毕朝忠运用益气升阳法临床经验总结

发布时间：2018-01-17 12:27

本文关键词：毕朝忠运用益气升阳法临床经验总结　出处：《成都中医药大学》2016年硕士论文　论文类型：学位论文

【摘要】：目的：毕朝忠主任中医师,1966年毕业于贵阳中医学院,曾任江西国营七二矿职工医院中医科主任、业务副院长,1991年至1998年任重庆市沙坪坝区中医院任业务副院长、院长。曾任重庆市沙坪坝区第九届政协委员,重庆市沙坪坝区医药学会副会长,重庆市中西医结合学会理事,重庆市中医学会热病专委,重庆市中医高级职称评审委员会委员。2000年评选为重庆市名中医。2003年任重庆市首批老中医药专家学术继承工作指导老师。从医四十载,孜孜求索,勤求古训,博采众方,以中医内科、儿科、皮肤科见长,在治疗肺系疾病、肾脏疾病、脾胃疾病、心脑疾病、皮肤疾病等方面颇有建树。毕朝忠老师临床中以望、闻、问、切四诊为本,结合现代诊疗手段,辩证与辩病相结合,学术上注重整体观念,治病必求其本,临床疗效好；其深谙李东垣益气升阳法的运用,临证善用升阳益胃汤、补中益气汤等益气升阳方剂治疗诸多常见病、疑难病,其法师古而不泥古,加减时有神来之笔,往往能立起沉疴。曾在《中医杂志》、《中国中医急症》、《新中医》等发表论文20余篇,自拟方“宣肺止咳合剂”,作为院内制剂广泛运用于临床,疗效确切,该项目的临床及实验研究,获1996年重庆市卫生科技进步三等奖。本论文主要通过对毕朝忠主任中医师的临床医案进行整理研究,通过系统的整理、挖掘、研究,收集整理毕老临证运用益气升阳法的临床宝贵资料,探索一种主观与客观相结合的方法,深入挖掘毕朝忠老师运用益气升阳法治疗常见病、疑难病的学术经验和诊疗规律,较为客观地总结毕老临证运用益气升阳法加减规律的临床经验,为进一步推广其学术经验和发展创新提供理论依据,促进毕朝忠老中医学术经验的继承和发扬。方法：通过系统的文献复习,对古代和现代中医学家对益气升阳法资料疾病的著作和经典医案进行整理,系统总结益气升阳法现代研究进展和近现代益气升阳法临床应用现状与趋势,阐述益气升阳法的治疗疾病的重要意义,为临床研究提供重要的理论依据。通过对毕朝忠老师2012年8月至2015年6月临床运用益气升阳法治疗疾病的100例回顾性门诊病例资料和200例前瞻性病例资料进行收集、整理,建立数据信息库,用数据挖掘的方法,应用数据挖掘软件Spss clmentine,采用频数法、聚类法、相关性分析等手段对毕朝忠老中医运用益气升阳法治疗相关疾病的治法治则、临床疗效和用药频次进行分析处理研究,总结出其证候诊断思路、基本方及加减用药规律,进一步总结名老中医学术思想和提高运用益气升阳法的临床疗效。运用深度访谈的研究方法探讨数据挖掘结果中隐含的学术思想内涵。深度访谈的研究在数据统计与挖掘的基础上进行,其内容围绕挖掘的结果与数据统计,以名老中医毕朝忠的观点为主,结合运用中医理论知识分析判断进行。访谈的内容围绕毕朝忠老中医运用益气升阳法的临床体会、用药经验、辨证思路、以往的科研成果、发表的论文、论著以提交纸质文档请其审阅批改的方式进行,每次访谈结束后及时加以总结。访谈的内容逐渐深入,从辨证方法、辨证思维模式、药物配伍特点、对药应用经验、经方应用体会、临床疗效总结到最终概括出毕朝忠名老中医运用益气升阳法的临证经验。结果：运用数据挖掘技术分析得出毕朝忠老师治疗常见病善用益气升阳法,其数据结果如下：1.运用频次法分析得出毕朝忠老中医在治疗常见病是最常使用的方剂有升阳益胃汤、补中益气汤、升阳散火汤以及归脾汤加减。2.运用频次法分析得出毕朝忠老师在相关疾病治疗中了；临床最常用的药物有黄芪、白术、党参(人参、太子参)、甘草、陈皮、法半夏、当归、茯苓、川芎、防风、羌活、独活、威灵仙、葛根、黄连、柴胡、白芍、黄芩、神曲、麦芽、谷芽、山楂、鸡内金、何首乌、丹参、枸杞、钩藤、砂仁、川木香等27味,使用频次均在50%以上,用药的特点具有健脾、运脾、除湿、理气、化痰、平肝、升阳、散火、活血等功效。充分验证了毕朝忠老师益气升阳、重视脾胃的学术经验。3.通过复杂系统熵聚类分析方法得到的毕朝忠老师益气升阳的核心药物组合为：参+白术+黄芪为健脾益气常用组合；陈皮+半夏为化痰理气常用组合；防风、羌活、独活、柴胡、升麻、威灵仙、葛根为升阳常用组合。结论：1.毕朝忠老中医在常见病的诊治中深受李东垣、施今墨及贵州名中医石玉书的影响,善用大处方,虽药品繁多,但搭配配合得体,法度严谨,毫无繁琐冗赘之感。他强调脾胃的重要,注重调理脾胃,不仅从脾胃入手治疗多种疾病,而且在治疗疾病的同时不忘顾护脾胃。2.毕朝忠老师重视人体的整体动态平衡,并结合重庆地区地理、气候因素,提出脾胃失调、痰湿内停、阳气闭郁为重庆地区常见病多发的主要病机,治疗上需注重顾护脾胃、调整阴阳、扶正纠偏、益气升阳。其益气升阳的学术经验,反映了重庆地区常见病发病的病机特点,对临床有很好的指导意义。3.毕朝忠老师的“益气升阳法”治疗常见病的经验疗效满意,并长于使用风药,强调调整气机的升降和出入,值得推广和应用。4.通过数据挖掘技术整理毕朝忠老师的益气升阳学术经验,揭示了毕朝忠老师的遣方用药规律,印证了毕老师顾护脾胃、调整气机升降出入、益气升阳的的学术经验,充分说明计算机技术在整理名老中医学术经验中具有重要意义。
[Abstract]:Objective: Bi Zhaozhong, director of Chinese medicine, graduated from Guiyang College of Traditional Chinese Medicine in 1966, served as director of the Department of traditional Chinese medicine of Jiangxi No. 72 mine workers hospital, vice president of business, 1991 to 1998, Shapingba District Hospital of Chongqing city served as vice president, Dean of business. He served in the Chongqing District of Shapingba City, the ninth session of the CPPCC National Committee, vice president of the Chongqing District of Shapingba City, the Institute of medicine. Institute of Chongqing traditional Chinese medicine, Chongqing Academy of traditional Chinese medicine fever special commission, Chongqing Chinese senior assessment committee.2000 named the Chongqing city Chongqing City, the first Chinese.2003 years old Chinese medicine experts in the academic inheritance to guide the work of teacher. Doctor forty years, diligently seeking, ground for old, from aspects, based on traditional Chinese Medicine Department of Pediatrics, Department of Dermatology and in the treatment of lung disease, kidney disease, stomach disease, cardiovascular disease, skin disease and other clinical successes. Bi Zhaozhong teacher In order to look, smell, ask, cut four oriented, combined with modern treatment methods, the combination of dialectical and argue disease academic attention to the overall concept, this