基于中医整体观研究林平主任功能性消化不良诊疗经验

发布时间：2018-01-03 09:54

本文关键词：基于中医整体观研究林平主任功能性消化不良诊疗经验　出处：《福建中医药大学》2016年硕士论文　论文类型：学位论文

【摘要】：目的：基于中医整体观思维,探讨研究导师林平主任运用五脏相关理论诊断治疗功能性消化不良的学术思想,分析总结导师以自拟“调脏运气汤”为基本方,根据患者兼夹证和主要症状进行加减用药的临床治疗经验。方法：整理分析导师发表的9篇功能性消化不良相关研究论文,结合跟诊中聆听导师的分析教诲及对相关病案进行研究等方法,研究总结导师基于中医整体观思维提出的功能性消化不良基本病机,以“调脏运气汤”为基本方,随兼夹证和主要症状进行加减的用药规律、临证经验和特色方法。结果：(1)以中医整体思维认识基本病机。FD病位涉及脾、肝、胃、心、肺、肾及大肠、小肠等诸多脏腑,基本病机是脾虚、肝胃肠气机郁滞、心神不宁；(2)治疗上把握基本病机,五脏并调。调整基本病机贯穿治疗始终,同时关注五脏协调；(3)自拟“调脏运气汤”作为基本方。仿“柴芍六君子汤”之意,去壅滞之党参,加入炒麦芽以助运化,再入引经药,充分体现中医整体思维；(4)随证和症加减用药。根据患者的兼夹证和主要症状对“调脏运气汤”进行加减选药；(5)注重调整平衡。一是注重调节局部与整体的平衡,以局部促进整体、以整体带动局部,使气机调达、升降有节,使机体气血津液运行无碍,二是强调诸脏“和”,诸脏腑阴阳平衡协调；(6)强调药性平和味甘。药到病所,所用之药当以平和为要,视其兼证而稍作调整,不可过于刺激而加重病情,不能过于香燥而伤津,不能过于滋腻而碍脾,不能过于苦涩而拒药；(7)强调内外治疗并举。提倡中药内服,外敷泡足,整体治疗达到疏肝健脾,调畅气机、宁心安神等五脏并调的作用,充分体现中医临床诊疗特色；(8)饮食以清淡、易消化食物为主,主张细嚼慢咽,少吃多餐以减少胃肠负担；(9)强调治养结合。初期七分治三分养,中期三分治七分养,后期二分治八分养；(10)倡导调整生活起居。情志调畅,起居有节,使脏腑气血归于平衡协调。诸法合用,从而达到五脏和调,恢复机能的效果。结论：(1)林平主任以中医整体观为指导、运用五脏相关理论诊断治疗功能性消化不良的学术思想,治疗上强调把握基本病机、五脏并调；(2)以自拟“调脏运气汤”为基本方,随证和症加减用药,符合“病证结合”的治疗思想；(3)注重调整平衡、用药性平味甘、强调内外治疗并举、饮食清淡、注重治养结合和倡导调整生活起居等中医思维,对功能性消化不良的治疗具有较好的临床意义。
[Abstract]:Objective: based on the holistic thinking of traditional Chinese medicine, this paper discusses the academic thought of using the theory of five visceral organs to diagnose and treat functional dyspepsia, and analyzes and sums up the tutor's basic prescription of "Tiaojiangyong decoction". Methods: according to the clinical experience of adding and subtracting drugs to patients with syndrome and main symptoms. Methods: nine related research papers on functional dyspepsia published by our tutor were analyzed. Combined with the analysis and instruction of listening to the tutor in the diagnosis and the research on the relevant medical records, the study summarized the basic pathogenesis of functional dyspepsia proposed by the tutor based on the holistic thinking of traditional Chinese medicine. Take "Tiaojiangyong decoction" as the basic prescription, along with the drug law of adding and subtracting the syndrome and the main symptoms, clinical experience and characteristic method. Results: 1) understanding the basic pathogenesis. FD disease position involves the spleen with the whole thinking of traditional Chinese medicine. Liver, stomach, heart, lung, kidney, large intestine, small intestine and many other organs, the basic pathogenesis is spleen deficiency, liver and gastrointestinal qi stagnation, restlessness; (2) grasping the basic pathogenesis and regulating the five viscera organs in the treatment. Adjusting the basic pathogenesis throughout the treatment and paying attention to the coordination of the five viscera organs at the same time; "regulating the dirty luck soup" as the basic prescription. Imitating the meaning of "Chaijiaoliuliujunzi decoction", adding stir-fried malt to help transport, introducing medicine again, fully reflecting the whole thinking of traditional Chinese medicine; According to the symptoms and symptoms of the patients and the main symptoms of "Tiaozongyong decoction" to add or subtract drugs; Pay attention to adjust balance. One is pay attention to adjust the balance of part and whole, with part promote whole, with whole drive part, make Qi machine adjust to reach, rise and fall have a section, make body Qi blood body fluid runs unobstructed. The second is to emphasize the "harmony" of the viscera and the balance between yin and yang of the viscera; (6) emphasize that the medicine is gentle and sweet. The medicine used in the disease should be peaceful, and should be adjusted slightly according to its syndromes. It should not be too irritating to aggravate the illness. It should not be too fragrant to injure and injure the spleen. It should not be too greasy to interfere with the spleen. Do not reject drugs too bitter; The internal and external treatment of traditional Chinese medicine should be taken internally, the external application should be applied to the foot, and the whole treatment would achieve the functions of soothing liver and invigorating spleen, regulating qi, calming the heart and calming the mind, and fully reflecting the characteristics of clinical diagnosis and treatment of traditional Chinese medicine. The diet is light, easy to digest food, advocate chewing slowly, eat less to reduce gastrointestinal burden; It emphasizes the combination of management and nourishment. In the early period, the seven divisions are divided into three parts, in the middle period, the three parts are divided into seven parts, and in the later period, two parts are divided into eight parts; Advocate the adjustment of daily life. The mood is smooth, the living is in harmony, so that the viscera qi and blood are balanced and coordinated. All the methods are used to achieve the five viscera and the regulation. Conclusion: director Lin Ping, guided by the holistic view of traditional Chinese medicine, used the theory of the five viscera to diagnose and treat functional dyspepsia, and emphasized on grasping the basic pathogenesis and regulating the five viscera organs in the treatment of functional dyspepsia. (2) taking the self-made "Tiao Zang Julong decoction" as the basic prescription, the treatment thought of "combination of disease and syndrome" is conformed to the treatment thought of "combination of disease and syndromes". 3) pay attention to adjust balance, use medicine to balance taste, emphasize both internal and external treatment, light diet, pay attention to the combination of treatment and nourishment and advocate the adjustment of living and other traditional Chinese medicine thinking. It has good clinical significance for the treatment of functional dyspepsia.
【学位授予单位】：福建中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R249;R259

【相似文献】