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目的:总结中医师在经验方基础上进行加减药物的运用思路,为推广应用经验方提供客观依据。方法:收集广东省中医院杨志敏教授运用“四逆汤加桂甘龙骨牡蛎汤”加减治疗失眠症的患者临床特征。按疗效评价标准,对有效组患者,运用关联规则(GRI算法),分析加减药物与临床特征之间的关联规则。并将结果反馈专家,总结加减法运用思路。结果:共收集杨志敏教授运用“四逆汤加桂甘龙骨牡蛎汤”加减治疗的失眠症患者40例及其临床特征共106个。按疗效评价标准,有效患者28例,无效患者12例,总有效率为70%。对有效组患者,运用关联规则(GRI算法),分别分析除经验方固定药物外的28个加减药物与81个临床特征之间的关联规则,得出关联规则12条,包含了5种加减药物。结论:用关联规则GRI算法,把临床特征设定为前置项,把加减药物设定为后置项,是一种有效的探索经验方加减法运用思路的客观方法。
OBJECTIVE: To summarize the thinking of Chinese medicine practitioners on the basis of experiences and prescriptions, and to provide objective evidences for popularizing and applying empirical experiences. Methods: The clinical features of patients treated with “Sini Tang and Gui Gan Longgu Muli Decoction” plus “Addition and subtraction” were collected by Professor Yang Zhimin from Guangdong Provincial Hospital of Traditional Chinese Medicine. According to the evaluation criteria of efficacy, association rules (GRI algorithm) were used to analyze the association rules between additive and subtractive drugs and clinical features in effective patients. Feedback the results and experts, summed up the use of addition and subtraction method. Results: A total of 40 cases of patients with insomnia treated by Professor Yang Zhimin and 106 clinical features of “Sini Tang plus Gui Gan Long Gu Oyster Soup” were collected. According to the evaluation standard of curative effect, there are 28 effective patients and 12 ineffective patients, the total effective rate is 70%. The association rules (GRI algorithm) were used to analyze the association rules of 28 additive and 81 clinical features except for the fixed prescription drugs in effective group, and 12 association rules were obtained, including 5 kinds of additive rules Less medicine. Conclusion: Using the association rules GRI algorithm to set the clinical features as the antecedent, and the addition and subtraction drugs as the post-term, is an objective way to explore the ways of using the experience-side addition and subtraction.