迟莉丽教授辨治脾胃病学术思想和临床经验研究

发布时间：2018-01-22 14:49

本文关键词： 迟莉丽教授学术思想临床经验研究　出处：《山东中医药大学》2016年硕士论文　论文类型：学位论文

【摘要】：目的:中医药的继承和发展都离不开名中医。迟莉丽教授医理精湛,学识渊博,中西医贯通,师承全国名老中医隗继武教授,本文通过对迟莉丽教授学术专著、论文等资料的整理,研究迟莉丽教授辨治脾胃病的学术思想、临床经验,使迟莉丽教授的宝贵学术经验得以更好的继承和发扬,以提高治疗脾胃病的临床疗效。方法:收集迟莉丽教授从2014-4至2015-12月份的门诊病历及病房病历,迟教授学术专著、论文,并分析整理,撰写研究论文,从以下三方面总结研究:1.迟莉丽教授的学术思想包括辨证思路及治疗大法两部分2.迟莉丽教授的临床经验包括胃病、肠病两部分3.用药特点。结果:1.她在辨证方面强调遵循三大基本原则,即中西医结合、三因治宜、辨病求因。迟莉丽教授对舌诊的造诣颇深,认为病浅者辨苔,病深者辨舌,本研究深入总结了她辨舌诊病的经验。迟教授善从情志方面诊治疾病,重视从肝脾和肝胃论治,并阐发内经中“二阳之病发心脾”之论,治当宁心安神,阐发“诸气伖郁,皆属于肺”之论,当滋肺阴,宣肺气以畅情志之法。她精研六郁的症治之法。脾病从湿论治,倡导三焦同治,喜用芳香轻灵。2.在临床经验方面,迟师认为脾脏的病理特点是“阳气不足,阴气有余”,故脾病多虚、多寒。胃腑的病理特点是“阳常有余,阴常不足”,胃病多实、多热,论治胃病时尤重“胃阴、脾阳”的固护,她善用和法,认为脾胃是寒热虚实错杂证的易发脏腑。重视辨病与辨证相结合,辨证的基础上处处体现辨病用药的特色。治疗肠病方面,对于肠易激综合征,当以抑木扶土,自拟理肠饮加减疗效颇佳。对于功能性便秘,迟莉丽教授以阴阳为纲,以虚实为本,详辨阴凝还是阳结,重视增液及通腑。辨治溃疡性结肠炎,她认为“虚”、“毒”、“瘀”为的病机关键,其中脾气亏虚为发病之本、湿热痰毒为发病之标、气滞血瘀贯穿疾病始终,内疡痈脓的形成为局部病理变化,总结出三期论治的理论,发作期急则治标,以清利湿热毒瘀为主,缓解期标本兼治,健脾与清利湿热毒瘀同施,缓解期多见脾肾两虚,瘀阻肠络,治当补益脾肾,兼清余邪,通络活血。3.用药方面,迟教授用药不求新奇,平淡中常显佳效,无论药味、药量皆斟酌妥帖,丝丝入扣。她善用甘润濡养,慎用燥烈之品,以芳香轻灵为主,避免重伐沉降等。本文总结分析其善用药对10余组。结论:迟教授珍贵的学术思想和丰富床经验,值得我们去继承和深入探研。
[Abstract]:Objective: the inheritance and development of traditional Chinese medicine can not be separated from famous Chinese medicine. The research on the academic thought and clinical experience of Professor Chi Lili's diagnosis and treatment of spleen and stomach disease makes the valuable academic experience of Professor Chi Lili better inherit and carry forward. Methods: the outpatient and ward medical records of Professor Chi Lili from 2014-4 to 2015-12 were collected. Writing a research paper, summarizing the following three aspects of research: 1. Professor Chi Lili's academic thought includes two parts: dialectical thinking and treatment. 2. Professor Chi Lili's clinical experience includes stomach diseases. Results 1. She emphasized following three basic principles in differentiation of symptoms and signs, that is, combination of traditional Chinese and western medicine, treatment of three reasons, seeking cause of disease differentiation. Professor Chi Lili was quite accomplished in tongue diagnosis. This study summarized her experience in diagnosis of tongue diseases. Professor Chi was good at diagnosing diseases from the aspect of emotion and attached importance to the treatment from liver and spleen and liver and stomach. And expound the theory of "the disease of two yang and the heart and spleen" in the Internal Classic, cure the heart and calm the mind, elucidate the theory that "all qi and depression belong to the lung", when the lung yin. The method of promoting lung qi with unobstructed emotion. She studied the method of treating the syndrome of six depression. Spleen disease was treated from dampness, advocating the same treatment of three jiao, and liking to use fragrance and light spirit. 2. In clinical experience, Chi Shi thought that the pathological characteristic of spleen was "deficiency of yang qi". Yin Qi has more than ", so spleen disease more asthenia, more cold." the pathological characteristics of the stomach organs are "Yang often surplus, Yin often insufficient", stomach diseases more solid, more heat, in the treatment of stomach diseases, especially the "stomach Yin, spleen Yang" of the solid care, she uses the method of harmony. It is believed that spleen and stomach are easy to produce zang-fu organs of the complex syndrome of cold and heat deficiency and deficiency, and pay attention to the combination of disease differentiation and syndrome differentiation, and on the basis of differentiation of symptoms and signs, the characteristics of medicine for differentiation of diseases should be reflected everywhere. In the treatment of bowel disease, for the irritable bowel syndrome, the inhibition of wood and soil should be used to support the soil. For functional constipation, Professor Chi Lili takes Yin and Yang as the outline, takes the deficiency and reality as the foundation, distinguishes the Yin coagulation or the yang knot in detail, pays attention to increasing the liquid and the opening up the Fu organs, discriminates and treats ulcerative colitis, she thinks "deficiency". "toxin", "stasis" for the pathogenesis of the key, in which the deficiency of temper is the root of the disease, damp-heat phlegm toxin is the standard of the disease, Qi stagnation and blood stasis throughout the disease, the formation of abscess and abscess is local pathological changes. Summing up the theory of three stages of treatment, the attack is urgent to treat the symptoms, mainly Qingli damp-heat toxin stasis, remission period of both symptoms and symptoms, spleen and Qingli damp-heat toxin and blood stasis at the same time, in the remission period more see spleen and kidney deficiency, stasis obstruction of intestinal collaterals. Treatment when tonifying the spleen and kidney, while clearing the remaining evil, clearing the collaterals and activating blood. 3. In the aspect of medication, Professor Chi did not seek novelty in medication, plain and obvious effect, regardless of the medicine taste, the amount of medicine were considered properly, silk into the buckle. She made good use of the sweet moisturizing and nourishing. This article summarized and analyzed the utilization of the medicine for more than 10 groups. Conclusion: Chi teaches precious academic thoughts and rich bed experience. It is worth us to inherit and explore deeply.
【学位授予单位】：山东中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R249;R256.3

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