李德新教授辨治郁病临床经验研究

发布时间：2017-12-28 17:02

  本文关键词：李德新教授辨治郁病临床经验研究　出处：《辽宁中医药大学》2016年硕士论文　论文类型：学位论文

  更多相关文章： 郁病 病因病机 辨证论治 经验研究 李德新教授

【摘要】：目的:本文旨在总结李德新教授对郁病病因病机的认识,归纳临床辨证思路,诊治经验及特色,有效的提高郁病临床疗效。材料与方法:1.通过回顾性查阅大量相关文献,整理古代医家对郁病的认识及现代医家在汲取理论精华的基础上借助实验手段研究郁病的进展,总结发展现状及存在问题,撰写文献综述;2.跟师侍诊,收集、整理、分析郁病患者病历百余例,将经典理论与临床实践相结合,总结李师对郁病病因病机的认识,临床辨证及治疗特色。结果:1.李德新教授推崇朱丹溪之六郁学说,认为气郁是六郁发生的前提和核心,分析郁病的病机特点当从气机升降的角度出发,并应首先辨清“病”与“郁”的对立统一关系。2.在辨证时,一方面要辨清疾病的发展阶段,分析气郁而湿滞,湿滞而成热,热郁而生痰,痰滞而血不行,血滞而食不化,六郁常常相兼为患的特点,根据每个阶段的症候特征,了解疾病的所处阶段。另一方面,结合“肝为五脏之贼”易受邪而传它脏的生理特性及五行传变规律,通过四诊合参判断疾病的发展及转归,先安未受邪之地,防患于未然。3.治疗上,重视脾胃与郁病发病之间的密切关系,以六郁为要,权其轻重,气郁时以柴胡疏肝散为基础,化火、化热予丹栀逍遥散,气郁痰阻,治以半夏厚朴汤,痰郁而血不行,出现瘀滞之象,佐以血府逐瘀汤化裁。根据“左升右降”理论注重气机的调畅,善于调理脾胃气血、阴阳、升降、燥湿,以蕴诸腑,共达安心神之旨。4.用药擅长从脾胃入手,用白术、茯苓、甘草等助土得以升木,以培其本;根据肝脏本身的生理特征,在疏肝理气之时注意肝阴肝血的保护,巧用当归、芍药等荣血养肝而补肝之体;柴胡、薄荷、升麻等辛散升发之品以顺肝之性,复肝之用。5.根据脾胃的生理功能及在五脏之中的重要地位,以调理脾胃为中心多脏并调,结合脏腑之间的生克制化关系,调整五脏功能及十二经气血,使整个机体气机条畅,气血冲和,郁滞自开。结论:通过对李德新教授辨治郁病的经验研究,得出以下结论:1.以气郁为要,辨清“因郁致病”或“因病致郁”,标本缓急以治之。2.辨别疾病的所处阶段、传变、转归,防患于未然。3.从调脾胃而治郁的角度出发,善调气机,疗效显著。4.培土以固其本,疏肝不忘柔肝,尤为注重肝阴、肝血的顾护。5.在调脾胃为中心的基础上多脏并调,以达气机条畅,气血冲和的理想状态。
[Abstract]:Objective: This paper aims to summarize professor Li Dexin's understanding of etiology and pathogenesis of depression, summarize clinical thinking, diagnosis and treatment experience and characteristics, and effectively improve the clinical efficacy of depression. Materials and methods: 1. through retrospective consulting a number of literature, experimental research progress of depression by means of arranging ancient physicians understanding of depression and modern physicians based on absorbing the essence of the theory, and summarize the existing problems of current development, writing literature review; 2. with sommelier diagnosis, collect and analyze records of depression patients with more than 100 cases, the classic combination of theory and practice, summed up the teacher Li on the etiology and pathogenesis of depression disease, clinical diagnosis and treatment characteristics. Results: 1.. Professor Li Dexin praised Zhu Danxi's theory of "six depression". He thought that qi depression is the premise and core of the occurrence of six depression. The pathogenesis of depression is analyzed. When we start from the angle of air lift, we should first distinguish the unity of opposites between "disease" and "depression". 2., when differentiating syndromes, we should identify the development stages of diseases on the one hand, analyze the stagnation of Qi and stagnation of dampness, heat from stagnation and heat, heat stagnation and phlegm, phlegm stagnation and blood failure, blood stagnation and food consumption. Six depression is often accompanied by the characteristics of disease. According to the symptomatic characteristics of each stage, we can understand the stage of disease. On the other hand, combined with the physiological characteristics of the liver to 5 of the thief "vulnerable to evil and pass it dirty and five line transmission rules, and outcome of development through the combination of all the judgment of disease, first an unaffected evil, nip in the bud. 3. treatment, pay attention to the close relationship between the incidence of depression and spleen and stomach disease, with six Yu to the right degree of Qi when using Chaihushugansan as the foundation, fire, heat to Danzhixiaoyao powder, qi stagnation of phlegm, treated by Banxia Houpu decoction, phlegm depression and blood stasis can occur lag image, combined with Xuefuzhuyu decoction. According to the "left right up down" theory on the smooth transfer of Qi, spleen and stomach qi and blood, yin and Yang, good at lifting, dampness, in the Fu Yun, amounting to the purpose of peace of mind of god. 4. good medication from the spleen and stomach of Atractylodes, Poria, licorice and other soil to help rose wood, in order to improve the; according to the physiological characteristics of liver itself, pay attention to the protection of liver Yin liver blood in liver Qi when using angelica, peony and blood and tonifying liver and nourishing liver Rong body; bupleurum root, mint, when the goods Sansheng cohosh to shun the liver, liver with complex. 5. according to the important physiological function of the spleen and stomach and internal organs in the spleen and stomach as the center, with more dirty and adjustable, with the restraint of the relationship between the internal organs, adjust the function of internal organs and twelve by the blood, make the whole body Qi smooth, blood stasis and flushing, self opening. Conclusion: through the empirical research of Professor Li Dexin in treating depression, draws the following conclusions: 1. to Qi to discern for stagnation of pathogenic or illness caused by the depression, Biao to cure. 2. to identify the stages, changes and outcomes of the disease, and to prevent the disease. 3. from the angle of regulating spleen and stomach and treating depression, the effect of good air conditioner is remarkable. 4. in the solid earth, don't forget the liver and liver, particularly on liver yin, liver blood nursing care. 5. on the basis of regulating the spleen and stomach on the basis of many dirty and adjustable, to reach the Qi, Qi and blood flow and the ideal state.
【学位授予单位】：辽宁中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R249;R277.7
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本文编号：1346638