中国中药杂志

2019, v.44(15) 3135-3142

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基于HIS临床医案的藏族医治疗萨滞布病(中风后遗症)用药规律研究
Study on regularity of Tibetan medicine in treatment of gZav-Grib disease (apoplexy sequelae) based on HIS clinical medical records

贡保东知;文成当智;扎西罗布;曾商禹;切尼项毛;宋鑫晨;尼玛次仁;张艺;
GONGBAO Dong-zhi;WENCHENG Dang-zhi;ZHAXI Luo-bu;ZENG Shang-yu;QIENI Xiang-mao;SONG Xin-chen;NIMA Ci-ren;ZHANG Yi;Ethnic Medicine School,Chengdu University of Traditional Chinese Medicine;Department of Brain Disease,Tibetan Hospital of Tibet Autonomous Region;Tibet University of Tibetan Medical;Research Center for Academic Inheritance and Innovation of Ethnic Medicine,Chengdu University of Traditional Chinese Medicine;

摘要(Abstract):

研究藏族医治疗萨滞布病(中风后遗症)用药规律及特点,选取西藏自治区藏医院和那曲市藏医院的萨滞布病患者HIS医疗信息,运用SPSS Modeler和Gephi等数据挖掘和可视化软件研究藏族医治疗萨滞布病的临床真实用药规律。最终纳入479例萨滞布病患者病案,患者平均年龄为63岁,平均住院日为32 d;总共含82首藏族医治疗萨滞布方剂,其中频次靠前的有二十味沉香丸(338次)、如意珍宝丸(322次)、七十味珍珠丸(315次)等。根据藏族医三因的蓄、发、息规律,发现选择清晨(6:00—8:00)、早上(8:00—10:00)、中午(12:00—14:00)、晚上(18:00—20:00)等4个时段进行用药治疗,其中清晨用七十味珍珠丸,早上用如意珍宝丸,中午用十八味杜鹃丸,晚上用二十味沉香丸是常用时序组合。从关联规则分析,支持度10%、置信度70%时,有18种方剂组合,其中置信度高于80%的有2个组合,其方剂药性主要以干、软、稀、凉、钝、寒、稳等为主。萨滞布病可分为隆滞布型和查滞布型,其中隆滞布型用药以七十味珍珠丸为核心方,而查滞布型用药以如意珍宝丸为核心方;藏族医治疗萨滞布病以"隆血并治,白脉与黑脉兼顾"为治疗思路,以行气、清血热、干坏血为主治功效,达到标本兼治的目的。HIS临床医案的数据挖掘不仅能发现藏族医治疗萨滞布病治疗用药规律,而且可以为优化藏族医治疗萨滞布病治疗方案提供科学依据。
This research is launched to look for the medication rules and characteristics of Tibetan medicine in the treatment of gZav-Grib( apoplexy sequelae). HIS records of gZav-Grib patients were selected from the Tibetan Hospital of Tibet Autonomous Region and Tibetan Hospital of the city of Naqu. SPSS Modeler,Gephi and other data mining and visualization software were used to study the actual law of drug use in the treatment of gZav-Grib in Tibetan medicine. Finally,479 cases of gZav-Grib patients in Tibetan medicine were included. Their average age is 63 and average hospital stay was 32 days. In total,82 Tibetan medicine prescriptions were used for treating gZav-Grib. The frequency in the front is Twenty-flavor Chenxiang Pills( 338 times),Ruyi Zhenbao Pills( 322 times),and Seventy-flavor Zhenzhu Pills( 315 times). According to the regularity of Tebitan medicine,they were applied in different time periods including the early morning,morning,noon,and evening,for example,in the early morning: Seventy-flavor Zhenzhu Pills,morning: Ruyi Zhenbao Pills,noon: Eighteen-flavor Dujuan Pills,evening: Twenty-flavor Chenxiang Pills. In the clinical joint,18 groups were found in the 10% support and 70% confidence. There are two prescriptions confidence more than 80% which nature focus on Gan,Ruan,Xi,Liang,Dun,Han,Wen. gZav-Grib of Tibetan medicine can be divided into two types: r Lung-Grib type and k Hrag-Grib type,in which the medicine of r Lung-Grib type takes Seventy-flavor Zhenzhu Pills as the core prescription,while the medicine of k Hrag-Grib type takes Ruyi Zhenbao Pills as the core prescription. It is found that the treatment of gZav-Grib by Tibetan medicine is mainly dominated by the treatment idea about " Therapeutic r Lung and blood,Consideration of venous diseases". Treatment functions is promoting the circulation of Qi,clearing blood heat and getting rid of bad blood,achieving the purpose of treating both principal secondary aspect of gZav-Grib. The research methods based on the HIS can't only optimize the Tibetan treating gZav-Grib sequela treatment plan and rule of medication,but also provide the scientific basis for Tibetan medicine treat gZav-Grib.

关键词(KeyWords): 藏族医;萨滞布病;数据挖掘;HIS;用药规律
Tibetan medicine;gZav-Grib;data mining;HIS;medication rule

Abstract:

Keywords:

基金项目(Foundation): 国家重点研发计划项目(2017YFC1703900)

作者(Author): 贡保东知;文成当智;扎西罗布;曾商禹;切尼项毛;宋鑫晨;尼玛次仁;张艺;
GONGBAO Dong-zhi;WENCHENG Dang-zhi;ZHAXI Luo-bu;ZENG Shang-yu;QIENI Xiang-mao;SONG Xin-chen;NIMA Ci-ren;ZHANG Yi;Ethnic Medicine School,Chengdu University of Traditional Chinese Medicine;Department of Brain Disease,Tibetan Hospital of Tibet Autonomous Region;Tibet University of Tibetan Medical;Research Center for Academic Inheritance and Innovation of Ethnic Medicine,Chengdu University of Traditional Chinese Medicine;

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