不同地域扶阳医家的用药规律研究

发布时间：2018-03-01 22:15

  本文关键词： 扶阳派 医案 用药规律 不同地域　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:本次研究立足于不同地域扶阳派医家的医案,对其用药规律作出研究,结合扶阳派著作及《伤寒论》理论加以整合分析,比较不同地域扶阳派医家用药的共同与差异、综合归纳其用药思路与规律,为临床辨证论治、遣方用药提供思路,盼能有助扶阳理论在不同地域得到进一步的推广。方法:理论研究:运用文献计量学方法,对不同地域扶阳派医家学术思想进行研究的文献、书籍进行搜索、归纳、整理。分析中医期刊文献中对扶阳派用药规律的认识。此外,又通过对扶阳派专著的研究,总结扶阳派的核心扶阳辨证思维及用药思维。医案研究:收集6个地域的10位医家共284个医案进行数据分析,医家分别为:卢崇汉(四川)、范中林(四川)、唐步祺(四川)、吴佩衡(云南)、顾树祥(云南)、傅文录(河南)、李统华(河南)、祝味菊(上海)、李可(山西)、张存悌(辽宁)。运用统计软件,对所得数据进行描述性分析、推断性分析和数据挖掘,对不同地域的医案的药物配伍、方证关系、药证关系、加减思路等进行比较分析。结果:1.文献研究部份:全面搜索中国学术期刊全文数据库(CNM)、知网数据库(CNKI)与扶阳派用药规律相关的文献共113篇,当中属理论探讨的共48篇,医家学术思想分析的共27篇,医案赏析的共15篇,方证探讨的共8篇,用药剂量探讨的共5篇,临床研究的共3篇,药理研究的1篇;含有统计数据的用药规律研究共6篇。统计结果显示与扶阳派用药相关的文献从2004年起出现并逐步增多,至2011年达到高峰21篇后文献数目逐步回落至2015年的4篇,可见研究扶阳派用药方面的相关文献有减少迹象。而过去研究扶阳派的文献大部份为理论研究,少有包含统计数据的研究,也未有提出地域因素对扶阳派用药的影响。2.医案研究部份:收纳研究医案284个,包含137个病种;录入症状174个,累计频数2190次;录入药物217种,累计频数2804次;录入舌象17种,累计频数737次;录入脉象18种,累计频数622次。通过统计分析可知不同地域扶阳派医家用药共同特点(1)擅用姜桂附(2)善用经方(3)少用苦寒药物(4)常配伍健脾化湿药。不同地域扶阳派医家用药的不同点:四川医家:(1)用药精炼(2)广用四逆汤、麻黄附子细辛汤(3)少用滋阴药(4)善用温热药治疗肺系病。云南医家:(1)用药精炼(2)广用四逆汤、麻黄附子细辛汤(3)肉桂的特殊用法(4)独创新方。河南医家:(1)活血化瘀药的应用(2)善于融合各扶阳派医家之经验(3)善用温潜法(4)不忌用补阴药(5)独创新方。上海医家:(1)用药量轻(2)善用温潜法(3)广用理气化湿药。山西医家:(1)药量偏大,药味较多(2)多用补肾药(3)善用温潜法(4)不忌用补阴药(5)独创新方。辽宁医家:(1)善于融合各扶阳派医家之经验。结论:研究结果显示,各地域的扶阳医家的用药都有其显著异别,受到三大因素所影响:(1)地域因素(2)师承因素(3)时代因素,而出现不同的用药规律和特色。说明扶阳理论能够在不同的地域,经过适当的调整后发挥其优势。只要不脱离辨证论治的原则,不问病因病机而滥用附子,扶阳派医理相信是可以在全国甚至全世界通行的。
[Abstract]:The purpose of this research is based on the different regions of Fuyang sent doctors medical case, make a study of the drug laws, school books and treatise on the theory of integration of < > analysis combined with the Fuyang, compare the different Fuyang sent physicians of the drug together with differences, summarized its drug ideas and rules for clinical treatment based on syndrome differentiation prescription, provide ideas, hoping to help Fuyang theory further in different regions. Methods: theoretical research: using the method of bibliometrics, in different areas of Fuyang school academic thought of doctors research literature, books for search, induction, consolidation. Analysis of the understanding of drug laws of Fuyang school Chinese Journal of literature. In addition, through the study of Fu Yang sent a book, send the summary Fuyang core Fuyang dialectical thinking and medication thinking. Case study: 10 physicians from 6 regions and a total of 284 medical records for data analysis, Doctors are: Lu Chonghan (Sichuan), Fan Zhonglin (Sichuan), Tang Buqi (Sichuan), Wu Peiheng (Yunnan), Gu Shuxiang (Yunnan), Fu Wenlu (Henan), Li Tonghua (Henan), to Weiju (Shanghai), Li Ke (Shanxi), Zhang Cunti (Liaoning). Using statistical software, descriptive analysis of income data analysis and data mining, inference, drug compatibility, different regions of medical prescription and syndrome relationship, prescription, and ideas were compared and analyzed. Results: 1. literature research part: comprehensive search Chinese Academic Journal Full-text Database (CNM), CNKI database (CNKI) and Fuyang School of literature related to drug law a total of 113 articles, which belongs to the theory of the total of 48, analysis of the doctor's academic thought consists of 27 parts, a total of 15 cases of the syndrome, to a total of 8, a total of 5 doses of clinical research, a total of 3 papers, 1 papers of pharmacological research; medication compliance with statistical data. The law of a total of 6 articles. The statistical results show and Fuyang sent the drug related documents from 2004 to 2011 and gradually increased, reached a peak in 21 after a number of literature gradually declined to 4 in 2015, the related literature of Fuyang sent medication visible have reduced signs. In the past research of Fu Yang school most of the literature is the theoretical research, few studies have included statistical data, also did not put forward regional factors on the Fuyang send medication effect of.2. case study: 284 cases included studies, including 137 disease symptoms; input 174, cumulative frequency 2190 times; input 217 kinds of drugs, the cumulative frequency of 2804 times; the entry of tongue as of 17, the cumulative frequency of 737 times; 18 kinds of input pulse, cumulative frequency 622 times. Through statistical analysis of different regions of Fu Yang sent physicians of the drug (1) using common ginger Guifu (2) by use of (3) with less bitter cold drugs (4) is often combined with spleen 婀胯嵂.涓嶅悓鍦板煙鎵堕槼娲惧尰瀹剁敤鑽�鐨勪笉鍚岀偅�

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