will seek medical treatment, clinical curative effect is good; the well versed in Li Dongyuan Yiqi Shengyang method, clinical use of shengyangyiwei decoction, Buzhongyiqi decoction, Yiqi Shengyang the prescription difficult disease to treat many diseases, and the master of the ancient and not imitation, and have often set up an inspired passage, ills. In "Journal of traditional Chinese Medicine >, < < New > Chinese emergency medicine, Chinese Medicine > and published more than 20 papers, since" xuanfeizhike mixture ", as in the hospital agents are widely used in clinical, curative effect, clinical and experimental research of the project, third-prize won the 1996 Chongqing Health Science and technology progress. This thesis mainly through the clinical medical records of Bi Zhaozhong, director of Chinese medicine for research, through the system arrangement, mining, research, collection of Bi Lao syndrome The clinical use of valuable information Yiqi Shengyang method, explore a method combining subjective and objective, in-depth excavation of Bi Zhaozhong teacher treatment of common diseases by Reinforcing Qi, academic experience and rule of diagnosis and treatment of difficult diseases, objectively summarize Bi Lao's clinical experience in the use of the clinical method of Reinforcing Qi Decoction, and provide a theoretical basis for further to promote the academic experience and innovation, promote the inheritance and development of the academic experience of Bi Zhaozhong old Chinese medicine. Methods: through literature review, the ancient and modern medical works of Yiqi Shengyang disease and classical medical data collation, systematically summarize the modern research progress of modern law and Reinforcing Qi reinforcing Qi clinical application method with the trend, this paper expounds the significance of the method of Yiqi Shengyang disease treatment, provide important theoretical basis for clinical research. Based on the Bi direction of Zhong Lao From August 2012 to June 2015 normal treatment in clinical application of 100 cases of disease by Yiqi Shengyang retrospective clinic cases and 200 cases of prospective data collection, collation, establishment of data base, data mining method, application of data mining software Spss clmentine, using the frequency method, clustering analysis, correlation analysis and other means of old Chinese Bi Zhaozhong treatment of related diseases by Reinforcing Qi method rule, clinical efficacy and drug use frequency analysis research, summed up the basic ideas of syndrome diagnosis, and the prescription law, further summarizes the old Chinese academic thought and improve the clinical curative effect of Yiqi Shengyang study method. Using the method of depth interview data mining results the connotation of implicit academic thought. Based on the statistics and data mining research in depth interviews on the content around the mining results and The statistical data in old Chinese medicine Bi Zhaozhong's point of view, combined with the use of theoretical knowledge of traditional Chinese medicine. The interview content analysis on clinical experience, Bi Zhaozhong old Chinese medicine experience using Yiqi Shengyang method, dialectical thinking, previous research results, published papers, works to submit a paper document please review the correct way. Every time after the end of the interview time is summarized. The interview content gradually, from the dialectical method, dialectical thinking mode, characteristics of drugs, drug application experience, experience in clinical application of classical prescriptions, finally