名老中医许鑫梅治疗胃脘痛的用药规律研究

发布时间：2018-01-09 11:14

本文关键词：名老中医许鑫梅治疗胃脘痛的用药规律研究　出处：《广州中医药大学》2017年博士论文　论文类型：学位论文

【摘要】：目的:胃脘痛是临床上常见的中医内科疾病,现代医学把上腹部疼痛为主症的急慢性胃炎、消化性溃扬、胃癌、功能性消化不良等疾病归属于胃痛的范畴。许鑫梅教授是全国名老中医药专家,尤善治疗消化系统疾病。本研究通过总结许鑫梅教授处方用药规律,研究其治疗胃脘痛的临床经验及学术思想,对传承及推广许鑫梅教授临证治疗胃脘痛优势经验。同时对初诊患者进行流行病学研究,完成中医辩证分型及体质分类,进行统计分析,探讨它们之间的相关性,结合许鑫梅教授临床用药特点,从而为个体化治疗及预防胃脘痛提供临床依据,以期提高胃脘痛的中医药治疗效果。方法:本研究通过收集2016年3月至2016年10月于广州中医药大学第一附属医院岭南名医门诊处方,共收集180张许鑫梅教授治疗胃脘痛患者的中药处方,运用统计软件对许教授所用药物进行频数分析、聚类分析,并对药物的四气五味及归经进行总结,总结许鑫梅教授临证治疗胃脘痛处方用药特点,并总结其治疗此病的临床经验及学术思想。本研究同时对138例初诊的胃脘痛患者进行流行病学研究,对患者进行中医辩证分型及体质分类,比较胃痛不同证型中不同体质类型所占比率,从而研究它们之间可能存在的相关性,为胃痛的治疗、预防提供可靠的临床依据。所得数据采用SPSS 20.0统计软件分析,采取X2检验。结论:许鑫梅教授善以补气健脾的药物来治疗胃脘痛,组方以四君子为基础,临证用药物无明显寒热偏颇,主张寒温并用,阴阳平调。使用甘味药物居首,因其能补、能和、能缓,具有补虚、和中、调和药性、缓急止痛之功,且甘味药口感良好,减少患者饮药的痛苦,增加医从性。许教授临证治疗胃脘痛,注重从脾胃、肺、大肠、肝论治,主张"胃咽合病"、"治上应不忘顾下"、情志调摄等,对胃脘痛有独到的临证思路。中医辩证分型及体征分类在临床应用上,有一定相关性,结合许鑫梅教授临床经验,对胃脘痛患者提供非药物治疗指导,患者需养成良好起居、饮食习惯,医生在治疗过程中需适当进行心理干预。
[Abstract]:Objective: epigastric pain is a common internal medicine disease in traditional Chinese medicine. Modern medicine is characterized by acute and chronic gastritis with epigastric pain. Functional dyspepsia and other diseases belong to the category of stomach pain. Professor Xu Xinmei is a famous Chinese medicine expert, especially good at treating digestive system diseases. To study its clinical experience and academic thinking in the treatment of epigastric pain, to inherit and promote Professor Xu Xinmei's clinical experience in the treatment of epigastric pain, and to carry out epidemiological study on newly diagnosed patients. Complete TCM dialectical classification and constitution classification, statistical analysis, explore the correlation between them, combined with the clinical characteristics of Professor Xu Xinmei, so as to provide a clinical basis for individualized treatment and prevention of epigastric pain. Methods: from March 2016 to October 2016 in Guangzhou University of traditional Chinese Medicine Hospital Lingnan famous out-patient prescriptions were collected. A total of 180 prescriptions of Professor Xu Xinmei for the treatment of epigastric pain were collected. The frequency and cluster analysis of the drugs used by Professor Xu were analyzed by statistical software. The clinical experience and academic thoughts of Professor Xu Xinmei in treating epigastric pain were summarized. An epidemiological study was carried out on 138 newly diagnosed patients with epigastric pain. In order to study the possible correlation between the different types of stomach pain and the treatment of stomach pain, the patients were classified by TCM dialectical classification and physique classification, and the ratio of different types of stomach pain was compared. The data were analyzed by SPSS 20.0 statistical software and X2 test. Conclusion: professor Xu Xinmei is good at treating epigastric pain with the medicine of invigorating qi and invigorating spleen. The prescription is based on the four gentlemen, and the medicine used in clinical syndrome has no obvious bias of cold and heat, and advocates the use of cold and temperature, Yin and Yang leveling. The use of sweet flavor medicine is the first, because it can supplement, can and, can slow down, and has the ability of tonifying deficiency, harmony and medicine. Urgent pain relief, and the taste of sweet medicine good, reduce the pain of patients drink drugs, increase the medical compliance. Professor Xu clinical treatment of epigastric pain, focus on the spleen and stomach, lung, large intestine, liver treatment, advocate "gastropharyngeal syndromes." "We should not forget to take care of the treatment", such as emotional adjustment, etc., there is a unique clinical symptoms of epigastric pain. Dialectical classification of TCM and physical signs in clinical application, there is a certain relevance, combined with Professor Xu Xinmei's clinical experience. Patients with epigastric pain should be given non-drug treatment guidance. Patients should develop good living and eating habits. Doctors should take psychological intervention in the course of treatment.
【学位授予单位】：广州中医药大学
【学位级别】：博士
【学位授予年份】：2017
【分类号】：R249;R256.33

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