摘要
目的:总结名老中医辨治慢性胃炎(chronic gastritis,CG)的临床经验。方法:借助名医传承平台检索CG病例,运用数据挖掘软件进行频次统计、复杂网络和关联规则分析。结果:共纳入了800份病例,在证候表现方面,症状多见胃胀、胃痛;舌象多见苔白、舌红;脉象多见脉弦、脉细;证素多见胃、脾、气滞、热、肝、寒、气虚、湿。在药物性味方面,总体药性以温居首,寒平次之,药味以辛苦甘并举,酸淡咸涩较少;取前50味高频药物,性味组合多见辛温、苦寒、辛苦温、甘平、辛甘温。在组方选药方面,总共涉及301味药物,功效以补气、理气居多;药物分为3个社群,甘草作为核心节点,半夏、陈皮、白术、茯苓与其联系紧密。结论:CG以脾胃虚弱为本,邪气郁滞为标,其中病性以气滞、气虚、湿阻为主,郁久容易从阳化热,病位以脾胃为中心,亦可旁及肝胆等脏。故而治疗时宜阴阳并投,升降并用,主以辛(苦甘)温,佐以苦寒、甘平。组方思路通补兼施,调气为先,重在补脾气、行滞气、祛湿气,兼以解郁热、化痰瘀、消食积、养胃阴,辅以益气血、利肝胆。
Objective:To summarize the clinical experience of famous traditional Chinese medicine dotcors in diagnosis and treatment of chronic gastritis(CG).Methods:Using the renowned medical heritage platform to search for CG cases,using data mining software for frequency statistics,complex network,and association rule analysis.Results:A total of 800 medical records were included,and in terms of syndrome manifestations,the symptoms are mostly bloating and stomach pain;Tongue images are white coating and red tongue;Pulse patterns are often stringed and thin pulse;Symptoms often include Stomach,Spleen,Qi stagnation,Heat,Liver,Cold,Qi deficiency and Dampness.In terms of medicinal properties and taste,the medicinal properties are Warm or cold or mild.The medicinal tastes are pungent,bitter and sweet,with less medicinal are acid,delicate,salty and astringent;Take the top 50 high-frequency drugs,and the combination of properties and flavors are often pungent and warm,bitter and cold,pungent and bitter and warm,sweat and mild as well as pungent and sweat and warm.In terms of prescription selection,a total of 301 drugs are involved,with most of their effects being Qi tonifying and Qi regulating.The medicine group is divided into three communities,with Gancao(licorice)as the core drug with Banxia(pinellia ternate),Chenpi(dried tangerine peel),Baizhu(atractylodes macrocephala)and Fuling(poria cocos)being closely related to it.Conclusion:Famous traditional Chinese medicine doctor believes that original cause of CG is Spleen and Stomach weakness,with evil factor stagnation being the symptom character.The disease is mainly characterized by Qi stagnation,Qi deficiency and Dampness obstruction.Prolonged depression can be easily transformed to Heat from Yang aspect.The location of the disease is the Spleen and Stomach while Liver and Gallbladder may also be affected.Therefore,when treating,it is advisable to combine Yin and Yang,and use both Qi ascending and Qi descending methods.The main drugs are pungent(bitter and sweet)and warm in character,accompanied by bitter and cold as well as sweet and mild drugs.The prescription is mainly aimed at dredging and tonifying and Qi regulation.The focus is on tonifying the Spleen,relieving stagnation of Qi,removing Dampness,relieving stagnated Heat stagnation,resolving Phlegm and stasis,reducing food accumulation and nourishing Stomach Yin.Besides,nourishing Qi and blood as well as dredging Liver and Gallbladder can be done to be the complementary method.
作者
曹娜
张钰欣
刘雨昕
刘金涛
王维广
吴宇峰
陈子杰
翟双庆
CAO Na;ZHANG Yuxin;LIU Yuxin;LIU Jintao;WANG Weiguang;WU Yufeng;CHEN Zijie;ZHAI Shuangqing(School of Chinese Medicine,Beijing University of Chinese Medicine,Beijing China 100029)
出处
《中医学报》
CAS
2024年第4期886-892,共7页
Acta Chinese Medicine
基金
国家重点研发计划项目(2018YFC1704100,2018YFC1704105)
中央高校基本科研业务费专项资助项目(2022-JYB-JBZR-011)。
关键词
慢性胃炎
名老中医
辨治经验
数据挖掘
chronic gastritis
famous traditional Chinese medicine doctor
experience in diagnosis and treatment
data mining
