| 张宾,相安,邵臧杰,等.基于病案数据挖掘定量结合定性研究周仲瑛教授辨治肝癌方案[J].浙江中医药大学学报,2019,43(6):562-565. |
| 基于病案数据挖掘定量结合定性研究周仲瑛教授辨治肝癌方案 |
| Quantitative and Qualitative Study of Professor ZHOU Zhongying's Treatment of Liver Cancer by the Data Mining of Case Report |
| DOI：10.16466/j.issn1005-5509.2019.06.008 |
| 中文关键词: 湿热瘀毒 数据挖掘 病机 周仲瑛 肝癌 方案 |
| 英文关键词: dampness-heat-blood stasis-toxin data mining pathogenesis ZHOU Zhongying liver cancer programme |
| 基金项目:国家自然科学基金项目(81873207)；国家中医药管理局项目(国中医药人教发[2010]59号) |
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| 中文摘要: |
| [目的]基于病案数据挖掘定量结合定性总结周仲瑛教授辨治肝癌方案。[方法]通过整理周仲瑛教授辨治肝癌的病案，并结合数据挖掘和名医定性访谈的方法，对周仲瑛教授辨治肝癌病机特点、治则治法、临证方案加以总结。[结果]周仲瑛教授治疗肝癌主要着眼于病机分析，认为肝癌的基本病机是湿热瘀毒互结，肝脾两伤。病理因素是以癌毒为核心，与湿、热、痰、瘀、郁等胶结复合为患。病理性质多属本虚标实，虚实夹杂。病位主要在肝脾，涉及胆、胃、肾、肺。病机演变,早期以湿热瘀毒内伏为主，中晚期癌毒暗耗气血，病机往往复杂多变。而治疗重在把握扶正祛邪的主次。临证常见7种复合证型为:湿热瘀毒郁结，癌毒内蕴，肝脾两伤证；湿热瘀毒郁结，肝胃失和，胃气上逆证；肝郁脾虚，湿热瘀毒互结证；肝肾阴虚，湿热瘀毒郁滞证；湿热瘀毒互结，络热血溢证；气阴两虚，湿热瘀毒互结证；肝脾两伤，土败木贼，气滞水停，湿热瘀毒未尽证。[结论]周仲瑛教授临证采用病机辨证方法，结合基本病机，围绕病机之间的兼夹、复合、转化及演变，因机立法，随证加减。所列出的7种常见复合证型及辨治方案涉及了肝癌病程的各个阶段。临床特色突出，改善了患者的生活质量，疗效肯定。其临证方案对中医药治疗肝癌具有借鉴意义和推广价值。 |
| 英文摘要: |
| [Objective]To make quantitative and qualitative study of Professor ZHOU Zhongying’s treatment of liver cancer by the data mining of case report.[Methods]By sorting out the case of Professor ZHOU Zhongying's diagnosis and treatment of liver cancer, combined with data mining methods and qualitative interviews with famous doctors, Professor ZHOU Zhongying's pathogenesis of treating liver cancer, treatment method and treatment programs were summarized. [Results]Professor ZHOU Zhongying's treatment of liver cancer mainly focuses on the pathogenesis analysis. The basic pathogenesis of liver cancer is damp and heat, blood stasis and toxin,deficiency of liver and spleen.The pathological factor is centered on cancerous toxin, and it is combined with damp, heat, blood stasis, stagnation and so on. Pathological nature is obviously deficiency in origin and excess in superficislity, and deficiency-exess mixture. The disease location is mainly in the liver and spleen, involving the gallbladder, stomach, kidney and lung. In the early stage of the evolution of the pathogenesis, the condition is not obvious. In the middle and late stage of cancers,pathogenesis is often complicated and variable. The treatment is focused on grasping the primary and secondary between reinforcing the healthy and eliminating the pathogenic. The seven complex syndrome types of clinical syndrome are:damp and heat, blood stasis and toxin,deficiency of liver and spleen syndrome; damp and heat, blood stasis and toxin, disharmony between liver and stomach syndrome; damp and heat, blood stasis and toxin,liver stagnation and spleen deficiency syndrome; liver and kidney Yin deficiency, damp and heat, blood stasis and toxin syndrome; damp and heat, blood stasis and toxin, syndrome of interactivity of blood stasis and heat; Qi and Yin deficiency, damp and heat, blood stasis and toxin syndrome; damp and heat, blood stasis and toxin,deficiency of liver and spleen, syndromeof Qi stagnation.[Conclusion]Professor ZHOU adopts the methods of the differentiation of pathogenesis,combined with basis pathogenesis and differentiation,focuses on compound, inversion,evolution of pathogenesis.The seven common composite syndrome types and treatment options listed involve various stages of the course of liver cancer. Professor ZHOU’s case report has outstanding clinical features and improved the quality of life of patients. Its clinical evidence program has reference significance and promotion value for Chinese medicine treatment of liver cancer. |
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