丁甘仁外科医案辨证规律初探

发布时间：2018-01-06 15:32

本文关键词：丁甘仁外科医案辨证规律初探　出处：《南京中医药大学学报》2017年04期 　论文类型：期刊论文

【摘要】：目的分析丁甘仁医案著作中外科病案的辨证规律。方法采用Apriori算法建模,对丁氏外科医案进行关联规则分析,并结合传统的文献研究及频数统计,探索丁氏外科的辨病、辨证特色。结果丁氏外科医案中疽为优势病种,痈、骨槽风、瘰疬等病也较为常见。与《中医外科学》中辨证对比,丁氏对疽的辨证更注重里证,而非表里同病;丁氏对大头瘟的辨证以表实热证为主要证型,而非内热证。此外,丁氏医案中辨证为血虚气滞或阴亏气滞的病案比气滞血瘀、痰瘀互结、气血两虚等常规外科证型更为常见。结论丁甘仁外科医案所体现的辨证规律对当下外科疾病的辨证具有重要的参考价值;阴血亏与气滞两种病机的并存多出现在瘤、癌、瘰疬、附骨疽等病案中,反映了丁氏对"因虚而滞"和"因滞而虚"两种病变机理的认识,丰富了中医气血关系的理论,扩充了中医外科辨证的思路。
[Abstract]:Objective to analyze the dialectical rules of surgical records in Ding Ganren's medical records. Methods Apriori algorithm was used to model the association rules of Ding's surgical records, and combined with the traditional literature research and frequency statistics. Results gangrene was the dominant disease, carbuncle, alveolar wind, scrofula and other diseases were more common in Ding's surgery. Ding's syndrome differentiation of gangrene pays more attention to internal syndromes rather than superficial syndromes. Ding's syndrome differentiation of large head plague is the main syndrome type, but not the internal heat syndrome. In addition, the syndrome differentiation of Ding's medical case is blood deficiency qi stagnation or Yin deficiency qi stagnation than qi stagnation and blood stasis, phlegm and blood stasis. Conclusion the pattern of syndrome differentiation embodied in Ding Ganren's surgical case has important reference value for the differentiation of current surgical diseases. The coexistence of yin and blood deficiency and qi stagnation in tumor, cancer, scrofula and bone gangrene reflects Ding's understanding of the mechanism of "stagnation due to deficiency" and "deficiency due to stagnation". It enriches the theory of qi-blood relationship and expands the thinking of TCM surgical syndrome differentiation.
【作者单位】：上海中医药大学基础医学院;上海中医药大学中医药文化研究与传播中心;
【基金】：海派中医流派(丁氏内科)传承研究基础建设项目(zy3-cccx-1-1001)
【分类号】：R249;R26
【正文快照】： 丁甘仁先生是近代中国著名的中医学家,医学教育家,孟河医派的代表人物。其学术理论悉遵经旨而多有发挥,其临证治验常变有度,其医案及专著包涵着丰富的临证经验。在其外科病案中,丁氏对很多奇险重久之病症的临证过程记载精详,辨证思维多有流露。笔者从丁氏几部有影响的医案著作

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