Zhang Bei-Hua, Gao Rui, Li Zhen-Hua, Li Bao-Shuang, Wang Feng-Yun, Tang Xu-Dong
Graduate School, China Academy of Chinese Medical Sciences, Beijing 100700, China.
Zhongguo Zhong Xi Yi Jie He Za Zhi. 2013 Jun;33(6):757-60.
The pathogenesis of irritable bowel syndrome (IBS), a functional gastrointestinal disorder, is poorly understood. Treatment by Chinese medicine and pharmacy (CMP) is superior to treatment by Western medicine (WM). Therefore, we aimed to analyze Chinese medical experts' experiences in treating IBS by data mining.
By retrieving related literatures from 1994 to 2012 from CNKI, we chose proved cases and screened effective medical records to establish a database using structural electronic medical case collecting system and data mining. The thinking ways of modern physicians in diagnosis and treatment of IBS were analyzed.
Totally 116 medical cases from 46 Chinese medical experts were recruited and analyzed. Results showed that Gan depression and Pi deficiency were most basic syndrome elements. In addition, cold dampness, damp heat, yang deficiency, and Shen deficiency were main elements for the development of diarrhea predominant IBS (IBS-D). Qi stagnation, yin deficiency, qi deficiency, and blood stasis were main elements for the development of constipation predominant IBS (IBS-C). Soothing Gan-qi and strengthening Pi was the most important treatment method. White peony root, prepared atractylodes, prepared licorice, tangerine peel, poria, bupleurum, Radix sileris, lanceolata, and Radix aucklandiae were the most common Chinese herbs used in treating IBS.
(1) Gan depression and Pi deficiency was the main pathogenesis for IBS. Diagnosis and treatment of IBS should be performed clinically according to its development. Tongxie Yao-fang should be used as the basic prescription with modification according to syndrome differentiation. (2) Data mining will have a wide application prospect in studying medical cases.
肠易激综合征（IBS）作为一种功能性胃肠疾病，其发病机制尚不清楚。中医药治疗优于西医治疗。因此，我们旨在通过数据挖掘分析中医专家治疗IBS的经验。
通过检索1994年至2012年中国知网的相关文献，选择确诊病例并筛选有效病历，使用结构化电子病历采集系统和数据挖掘建立数据库。分析现代医生诊断和治疗IBS的思维方式。
共纳入并分析了46位中医专家的116例病例。结果显示，肝郁脾虚是最基本的证素。此外，寒湿、湿热、阳虚和肾虚是腹泻型肠易激综合征（IBS-D）发展的主要因素。气滞、阴虚、气虚和血瘀是便秘型肠易激综合征（IBS-C）发展的主要因素。疏肝健脾是最重要的治疗方法。白芍、白术、炙甘草、陈皮、茯苓、柴胡、防风、独活和木香是治疗IBS最常用的中药。
（1）肝郁脾虚是IBS的主要发病机制。IBS的诊断和治疗应根据其发展情况进行临床操作。痛泻要方应作为基本方剂，根据辨证进行加减。（2）数据挖掘在医案研究中具有广阔的应用前景。
