基于数据挖掘的国医大师周仲瑛辨治甲状腺癌医案数据解构与集外关联解析

来源:用户上传      作者:徐子缘 朱�� 陆明

　　 〔摘要〕 目的 通^数据挖掘对国医大师周仲瑛辨治甲状腺癌中医临床医案进行解构，分析周教授对于甲状腺癌的“机-证-药-方”经验。方法 通过Medcase数据处理平台，基于FP-Growth加强关联分析算法，对国医大师周仲瑛辨治甲状腺癌医案数据解构和分析。结果 本次研究涉及医案43则，共43人次167诊次。周教授辨证治疗甲状腺癌，临床高关联的症状有颈部肿胀、口干、咳嗽、寐差、胸闷、咽喉阻塞感、颈部疼痛;高关联的舌象有质暗红、苔黄薄腻;高关联的脉象有细脉、滑脉、弦脉、小脉;高关联的病机有痰瘀互结、气阴两伤;高关联的药物有夏枯草、僵蚕、玄参、鳖甲、香附等。颈部肿胀、颈部疼痛、咽喉阻塞感多归因于痰瘀互结。结论 甲状腺癌多属本虚标实之证，基本病机为痰瘀互结、气阴两伤，与肝、脾、肾关系密切。周教授以攻补兼施为总原则，治疗上强调理气解郁、活血祛瘀、化痰散结、益气养阴，重视滋养肝肾、补益脾胃，兼顾心肺。
　　 〔关键词〕 甲状腺癌;数据挖掘;集外关联;痰瘀互结;气阴两伤;周仲瑛
　　 〔中图分类号〕R273 〔文献标志码〕A 〔文章编号〕doi：10.3969/j.issn.1674-070X.2022.02.003
　　Data deconstruction and out-of-set correlation analysis of traditonal Chinese medicine master
　　Zhou Zhongying’s medicinal cases to treat thyroid cancer based on data mining
　　XU Ziyuan1， ZHU Yao1*， LU Ming1，2*
　　（1. Nanjing University of Chinese Medicine， Nanjing， Jiangsu 210029， China;
　　2. Data Mining Center， Medchitec Co.， Ltd.， Nanjing， Jiangsu 210029， China）
　　〔Abstract〕 Objective To deconstruct the traditional Chinese medicine （TCM） clinical cases of Zhou Zhongying， a master of TCM， through data mining， and analyze the experience of "mechanism-syndrome-drug-prescription" of Zhou Zhongying. Methods Medical case data of TCM master Zhou Zhongying's differentiation and treatment of thyroid cancer were deconstructed and analyzed through the data processing platform of Medcase and FP-Growth enhanced correlation analysis algorithm. Results This study involved 43 medical cases， 43 person-time and 167 times of visits. Professor Zhou treated thyroid cancer with syndrome differentiation. The symptoms with high clinical correlation were neck swelling， dry mouth， cough， poor sleep， chest tightness， throat obstruction and neck pain; the tongue images with high correlation were dark red， yellow and greasy coating; the highly correlated pulse images were veinlets， sliders， chords and small veins; the pathogenesis of high correlation was interaction of phlegm and blood stasis， Qi and Yin injury; the drugs with high correlation were Xiakucao （Prunellae Spica）， Jiangcan （Bombyx Batryticatus）， Xuanshen （Scrophulariae Radix）， Biejia （Trionycis Carapax）， Xiangfu （Cyperi Rhizoma）. Neck swelling， neck pain， throat obstruction were attributed to interaction of phlegm and blood stasis. Conclusion Thyroid cancer mostly belongs to the syndrome of deficiency and excess. The basic pathogenesis of thyroid cancer is the interaction of phlegm and blood stasis， and Qi and Yin injury， which is closely related to liver， spleen and kidney. Professor Zhou takes attacking and tonifying as the general principle， and emphasizes regulating Qi and relieving stagnation， promoting blood circulation and removing blood stasis， dissolving phlegm and dispersing concretions， nourishing Qi and Yin， and paying attention to nourishing liver and kidney， nourishing spleen and stomach， giving consideration to heart and lung.
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