summarizes the total node to complete Zhaozhong old Chinese medicine use method of Yiqi Shengyang clinical experience. Results: the data mining analysis the teacher Bi Zhaozhong treatment of common diseases using Yiqi Shengyang method, the results are as follows: 1. using frequency analysis method in traditional Chinese medicine in the treatment of Bi Zhaozhong disease is the most common The frequently used prescriptions with shengyangyiwei decoction, Buzhongyiqi decoction, shengyangsanhuo Decoction and Guipi Decoction on.2. using frequency analysis method in the treatment of diseases related to teacher Bi Zhaozhong; the most commonly used clinical drugs with Astragalus, Atractylodes, Codonopsis (Radix ginseng, Radix Pseudostellariae), liquorice, tangerine peel, pinellia tuber, angelica, poria, chuanxiong, Fangfeng, angelica, notopterygium, Radix Clematidis, radix puerariae, Rhizoma Coptidis, Radix Paeoniae Alba, Radix Scutellariae, Radix Bupleuri, medicated leaven, malt, rice malt, hawthorn, Gallus gallus, Polygonum multiflorum, Salvia miltiorrhiza, medlar, uncaria, Amomum, Kawa Kika and other 27 kinds, the frequency of use of drugs were more than 50%, has the characteristics of spleen, spleen, dampness, Qi, phlegm, calming the liver, sun, scattered fire, blood and other effects. Fully verify the teacher Bi Zhaozhong Yiqi Shengyang drug combination, core academic experience.3. the stomach through a complex system entropy clustering analysis method to get the Bi Zhaozhong teacher for Yiqi Shengyang: Ginseng + + Astragalus Atractylodes For the common combination of Spleen Qi + phlegm and Qi for Pinellia; peel common combination; wind, notopterygium, angelica, bupleurum, Cimicifuga, Clematis chinensis, Radix Puerariae for sun common combination. Conclusion: 1. Bi Zhaozhong old Chinese medicine in diagnosis and treatment of common diseases by Li Dongyuan, Shi Jinmo and Guizhou in the medical stone Yushu, use the prescription, though the drug is various, but with proper collocation, testimonies rigorous, no cumbersome feeling. He stressed that the redundancy of the spleen and stomach, pay attention not only from the spleen and stomach, spleen and stomach treatment of diseases, but also in the treatment of diseases at the same time did not forget the nursing care of the spleen and stomach.2. Bi Zhaozhong teachers pay more attention to the overall dynamic balance of human body, and combined with the Chongqing geographical, climatic factors the spleen and stomach, disorder, phlegm stop, Yang obstruction is the main pathogenesis of common diseases in Chongqing multiple treatment, need to focus on the nursing care of the spleen and stomach, regulating yin and Yang, Fu is correct, the Qi Reinforcing Qi. The sun's academic experience, reflect the disease pathogenesis characteristic in Chongqing area, to have a good clinical significance of.3. Bi Zhaozhong's "Yiqi Shengyang law" treatment of common disease experience satisfactory curative effect, and longer than the use of wind medicine, emphasize the adjustment of the air lift and entry, it is worthy of promotion and application of.4. through the data mining consolidation Bi Zhaozhong teacher Yiqi Shengyang academic experience, reveals the rules of prescriptions after Zhaozhong teacher, Mr. Bi confirmed the spleen and stomach qi is adjusted, the Yiqi Shengyang academic experience shows that computer technology plays an important role in the consolidation of old Chinese academic experience.

【学位授予单位】：成都中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R249;R242

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