國醫大師洪廣祥教授治療哮喘經驗挖掘分析

葉超　余建瑋　劉偉軍　查青林　喻強強

【摘要】 目的：挖掘與總結名老專家洪廣祥教授臨床辨治哮喘病的學術思想和證治規律。方法：以2008年5月-2009年10月就診的72例洪教授治療哮喘醫案為分析對象，采用文本挖掘技術進行分析。數據分析在SAS 9.1.3平臺上進行，進行頻數統計、證候治法分析、中藥關聯分析、中藥因子分析等處理，了解洪教授治療哮喘的核心藥物組方、證候分類規律、中藥配伍規律。結果：（1）72例哮喘病患者出現證候多為氣陽虛弱、痰瘀阻肺等；（2）中藥關聯規則分析提示哮喘的核心組方為：黃芪、防風、白術、桂枝、白芍、生姜、甘草、紅棗、葶藶子、陳皮、青皮、衛矛、牡荊子、檳榔、大黃、麻黃、蘇葉、半夏；（3）中藥因子分析可將治療哮喘常用藥物分為6個組合，分別具有益氣固表、溫陽護衛、宣肺平喘、化飲止咳和清瀉肺熱等功效。結論：深入挖掘名老中醫有效醫案的證治規律，有利于提高臨床醫生診治水平。數據挖掘結果客觀反映了洪廣祥教授治療哮喘病的臨床思路與經驗。

【關鍵詞】 哮喘； 醫案； 洪廣祥； 文本挖掘

Data Mining of Clinical Asthma Cases from Doctor Hong Guangxiang/YE Chao，YU Jianwei，LIU Weijun，et al.//Medical Innovation of China，2017，14（32）：078-082

【Abstract】 Objective：To investigate the clinical experience and scientific theory for asthma from Doctor Hong Guangxiang.Method：The study based on the clinical records of 72 patients with asthma treated by Doctor Hong Guangxiang，and analyzed by Text Mining Technology.Data analysis in SAS 9.1.3 software platform，through frequencies analysis，therapeutic principles factor analysis，“TCM-TCM” association analysis，“TCM” factor analysis，found out the hard core of medicine，the laws of the therapeutic principles，the combination laws of TCM from the case.Result：（1）The syndromes of 72 patients with asthma appeared frequently in yang and qi deficiency， retention of phlegm and blood stasis in the lung.（2） The “TCM- TCM” association analysis showed that asthma core medicine combination：astragalus membranaceus，hurricane lamp，bighead atractylodes，cassia twig，radices paeoniae alba，ginger，liquorice，red dates，semen lepidii，dried tangerine，pericarpium citri reticulatae viride，etc.（3）The “TCM” factor analysis result showed：asthma commonly used medicine combination has 6 kinds：replenish qi and consolidate the superficial resistance，warming yang and guard weiqi，freeing lung and relieving asthma，reducing phlegm and relieve cough，etc.Conclusion：Exploreing the rule of basic syndrome and treatment by medical records that modern famous doctor of TCM treating asthma further will help doctors to improve their technology of detection and treatment.The results of text data mining objectively reflect the clinical experience and scientific theory for asthma from Doctor Hong Guangxiang.

【Key words】 Bronchial asthma； Case； Hong Guangxiang； Text data mining

First-authors address：Affiliated Hospital of Jiangxi College of Traditional Chinese Medicine，Nanchang 330006，China

doi：10.3969/j.issn.1674-4985.2017.32.019

名老中醫是中醫藥學術的帶頭人，他們的臨床經驗是中醫行業的寶貴財富。洪廣祥教授從事中醫呼吸疾病、內科疑難病癥臨床50余年，是江西省中醫院主任醫師，國家級名老中醫，對呼吸系統疾病的中醫藥治療積累了豐富的診療經驗，尤其對支氣管哮喘、支氣管擴張、慢性阻塞性肺疾病等有其獨特的臨床見樹。在國內同行中率先提出“痰瘀伏肺為哮喘的宿根”“治痰治瘀以治氣為先”等新學說[1]。……