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1.中国中医科学院 广安门医院,北京 100053
2.上海中医药大学,上海 201203
3.河南中医药大学 第三附属医院,郑州 450046
4.河南中医药大学,郑州 450046
惠小珊,在读博士,从事中西医心血管临床与基础研究,E-mail:1713270467@qq.com
* 张金生,博士生导师,从事中西医脑血管临床与基础研究,E-mail:zjssir2004@sina.com
收稿日期:2020-08-11,
网络出版日期:2020-11-30,
纸质出版日期:2021-02-20
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惠小珊,杨帅,张金生等.基于量表等级化和主成分分析法探究缺血性中风证候要素与治法间关系[J].中国实验方剂学杂志,2021,27(04):159-167.
HUI Xiao-shan,YANG Shuai,ZHANG Jin-sheng,et al.Relationship Between Syndrome Elements and Therapy of Ischemic Stroke Based on Scale Hierarchy and Principal Component Analysis[J].Chinese Journal of Experimental Traditional Medical Formulae,2021,27(04):159-167.
惠小珊,杨帅,张金生等.基于量表等级化和主成分分析法探究缺血性中风证候要素与治法间关系[J].中国实验方剂学杂志,2021,27(04):159-167. DOI: 10.13422/j.cnki.syfjx.20210119.
HUI Xiao-shan,YANG Shuai,ZHANG Jin-sheng,et al.Relationship Between Syndrome Elements and Therapy of Ischemic Stroke Based on Scale Hierarchy and Principal Component Analysis[J].Chinese Journal of Experimental Traditional Medical Formulae,2021,27(04):159-167. DOI: 10.13422/j.cnki.syfjx.20210119.
目的
2
运用数据挖掘技术对缺血性中风治法的分布进行研究,评估其临床疗效价值。
方法
2
检索1978年1月至2018年12月中国期刊全文数据库(China National KnowledgeInfrastructure Database,CNKI),维普中文科技期刊数据库(China Science and Technology Periodical Database,VIP),万方数据库(Wanfang Data),中国生物医学文献数据库(Chinese Biomedical Literature Database,Sino Med)。基于上述四大数据库内检索有关中医药、中西医结合治疗缺血性中风临床观察、研究文献。对各个文献证候、治法、方药等信息进行规范化、等级化采集处理后建立缺血性中风证候要素与治法数据库。运用量表评价和等级化赋分方法分析证候要素和治法,通过Kendall's tau-b相关分析、主成分分析等多种统计方法描述缺血性中风证候要素与治法之间、各证候要素间、各治法间的相关性及其分布。
结果
2
通过异质性分析结果显示纳入文献具有同质性、可进行后续统计量的合并。本研究共纳入450条证候、治法,经统一规范化拆分后得到1 287个单一证候要素,1 562个单一治法。各证候要素与其相对应的治法(除窍闭-开窍)均具有较高的相关性,除了相对应的证候要素与治法外,痰湿-益气(-0.52),气虚-开窍(-0.56)也具有较高的相关性。课题组以Ⅰ类,Ⅱ类,Ⅲ类由高至低代表证候和治法要素的重要性。气虚、血瘀和火热、痰湿、腑实是缺血性中风Ⅰ类证候要素;阴虚、内风为其Ⅱ类证候要素;阴虚与阳虚为其Ⅲ类证候要素;袪痰湿、清热、通腑和熄风、活血化瘀、益气是缺血性中风Ⅰ类治法,袪痰湿、清热、通腑相伴出现的可能性较大;熄风、活血化瘀、益气相伴出现的可能性较大。滋阴、理气是缺血性中风Ⅱ类治法,其关联性较高,常相伴出现。开窍、补阳、通络分别为缺血性中风Ⅲ,Ⅳ,Ⅴ类治法。
结论
2
气虚、血瘀、痰湿、火热、腑实是缺血性中风主要证候要素,气虚血瘀、痰热腑实为其主要证候类型;袪痰湿、清热、通腑和活血化瘀、熄风、益气治法在缺血性中风治疗中占据主要地位;临床治疗缺血性中风时,袪痰湿、清热、通腑治法常联合使用,活血化瘀法常与益气熄风法联合使用,以起协同增效之力。
Objective
2
To study the distribution of ischemic stroke treatment with data mining technology and evaluate its clinical efficacy.
Method
2
China National Knowledge Infrastructure Database(CNKI),China Science and Technology Reader's Digest Database(VIP),Wanfang Data,Chinese Biomedical Literature Database(Sino Med)were retrieved from January 1978 to December 2018. The clinical observation and study literatures on the treatment of ischemic stroke with the combination of traditional Chinese medicine and Western medicine were retrieved in the four databases. After standardized and hierarchical collection and processing of all syndromes,treatment methods,prescriptions and other information in the literatures,a database of syndrome elements and treatment of ischemic stroke was established. Syndrome factors and treatment methods were analyzed by scale evaluation and hierarchical classification methods. Kendall's tau-b correlation analysis,principal component analysis and other statistical methods were used to describe the correlation and distribution of syndrome factors and treatment methods of ischemic stroke.
Result
2
The results of heterogeneity analysis showed that the included literatures were homogeneous and could be combined with subsequent statistics. A total of 450 syndromes and treatment methods were included in this study,and 1 287 single syndrome elements and 1 562 single treatment methods were obtained after unified and standardized splitting. Besides the corresponding syndrome elements and treatment methods,phlegm-dampness-invigorating Qi(-0.52) and Qi deficiency-invigorating Qi(-0.56) were also highly correlated. The study team represented the importance of syndrome and treatment elements with class Ⅰ,Ⅱ,Ⅲ from high to low. Qi deficiency,blood stasis and fire heat,phlegm,viscera excess were class Ⅰ syndrome elements;Yin deficiency,endogenous wind were class Ⅱ syndrome elements;Yin deficiency and Yang deficiency were class Ⅲ syndrome elements;Removing phlegm dampness,clearing heat,clearing the hollow viscera and extinguishing wind,promoting blood circulation to remove blood stasis,tonifying Qi were class Ⅰ treatment of ischemic stroke,and removing phlegm dampness,clearing heat,clearing the hollow viscera were more likely to appear simultaneously; and extinguishing wind,activating blood circulation and removing blood stasis,and benefiting Qi were more likely to appear simultaneously. Nourishing Yin and regulating Qi were class Ⅱ therapies of ischemic stroke,which were highly correlated and often appear simultaneously. Inducing resuscitation,tonifying Yang and dredging collaterals were class Ⅲ,Ⅳ,Ⅴ therapies.
Conclusion
2
Qi deficiency,blood stasis,phlegm dampness,fire heat and viscera excess were the main syndromes of ischemic stroke,while Qi deficiency and blood stasis,phlegm heat and viscera excess were the main syndromes. Eliminating phlegm and dampness,clearing heat,clearing the hollow viscera,promoting blood circulation and removing blood stasis,extinguishing wind and benefiting Qi were the main therapies for the treatment of ischemic stroke. In clinical treatment for ischemic stroke,the therapies for relieving phlegm and dampness,clearing heat and relieving organs are often used in combination,and the therapies for promoting blood circulation and removing blood stasis were often used in combination with the therapies for invigorating Qi and extinguishing wind for the synergistic effect.
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