dullness are common physical signs; dark-red tongue with white thin moss are common tongue; taut pulse, thready pulse, weak pulse and feeble pulse are common pulses; arrhythmia and myocardial ischemia are common laboratory examination result; cardiac function hemorheology and cardiac electrophysiological change are commonobserve items; Lung-Qi deficiency syndrome, Heart-Lung-Qi deficiency syndrome, Heart-Blood deficiency syndrome, Heart-Yang deficiency syndrome, Heart-Yang sudden collapse syndrome, Heart-Spleen deficiency syndrome and Heart-Cholecyst deficiency syndrome are common differential diagnosis; coronary heart disease, hypertension, valvular heart disease and cardiomyopathy are common disease kind; Shengmai San, Gualou Xiebai Banxia Tang and Guipi Tang are common recipes; ginseng, tuckahoe, dwarf lilyturf tuber,mongolian milkvetch root ,dan-shen root,fructus trichosanthis, macrostem onion,thinleaf milkwort root, cassia twig, calamus, cinnabar are common Chinese medicinal herb; the moxibustion of "xinshu" points is common acupuncture and moxibustion therapy ; eat something with less salt and more bitter, "He-word" breath exercise, less consideration, lie on the side with bending one’s knees are common health preserving methods; excessive consideration and eat something raw, cold food or pork are common abstinence.2 The research of network structure show that the five elements theory is the primary sign of the earliest application of network thinking in traditional Chinese medicine(TCM).in Warring States or Qin-Han Period; the Heart-Qi deficiency syndrome have several level network structures; β -Adrenergic Receptor(β -AR) - endothelin (ET) and nitricoxide synthase(NOS) are key points of the gene network structure of HQDS,these three genes expression could partly explain the mechanism of this network regulation; ginseng has better intervention to these three gene expression than leech and dan-shen root in single herb; the Xin-fu-kang recipe have more effect than these single herb.Conclusion: 1 Some new or neglected knowledge of TCM could be find out by data mining technique.2 Excessive consideration , overworked and emotional stress are common causes.3 Lung-Qi deficiency syndrome is common differential diagnosis.4 Mind changs were paid more attention in diagnosis and treatment of HQDS in ancient times than blood-vessel changs, but now just the opposite.5 The five elements theory is the primary sign of the earliest application of network thinking in TCM.6 The Heart-Qi deficiency syndrome have several level network structures which be regulated by each other.7 β -AR, ET and NOS are key points of gene network structure of HQDS, the expression of these three genes could partly explain the mechanism of this network regulation.8 The mechanism of herbs function is relate to the gene network regulation of HQDS, the Xin-fu-kang recipe have better effect than single herb.更多还原