摘要
目的探索名中医临床辨治胆囊息肉的证治特点。方法挖掘中国中医科学院广安门医院名中医经验数据库自2003年建库以来以“胆囊息肉”为第一诊断的病例数据,符合纳入标准的病例作为胆囊息肉组,使用倾向性评分匹配(PSM)筛选非胆囊息肉(胆囊炎、胆囊结石)患者作为对照组,使用中医临床科研信息共享系统中医临床数据预处理软件ETL V2.2.3对数据进行规范,运用SPSS25.0软件进行频数统计,使用中医复杂关系分析系统(Liquorice)分析临床要素的二维关系,总结辨证施治特点,比较2组临床疗效。结果胆囊息肉组210例,涉及494诊次;对照组成功匹配201例,涉及485诊次。胆囊息肉组最常见合并疾病为高血压,对照组为慢性胃炎;胆囊息肉组证候频次最高为肝脾不调证,对照组为气阴两虚证;可能的病因为饮食不节、情志失调,症状不典型;胆囊息肉组用药活血理气力量较强,对照组补气利湿药使用更多,主要为疏肝健脾、活血化瘀的配伍,胆囊息肉组活血化瘀较多,对照组还用清热利湿;2组核心处方为逍遥散和柴胡疏肝散,加用活血化瘀药,胆囊息肉组益气活血力量更强,对照组清热化痰作用更大。胆囊息肉组有复诊记录71例,有效率为59%(42/71);对照组有复诊记录85例,有效率为53%(45/85)。结论胆囊息肉的关键病机为肝脾不调,逍遥散、柴胡疏肝散、四君子汤为核心处方,临床常加益气活血等药物,如黄芪、太子参、桃仁、红花。
Objective To explore the characteristics of clinical differentiation and treatment of gallbladder polyp by TCM famous doctors.Methods The case data of gallbladder polyps as the first diagnosis since the establishment of the database of famous Chinese medicine experience of Guang'anmen Hospital of China Academy of Chinese Medical Sciences in 2003 were mined.The cases that met the inclusion criteria were selected as the gallbladder polyp group,and the patients with non-gallbladder polyp(cholecystitis and gallstones)were selected as the control group using propensity score matching(PSM).Data were processed by data pretreatment software(ETL V2.2.3)of data analysis and mining platform of TCM Clinical Research Information Sharing System.Frequency statistics were performed by SPSS 25.0 software.Two-dimensional relationship of clinical factors was analyzed by TCM Complex Relationship Analysis System(Liquorice),and characteristics of syndrome differentiation and treatment were summarized.Clinical efficacy of the two groups was compared.Results Totally 210 patients were included in the gallbladder polyp group,with 494 times of diagnosis,and 201 patients were successfully matched in the control group,with 485 times of diagnosis.Hypertension was the most common disease associated with gallbladder polyp,while chronic gastritis was the control group.The highest frequency of gallbladder polyp syndrome was liver and spleen maladjustment syndrome,and the control group was qi and yin deficiency syndrome.The possible causes would be poor diet or emotional disorders,with atypical symptoms.The medicines invigorating blood and regulating qi for gallbladder polyps were stronger,and the medicines invigorating qi and invigorating dampness were more in the control group,which mainly the compatibility of soothing the liver to invigorate the spleen,and promote blood circulation.The medicines promoting blood circulation in the gallbladder polyps group were more,and there are medicines with the efficacy of clearing heat to drain dampness in the control group.The core prescription of the two groups was Xiaoyao Powder and Chaihu Shugan Powder,and the drugs promoting blood circulation and removing blood stasis were added.Gallbladder polyps group had stronger qi and blood circulation power,while the control group had greater heat clearing and phlegm removing effect.There were 71 cases revisited in the gallbladder polyp group,with an effective rate of 59%(42/71),and 85 cases in the control group,with an effective rate of 53%(45/85).Conclusion The key pathogenesis of gallbladder polyp is liver and spleen maladjustment.Xiaoyao Powder,Chaihu Shugan Powder and Sijunzi Decoction are the core prescriptions for the treatment.Medicines supplemening qi and promoting blood circulation,such as Astragali Radix,Pseudostellariae Radix,Persicae Semen and Carthami Flos.
作者
王潞潞
张润顺
白宇宁
WANG Lulu;ZHANG Runshun;BAI Yuning(Guang'anmen Hospital,China Academy of Chinese Medical Sciences,Beijing 100053,China)
出处
《中国中医药信息杂志》
CAS
CSCD
2023年第2期31-38,共8页
Chinese Journal of Information on Traditional Chinese Medicine
基金
国家重点研发计划(2018YFC0117004)
中国中医科学院科技创新工程(CI2021A00513)。
关键词
胆囊息肉
证治特点
名中医经验
数据挖掘
gallbladder polyp
syndrome and treatment characteristics
experience of famous doctors
data mining
