基于数据挖掘探讨金实教授对慢性肝病的辨治思路

目的:探讨和总结金实教授治疗慢性肝病的辨证与治疗思路。方法:通过Medcase V3.2仓公诊籍国医脉案数据记录挖掘系统,运用频数分析与关联规则分析,从症状、证型、病机、治法等多方面对金实教授治疗慢性肝病的典型医案进行数据挖掘。结果:在纳入的1 915例慢性肝病医案中,慢性乙型病毒性肝炎最多,占43.1%;临证中所见慢性肝病病机以湿热瘀毒互结、肝脾失调为主,分别占19.7%,10.6%;证型分类以热毒内结证、肝胆湿热证最为常见,分别占22.6%,19%;治法以调肝运脾、清热化湿最为常见,分别占12.2%,8.2%。结论:金实教授临床辨证慢性肝病以热毒内结、肝胆湿热证为主,重视湿热瘀毒互结的病理因素,治法以调肝运脾为主,辅以清热、化湿、解毒、化瘀等,可归纳为"清、疏、运、化、补"。

Explore Syndrome Differentiation and Treatment Thinking of Professor JIN Shi in Treating Chronic Liver Disease Based on Data Mining

Objective: The aim of this study was to systematically summarize the syndrome differentiation and treatment thought of professor JIN Shi in treating chronic liver disease. Method: Medcase V3.2 storehouse and medical record national physician Maian data mining system was adopted to collect the typical cases of chronic liver disease treated by professor JIN Shi. Then frequency analysis and association rule analysis were used for data mining on symptoms, syndromes, pathogenesis and therapeutic principle. Result: There were 1 915 cases of chronic liver disease included, with chronic hepatitis B viral hepatitis the most disease (43.1%). Damp-heat-blood stasis-toxin and disorder of liver-spleen were the most frequent pathogenesis, accounting for 19.7% and 10.6% respectively;noxious heat stasis syndrome and damp-heat in liver-gallbladder syndrome were the most frequent syndrome, accounting for 22.6% and 19% respectively;regulating liver and activating spleen, clearing heat and damp, were the most common therapeutic principle, accounting for 12.2% and 8.2%, respectively. Conclusion: Noxious heat stasis syndrome and damp-heat in liver-gallbladder syndrome were the most frequent syndrome for chronic liver disease treated by professor JIN Shi, who valued the pathogenesis of damp-heat-blood stasis-toxin. The common therapies for chronic liver disease were regulating liver and activating spleen, and in the assistance of syndrome differentiation based adjuvant therapy, it can be applied to clear heat and damp, detoxify and disperse blood stasis, which can be generalized to clear, soothe, activate, dissolve and tonic.