基于医案数据挖掘的荨麻疹用药分析

【目的】分析荨麻疹医案的用药规律。【方法】从《中医医案知识服务与共享系统》所收录的麻疹医案中提取处方,并做归一化处理;采用Excel 2013和Matlab R2016a软件进行频次分析和聚类分析。【结果】符合筛选标准的400例医案中,共使用中药295味,总频次为4 363次。26味高频中药中,有7味解表药、7味清热药及6味补虚药;聚类分析结果分为5类。【结论】中药治疗荨麻疹常用解表药、清热药和补虚药。     

基于古籍医案文献分析的心力衰竭证治规律研究

目的探讨心力衰竭的中医证治规律。方法全面收集心力衰竭的中医古籍医案文献,分别建立症状、用药数据库,运用统计软件分别进行症状及用药频数分析、因子分析、聚类分析。结果收集到符合标准的医案文献334篇。心衰患者临床常见中医症状:喘息不得卧、胸闷、气短、心悸等;舌象:舌淡红、苔薄白、舌胖大、苔白腻等;脉象:脉沉细无力、脉迟缓、脉结代、脉涩等;症状因子分析得出心气亏虚、心阴不足、心阳不振等病机变化;心衰的症状聚类为心气亏虚、心阴不足、心阳不振等;因子分析和聚类分析的结果相符合。临床常用中药频次为人参、附子、茯苓、桂枝、生白术等;药物种类频次为补气药、温阳药、利水药等;通过对高频次用药的因子和聚类分析,可以得出与归类频数统计相同结论,心衰患者临床常用药物为补气药、温阳药、利水药、化痰药、养阴药、活血化瘀药。结论心阳不振、气阴两虚、痰浊水饮内停、瘀血内阻为心力衰竭的基本证型,温振心阳、益气养阴、化痰利水、活血化瘀为心力衰竭的基本治疗原则。     

利用聚类分析挖掘中药治疗反复自然流产的用药规律

目的:应用聚类分析等数据挖掘技术分析中药治疗反复自然流产(RSA)的用药规律,为临床医师诊治该病提供参考。方法:制定检索式,检索2004-2014年中国期刊全文数据库、中国中医药期刊文献数据库、维普全文数据库和万方数据库等期刊数据库,采集中医药治疗RSA的临床文献及方剂的相关数据,按照统一标准处理后录入数据库,采用频数分析、因子分析、聚类分析进行整合分析。结果:研究共纳入221篇文献,256首方剂,165种中药,总用药2 691频次;高频药物24种,出现1 972频次,占总药物频次的73.28%,说明治疗RSA所用中药较集中。通过因子分析将所用药物归纳为8个因子,有补益药、理血药、清热药、理气药、利水渗湿药、固涩药,占总用药频次的88.25%。结论:聚类分析揭示了RSA治疗的5类聚类方,是中医文献中常用治疗RSA的中药,反映了RSA的证治规律和用药思路。应用聚类分析等数据挖掘方法系统分析中药治疗反复自然流产的配伍规律,可为今后临床治疗反复自然流产提供有益的参考和借鉴。     

基于数据仓库技术发掘中医古文献医案哮喘证治规律

目的:探讨哮喘中医古文献医案的数据仓库构建技术,挖掘哮喘中医证治规律.方法:收集历代哮喘中医文献医案,将医案四诊信息、用药按最小知识单位进行分解标注、规范,构建哮喘文献医案数据仓库,采用频数分析、因子分析、关联规则分析、典型相关分析等方法对医案症-药相应规律进行挖掘分析.结果:共收集历代哮喘文献医案350例,构建了四诊信息、中药等哮喘证治主题数据仓库.因子分析结果提示,哮喘患者症状的出现具有明显的规律性,可概括为6组基本症状组合,分别反映了哮喘患者肺气郁闭、痰热蕴肺、肺阳虚弱、外邪侵袭、心肾两虚、痰浊阻肺等证候特征;哮喘治疗中药的组合可概括为7种,与小青龙汤、七味都气丸、定喘汤、解痉平喘方、麻杏甘石汤、玉屏风散、苏子降气汤的组方规律接近.关联规则分析提示哮喘的核心药物组合为甘草、麻黄、杏仁、半夏.症状-药物之间的典型相关分析结果显示,症状组合与中药组合相关.结论:采用数据仓库和数据挖掘技术能较好的挖掘出中医文献医案资料中潜藏的中医证治规律.     

