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基于数据挖掘分析名老中医治疗帕金森病的临证经验

TCM Experts’ Clinical Experience in Treating Parkinson’s Disease based on Data Mining

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【作者】 孙雪梁鹏梁建庆何建成

【Author】 SUN Xue;LIANG Peng;LIANG Jianqing;HE Jiancheng;School of Basic Medicine, Gansu University of TCM/Key Laboratory of Education Ministry Dunhuang Medicine and Translation from Gansu University of Traditional Chinese Medicine;The Second Clinical Medical School, Lanzhou University;School of Basic Medicine, Shanghai University of TCM;

【通讯作者】 梁建庆;

【机构】 甘肃中医药大学基础医学院/敦煌医学与转化教育部重点实验室兰州大学第二临床医学院上海中医药大学基础医学院

【摘要】 目的:运用数据挖掘技术分析名老中医治疗帕金森病(Parkinson’s disease,PD)的临证经验及用药规律。方法:检索1989至2020年中国知网(China national knowledge infrastructure,CNKI)数据库收载的中医药治疗PD的相关文献,经整理、筛选后纳入符合标准的文献,运用Excel及VOS viewer软件对文献中描述的证型、舌象、脉象及中药进行数据挖掘分析。结果:本研究通过证型名称规范后得到44种证型,最常见的前三种证型分别为肝肾阴虚证28.45%(33/116)、肝风内动证6.90%(8/116)、筋脉失养证5.17%(5/116);舌象分布:舌色以红22.86%(16/70)、暗/黯17.14%(12/70)、暗/黯红17.14%(12/70)常见,舌形以齿痕40.00%(6/15)、胖大33.33%(5/15)舌常见,苔质以薄44.00%(33/75)、腻24.00%(18/75)苔常见,苔色以黄70.21%(33/47)、白29.79%(14/47)色常见,舌下络脉以络脉青紫75.00%(3/4)、络脉色淡25.00%(1/4)常见;脉象分布:脉象以细27.63%(42/152)、弦27.63%(42/152)脉常见;中药分布:涉及中药128味,总频次为933次,高频中药主要有白芍4.61%(43/933)、天麻3.32%(31/933)、茯苓3.11%(29/933)、当归3.11%(29/933)、熟地黄3.00%(28/933)、牡蛎2.68%(25/933)、山萸肉2.57%(24/933)、全蝎2.47%(23/933)、牛膝2.25%(21/933)、龙骨2.14%(20/933)、黄芪2.14%(20/933)等。结论:PD病因病机复杂,属本虚标实证,本虚为肝肾亏损,标实为风、瘀、痰、热、毒互结,蕴塞脑窍;临床用药以补虚药为主,以平肝熄风药、活血化瘀药、祛湿化痰药为辅。

【Abstract】 Objective: To analyze the clinical experience of traditional Chinese medicine experts in treating Parkinson’s disease(PD) using data mining. Methods: By searching the papers related to TCM therapy for PD from CNKI between 1989 and 2020, the papers met the inclusion criteria were included after the sorting and screening, data mining of the patterns, tongue and pulse, pulse and the herbs described in the literature was performed using Excel and VOS viewer software. Results: In the study, 44 patterns were obtained by standardising the names of the patterns, the first three most common patterns were liver and kidney Yin deficiency pattern 28.45%(33/116), endogenous liver wind pattern 6.90%(8/116), tendon dystrophy pattern 5.17%(5/116); the distribution of tongue manifestations: the tongue color: red 22.86%(16/70), dark 17.14%(12/70), dark/dark red 17.14%(12/70), the tongue shape: with tooth marks 40.00%(6/15), and plump 33.33%(5/15); tongue coating:thin 44.00%(33/75) and greasy 24.00%(18/75), yellow 70.21%(33/47) and white 29.79%(14/47), sublingual vessel: bruise 75.00%(3/4), pale 25.00%(1/4); the distribution of pulse manifestations: thin 27.63%(42/152) and string-like 27.63%(42/152); the distribution of the herbs: 128 herbs were involved, total frequency was 933 times,high frequency herbs mainly contained Baishao(Paeoniae radix alba, 4.61%, 43/933), Tianma(Gastrodiae rhizoma, 3.32%, 31/933), Fuling(Poria, 3.11%, 29/933), Danggui(Angelicae sinensis radix, 3.11%, 29/933),Shudihuang(Rehmanniae radix praeparata, 3.00%, 28/933), Muli(Ostreae concha, 2.68%, 25/933), Shanyurou(Fructus Corni, 2.57%, 24/933), Quanxie(Scorpio, 2.47%, 23/933), Niuxi(Achyranthis bidentatae radix, 2.25%,21/933), fossil fragments(2.14%, 20/933) and Huangqi(Astragali radix, 2.14%, 20/933). Conclusion: With the complicated cause and pathogenesis, PD belongs to the syndrome of deficiency in origin and excess in superficiality, deficiency in origin means the depletion of liver and kidney, excess in superficiality is induced by intermingled wind, stasis, phlegm, heat and toxin, obstructing the brain orifices; clinical application of the herbs mainly use the ones of tonifying the deficieny, supplemented with the ones of calming liver to stop the wind,promoting blood circulation to remove blood stasis, dispelling dampness to resolve the phlegm.

【基金】 国家自然科学基金(82160929,81660767);敦煌医学与转化教育部重点实验室开放课题(DHYX22-06);甘肃中医药大学中青年科研基金(ZQ2015-17);甘肃中医药大学引进人才科研启动基金(2016YJRC-07)
  • 【文献出处】 西部中医药 ,Western Journal of Traditional Chinese Medicine , 编辑部邮箱 ,2024年03期
  • 【分类号】R277.7;R249
  • 【下载频次】296
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