| 引用本文:宋玥波1，2，芮一峰1，2，韩奕1，2，冯路达1，2，高颖1，2.240例肌萎缩侧索硬化的中医病位与伦敦分期的相关性研究[J].世界中医药,2020,(19):. |
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| 240例肌萎缩侧索硬化的中医病位与伦敦分期的相关性研究 |
| Correlation Between Disease Locations of Traditional Chinese Medicine and King's Staging in 240 Cases of Amyotrophic Lateral Sclerosis |
| 投稿时间：2020-04-17 |
| DOI：10.3969/j.issn.1673-7202.2020.19.028 |
| 中文关键词: 肌萎缩侧索硬化 运动神经元病 病位 伦敦分期 中医 |
| English Keywords:Amyotrophic lateral sclerosis Motor neuron disease Location of disease King's stage traditional Chinese medicine |
| 基金项目:中医药传承与创新“百千万”人才工程(岐黄工程)——国家中医药领军人才支持计划项目(国中医药人教发［2018］12号);中国博士后科学基金项目(2019M650594);中央高校基本科研业务项目(2019-JYB-XS-165) |
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| 中文摘要: |
| 目的:探索肌萎缩侧索硬化中医病位与伦敦分期的相关性,借助伦敦分期辅助明确中医病位演变规律,以进一步优化该病中医辨证论治诊疗方案,提高疾病预后判断的准确性。方法:应用临床流行病学调查方法采集240例病例资料,首先通过专家经验辨证归纳中医病位及相应症状群,其中,症状群以词频-逆向文档频率的统计方法提取;其次以四诊信息聚类分析的数据挖掘方法,聚类得出症状群;结合上述专家经验辨证及四诊信息聚类分析2种方法得出的症状群,归纳本病中医病位;并以中医病位、伦敦分期进行关联规则分析,探索二者相关性。结果:专家经验辨证和聚类分析均大致将本病中医病位分为脾胃、肝肾、心肺3组病位,关联规则分析示伦敦分期3期与脾胃病位正相关,其次为2期b;4期b与肝肾病位正相关,其次为3期,再次为2期b;4期b与心肺病位强正相关。结论:肌萎缩侧索硬化的中医病位在脾胃、肝肾、心肺,其中脾胃虚弱为本病早、中期的重要病理基础,肝肾亏虚为本病中、晚期的常见证候,宗气不足患者病情常已发展至病程末期。提倡在伦敦分期早期即接受中医药治疗以延缓病位演变进程、改善预后。在具体治疗措施上,应重视本病起于脾胃、上至心肺、下至肝肾的传变规律,遵循中医整体观及治未病的理念,调理本脏时及早顾护它脏,以提高临床疗效。 |
| English Summary: |
| To explore the correlation between the Amyotrophic Lateral Sclerosis disease location of traditional Chinese medicine(TCM) and King's staging, in order to assist to clarify the evolution rule of TCM disease location and related prognosis, and provide reference for clinical treatment and judgement of prognosis. Methods:A total of 240 subjects were enrolled by epidemiological methods. Firstly, the TCM disease location and the corresponding symptom group were summarized through the expert experience. Among them, the symptom group was extracted by the statistical method of word frequency-reverse document frequency; secondly, the data mining method of the four-diagnosis information cluster analysis was used to cluster the symptom group; combining the symptom clusters obtained by the above-mentioned expert experience differentiation and cluster analysis of four diagnosis information, the TCM disease position of the disease was summarized; and the association rules based on the TCM disease position were analyzed and King staging to explore the correlation between the 2 was explored. Results:Traditional syndrome differentiation and cluster analysis roughly divided the disease locations into spleen and stomach, liver and kidney, heart and lung. There is a positive correlation between Stage 3, 2b and spleen, stomach; between Stage 4b, 3 and 2b and liver, kidney; between Stage 4b and heart, lung. Conclusion:The disease locations in TCM of amyotrophic lateral sclerosis are in the spleen and stomach, liver and kidney, heart and lung. The weakness of spleen and stomach is the important pathological basis at the early and middle stage of ALS. The deficiency of liver and kidney is the common syndrome of the middle and advanced stage. Deficiency of Zongqi is common symptom at advanced stage. It is recommended to receive TCM treatment in the early stage of King staging to delay the evolution of the disease position and improve the prognosis. In terms of specific treatment measures, attention should be paid to the law of transmission of the disease from the spleen and stomach, up to the heart and lungs, and down to the liver and kidney, and we should follow the holistic view of TCM and the concept of disease prevention, and take care of the internal organs as soon as possible to improve clinical efficacy. |
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