基于现代文献痤疮证素分布特点及组合规律的研究

发布时间：2018-01-20 14:57

本文关键词： 痤疮中医证素用药规律文献研究　出处：《山西中医学院》2016年硕士论文　论文类型：学位论文

【摘要】：目的:基于现代文献的回顾性研究,归纳探讨痤疮中医证候分布特点、证素分布特点及组合规律、临床基本用药特点,为痤疮的进一步规范化研究和临床治疗提供参考。方法:课题采用文献回顾性研究方法,在中国学术期刊全文数据库(CNKI)中检索近20年关于中医药治疗痤疮的相关文献,参照纳入标准和排除标准,选出合格文献;在纳入的文献中提取证型、证素及临床用药等信息并进行量化,建立数据库,利用统计软件,进行频数、频率、构成比的描述性统计分析,并联系中医理论进行概括、分析。结果:1.本课题入选文献72篇,涉及到的证候名称有72种,经过合并整理,共归纳出痤疮的证候类型48种,其中常见证型有肺经风热型、胃肠湿热型、痰瘀互结型、肺胃蕴热型、脾胃湿热型、冲任不调型。2.提取出证候要素共21个,分别为病位证素8个:肺、胃、肝、脾、大肠、肾、胞宫、心;病性证素13个:热(火)、湿、痰、瘀血、(外)风、阴虚、气虚、气滞、毒、血热、血虚、寒、燥,病性证素包括10个实性证素和3个虚性证素。结果显示痤疮发病多在肺、胃,与肝、脾有关,最常见的致病因素为热(火)、湿,兼见痰、瘀血,发病多为实证。3.痤疮的证素组合形式共5种,以两证素组合和三证素组合较多,表明痤疮常为证素组合的联合发病;所有组合中以肺+风+热最多;病位证素的组合以肺、肺+胃较多;病性证素组合以热+湿、热+风为多;表明痤疮发病与肺、热(火)关系最密切,与胃、湿、(外)风有关,一般为致病因素联合作用导致,发病机制较为复杂。4.本课题涉及治疗痤疮常用药物分类为清热药、补虚药、活血化瘀药、化痰止咳平喘药、利水渗湿药,以清热药的使用频率最高,达44.47%;常用药物依次为甘草、黄芩、连翘、丹参、蒲公英、栀子、生地、赤芍、牡丹皮、桑白皮、金银花、白花蛇舌草、黄连、当归、枇杷叶,以清热药最多,加补虚药、活血化瘀药、化痰止咳平喘药、利水渗湿药等,由此看出痤疮的治疗以清热为主,兼以补益、化痰、活血、利水;以药测证,可见热(火)在痤疮的发病及发展过程中影响最大。结论:通过对痤疮证素特征的初步探讨,发现痤疮多为致病因子共同作用导致,致病机制比较复杂。痤疮的中医辨证方法较为繁多,涉及的证候类型名称不统一、不规范,证候分布离散性大。以证素为核心的辨证方法提取的证候要素涵盖了辨证所需的病变部位、病性性质的大部分信息,而且直观、方便,利于规范化研究。因此,从证素入手,对痤疮的规范化研究有积极地作用。
[Abstract]:Objective: based on the retrospective study of modern literature, the characteristics of TCM syndromes distribution, syndromes distribution and combination law, clinical characteristics of basic drug use were summarized and discussed. To provide a reference for the further standardized study and clinical treatment of acne. Methods: literature review method was used. In CNKI, a full text database of Chinese academic journals was used to search the relevant literature on the treatment of acne by traditional Chinese medicine (TCM) in the past 20 years, and to select qualified documents according to the inclusion criteria and exclusion criteria. The information of syndromes, syndromes and clinical use of drugs were extracted and quantified in the literature. Database was established, and the frequency, frequency and composition ratio were analyzed by statistical software. And combined with the theory of TCM to summarize and analyze. Results: 1. This paper selected 72 papers, involving 72 syndromes, through the consolidation, a total of 48 types of acne syndrome types. The common syndromes were lung meridian wind-heat type, gastrointestinal damp-heat type, phlegm and blood stasis type, lung and stomach heat accumulation type, spleen and stomach damp-heat type and Chong-Ren non-regulation type .2. 21 syndromes were extracted, respectively, 8 syndromes were from disease position: lung. Stomach, liver, spleen, large intestine, kidney, uterus, heart; Disease syndrome factors 13: heat (fire, dampness, phlegm, blood stasis) wind, yin deficiency, qi deficiency, Qi stagnation, poison, blood heat, blood deficiency, cold, dryness. The results showed that acne was mostly related to lung, stomach, liver and spleen. The most common pathogenic factors were heat (Huoxue, dampness, phlegm and blood stasis). There are 5 types of acne syndromes, including two syndromes and three syndromes, indicating that acne is often a combination of syndromes. The lung wind heat was the most in all combinations. The combination of syndrome factors in the disease position was lung and stomach. The combination of disease syndrome factors is heat and dampness, heat wind is more; It is suggested that acne is most closely related to lung, heat (fire), stomach and wet wind, which is generally caused by the combined effect of pathogenic factors. This topic involves the treatment of acne commonly used drugs classified as heat-clearing drugs, tonifying drugs, promoting blood circulation and removing blood stasis drugs, phlegm, cough, asthma, water and infiltration drugs, the highest frequency of use of heat-clearing drugs. Up to 44.47; The commonly used drugs are liquorice, baicalin, forsythia, salvia miltiorrhiza, dandelion, gardenia, raw land, Radix Paeoniae rubra, peony peel, mulberry peel, honeysuckle, Flos Lonicerae, Radix angelicae Sinensis, loquat leaf, and most of them are heat-clearing drugs. Add tonifying medicine, promoting blood circulation and removing blood stasis, eliminating phlegm and relieving cough and relieving asthma, and so on. From this, we can see that the treatment of acne is mainly to clear heat, but also to tonify, dissipate phlegm, promote blood circulation, and promote water; Heat (fire) is the most important factor in the pathogenesis and development of acne. Conclusion: through the preliminary study on the characteristics of acne syndromes, it is found that acne is mostly caused by the co-action of pathogenic factors. The pathogenesis of acne is more complex. Acne syndrome differentiation methods are more numerous, involving the syndromes type names are not uniform, non-standard. The syndrome elements extracted by the dialectical method with syndrome element as the core cover the location of pathological changes needed for differentiation, most of the information of the disease nature, and intuitive, convenient, conducive to standardized research. Starting with syndrome factors, the standardization study of acne has positive effect.
【学位授予单位】：山西中医学院
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R275.9

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