基于中医传承计算平台探析张聿青治疗吐血组方规律

摘要：目的 基于中医传承计算平台( V3.0),挖掘张聿青治疗吐血证的用药规律,总结其学术经验。方法 收集《张聿青医案》中治疗吐血证的所有方剂。运中医传承计算平台( V3.0)进行数据挖掘与分析。结果 共纳入 77首方剂,合计177味中药。药物以补虚药为主,其次为化痰止咳平喘药、清热类药物等; 四气统计寒性药物最多;药味使用数最多的是甘味药和苦味药;归经统计肺、肝、肾、心、胃、脾经的药物最常用;常用药物组合48个,聚类分析发现3个类方。结论 基于中医传承计算平台分析出来的药物组合,方剂配伍具有重要实用价值,可为临床提供一定借鉴意义。     

基于关联规则和复杂系统熵聚类治疗细菌性痢疾用药规律研究

目的:探讨细菌性痢疾的中医用药特点及规律。方法:计算机检索细菌性痢疾中医证治文献,提取医案的中医四诊信息,经过数据标准化处理并建立数据库,运用中医传承辅助系统挖掘其用药规律。结果:共纳入文献128篇,医案180例。核心药物为黄连、木香、白芍,核心组合12个,并推演出新处方6个。结论:清热燥湿解毒、行血调气,是治疗细菌性痢疾选药组方的核心原则,重视"通因通用"法及顾护正气,为临床应用提供依据和指导。     

中药复方治疗结缔组织病相关间质性肺病的用药规律

目的:运用文献数据挖掘的方式,探究结缔组织病相关间质性肺病的中医用药规律。方法:收集近20年中医文献中治疗结缔组织病相关间质性肺病的中药复方,提取方药信息,运用频数分析、关联规则分析、系统聚类分析等方法进行数据挖掘,探究其内在的中医用药规律。结果:筛选出的55篇文献,共有62张中医处方,涉及140味药,15种类别。其中使用频次≥10次的中药有27味,药物类别主要为补虚药、清热药、化痰止咳平喘药、活血化瘀药;药性多以温为主,其次为微寒、寒、平性药物;药味以苦、甘、辛味最为多见;药物多入肺、肝、脾、胃等经。关联规则分析显示常用药物组合主要有黄芪→党参、黄芪→北沙参、麦冬→北沙参、黄芪→五味子等。高频药物系统聚类分析得到4个聚类方,主要体现出中医药治疗结缔组织病相关间质性肺病多采用补脾益肺、养阴润肺、清热化痰、活血化瘀等治法。结论:结缔组织病相关间质性肺病的病机总属本虚标实,治疗上在益气养阴的同时,也须兼顾清热化痰、活血化瘀。     

古代情志病证医案中组方用药规律分析

目的:探讨古代情志病证医案中组方用药规律.方法:以筛选的古代91本医籍中的 1 040 条情志病证医案为研究对象,采用 Microsoft Office Access 2003建立情志病证医案数据库,规范录入数据,运用频数分析法、因子分析法、关联规则等方法进行统计分析.结果:古代情志病证治疗常用药物为健脾、安神、清热化痰、养阴、行气解郁类药物;其中,化痰、健脾、安神药物常被联合使用;调肝是中医情志病证的重要治法.结论:古代中医治疗情志病证的组方用药具有一定的规律,并受到历代经典名方的影响.     

大黄配伍浅析

目的:浅析常用中药大黄的配伍特点,以指导临床用药.方法:查阅相关文献,归纳、分析和综述.结果:大黄与解表药、清热药、泻下药、活血药、补虚药、化湿药、止血药、祛湿药、化痰药、理气药、温里药等多类药配伍应用,其中尤以配伍清热药最为多用,其次为活血化瘀药;而且,大黄通过配伍还可治疗多种疑难杂症.结论:大黄配伍应用广泛,在中医防病治病中发挥了重要作用,并为大黄配伍应用提供了文献支持.     

中医药治疗尿酸性肾病辨证及用药分析

目的:分析近年来临床治疗尿酸性肾病的常见证型和常用中药。方法:回顾分析1994—2008年间中医或中西医治疗尿酸性肾病的国内期刊文献的辨证和用药情况。结果:18篇文献纳入辨证研究,54篇文献纳入用药分析。根据分析,证型以虚证和虚实夹杂证为主,或夹湿夹瘀;临床用药以补虚药、利水渗湿药、活血化瘀药、祛风湿药、清热药最常用。结论:尿酸性肾病以虚证和虚实夹杂证为主,具有夹湿夹瘀的特点。     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.     

Expression of OPGmRNA and ODFmRNA in the patients of hip fracture due to osteoporosis

Objective：To investigate the gene expression of osteoprotegerin（OPG） and osteoclast differentiation factor（ODF） in the bone tissue of patients with hip fracture due to osteoporosis. Methods：OPGmRNA and ODFmRNA in the bone tissue in 50 cases of osteoporosis sufferers（over 50 years old） with hip fracture（Observer Group） and 30 cases of hip facture sufferers with no osteoporosis（Control group） were analyzed with the Semi-Quantitative RT-PCR method. Results：The mRNA expressed of ODF, OPG were both high in the patients with hip fracture. In the control group, the expression of OPG mRNA was observed, while the expression of ODF mRNA was very slight. Conclusion：Aged patients contained all signals including OPG, ODF that are essential for inducing osteoclastogenesis and promoting bone resorption.     

Dynamic Changes in Serum Estradiol and Progesterone levels in Patients of Premenstrual Syndrome with Adverse Flow of Liver-qi

Objective:To probe into the influence of changes of ovarian hormones on the pathogenesis of the specific sub-type premenstrual syndrome(PMS)and reveal partial microcosmic mechanisms of adverse flow of liver-qi.Methods:Estradiol(E2)and progesterone(P)levels in serum were determined at different phases of menstrual cycle by radioimmunoassay.Results:In the group of PMS with adverse flow of liver-qi.the secretive peak value Of E2 and P at the follicular phase significantly decreased,and the secretive peak value at the luteal phase did not come into being.Conclusions:Low E2 and P secretive peak at the follicular phase and absence of secretive peak at the luteal phase is one of the microcosmic mechanisms of PMS with adverse flow of liver-qi.One of the pathophysiologic mechanisms of specific sub-type PMS is probably the continuous low level of E2and P.     

Real-time Three-dimensional Echocardiography in Assessment of Left Ventricular and Right Ventricular Volumes

Real-time three-dimensional echocardiography (RT3DE)is a new ultrasound technique that enables dynamic threedimensional visualization and quantification of the heart in real time. Investigation of feasibility and methodology of RT3DE in determining left ventricular (LV) and right ventricular (RV) volumes, RT3DE was performed in 35 normal adults using Philips SONOS 7500 system with a 2-4 MHz matrix array transducer. The 60°×60° "pyramid" volume database was obtained and analyzed on a TomTec echo workstation. Both LV and RV volumes were calculated with four 3DE methods (i.e. apical 2, 4, 8, and 16-plane) through manually tracing ventricular endocardial borders in end diastole and end systole. Stroke volumes were then calculated. LV volume was also measured by 2DE Simpson's rule using GE VIVID 7 ultrasound machine.     

SCREENING FOR A 21-CHROMOSOME ABNORMALITY IN PREIMPLANTED EMBRYOS OF ELDERLY WOMEN

Increasing maternal age is the only etiological factor unequivocally linked to Down's syndrome in humans. The occurrence rate of newborns with Down's syndrome is about 1/220 in women over 35 years old. However, the occurrence rate in embryos fertilized in vitro, of the elder woman is unclear. Using FISH we screened the number of chromosome 21 in preimplanted embryos of 5 elderly women (average age, 38.4 years) to study the feasibility and necessity of screening trisomy 21 in embryos in patients over 35 years old at the in vitro fertilization (IVF) center.     

Scientific principles and rigorous processes should be followed in developing clinical guidelines for therapeutic interventions of integrative medicine

A clinical guideline for the therapeutic interventions of integrative medicine may be defined as a written document which states a series of recommendations on therapeutic interventions of integrative medicine for a special disease or condition. The guideline may provide assistance to medical professionals in making clinical decisions aimed at improving the clinical outcome of patients and reducing the costs of medical care（~＇4~. Recommendations issued by a guideline should be based on the best available evidence in both Western and Chinese medicine. For fulfilling this purpose, the development of clinical guidelines for therapeutic interventions in the field of integrative medicine should follow scientific principles and undergo a rigorous processes.