《医学衷中参西录》治疗温病组方用药特点研究

发布时间：2018-02-03 08:11

本文关键词： 《医学衷中参西录》温病方药研究　出处：《黑龙江中医药大学》2016年硕士论文　论文类型：学位论文

【摘要】：本文简述了中医对温病的认识,介绍了张锡纯对温病的认识。并将其辨治温病学术思想与吴又可、喻嘉言、叶天士、吴鞠通、王孟英五位温病名家的辨治温病学术思想相比较。重点对《医学衷中参西录》中张锡纯自拟治疗温病的33首方剂,进行六经分类及方义分析,分析研究其组方特点；对书中所载121例治温医案,进行六经辨证分型,并对所用到的231首方剂按分型进行药物频数统计,分析研究其用药特点,以期为临床治疗温病提供更多的辨证方法、组方思路和用药。《医学衷中参西录》中所载121例治温医案可分为太阳经证、太阳经证兼痰喘、太阳阳明合病证、太阳阳明少阳合病证、结胸证、太阳欲解证、阳明热证、阳明实证、阳明少阳合病证、阳明厥阴合病证、少阴证、厥阴证、瘥后不能自复证,共13种证型。通过对《医学衷中参西录》中温病的病因病机、自拟方的组方特点及治温医案中方药特点进行研究,得到以下结论：1.温病隶属于伤寒,伏气、风温、湿热是其主要病因；温病循六经传变,证治效法《伤寒论》的六经辨治。2.张锡纯治疗温病具有组方师古法而不拘定成方,中西药相济提高疗效,据病机灵活加减化裁的特点。3.治疗温病用药具有主用寒凉药以清热、配伍质润药以滋阴、配伍轻散药以透热、配入食物以助服药、讲究炮制以保药效的特点。善用石膏、甘草、山药、知母、党参、白芍、玄参、连翘、粳米、生地黄等药。4.治疗温病的常用配伍有：石膏与甘草、白芍与甘草、石膏与知母、石膏与山药、石膏与党参、山药与党参。5.按六经病证特点遣方用药。太阳经证重用连翘,太阳经证兼痰喘用小青龙加石膏汤加减,太阳阳明合病证常用石膏、甘草、蝉蜕、连翘,太阳阳明少阳合病证用连翘、薄荷、石膏、茵陈、龙胆草,结胸证常用炒瓜蒌子、炒紫苏子、代赭石,太阳欲解证用熟地黄、山药、枸杞子、阿胶、玄参、甘草,阳明热证常用甘草、石膏、山药、白芍、知母,阳明实证常用石膏、甘草、党参、知母、山药、粳米,阳明少阳合病证常用石膏、甘草、白芍、山药,阳明厥阴合病证常用甘草、白芍、山药、石膏、党参,少阴证常用白茅根、党参、甘草、石膏、鸡子黄、山药,厥阴证用白虎加人参汤。
[Abstract]:In this paper, the knowledge of febrile disease in TCM is briefly introduced, and Zhang Xichun's understanding of febrile disease is introduced, and his academic thought of differentiating and treating febrile disease with Wu Yuke, Yu Jiayan, Ye Tianshi and Wu Jutong is also introduced. Comparison of the academic thoughts of five famous febrile disease experts Wang Mengying. Focusing on the 33 prescriptions of Zhang Xichun's own treatment of febrile disease, the six meridians were classified and their meanings were analyzed. The characteristics of its prescription were analyzed and studied. For 121 cases of thermotherapy cases in the book, the six meridians syndrome differentiation classification, and 231 prescription according to the classification of drug frequency statistics, analysis and study of the characteristics of its drug use. In order to provide more dialectical methods for clinical treatment of febrile disease, prescription thinking and medication. 121 cases of cases of heat treatment included in "Shen Xi Lu" can be divided into yang meridian syndrome, yang meridian syndrome and phlegm asthma. Yang Yang Ming syndromes, Sun Yang Ming Shaoyang syndromes, chest syndrome, sun desire to understand syndrome, Yang Ming heat syndrome, Yang Ming syndrome, Yang Ming Shao Yang he disease syndrome, Yang Ming Jue Yin syndromes, little yin syndrome, Jueyin syndrome, can not recover from the syndrome after recuperation. A total of 13 syndromes. Through the study of the etiology and pathogenesis of moderate febrile disease, the characteristics of prescription of self-made prescription and the characteristics of prescription and medicine in the treatment of warming, the following conclusions are drawn: 1. Febrile disease belongs to typhoid fever. Latent qi, wind temperature, damp and heat are the main etiology. Febrile diseases spread according to the six meridians, syndrome and treatment follow the six meridians differentiation and treatment of febrile diseases. 2. Zhang Xichun's treatment of febrile diseases has the ancient method of organizing prescription and not making it into a prescription, and the combination of Chinese and western medicine can improve the curative effect. According to the characteristic of flexible addition and reduction of the pathogenesis, the treatment of febrile diseases has the main cold medicine to clear the heat, the combination of moisturizing drugs to nourish yin, the combination of light powder drugs to heat, and food to help take medicine. The best use of gypsum, licorice, yam, Anemarrhena, Codonopsis, Radix Paeoniae Alba, Radix Xuanshen, Forsythia suspensa, Japonica Rice, Rehmannia Rehmanniae and so on. 4. The common compatibility for the treatment of febrile disease is gypsum and liquorice. Radix Paeoniae Alba and liquorice, gypsum and Anemarrhena, gypsum and yam, gypsum and Codonopsis, Chinese yam and Codonopsis. Sun meridian syndrome and phlegm asthma with small Azure Dragon plus gypsum decoction subtraction, Sun Yang Ming syndromes commonly used gypsum, licorice, cicada slough, forsythia, Sun Yang Ming Shaoyang syndromes forsythia, mint, gypsum, Yinchen, Gentiana. Knot chest syndrome commonly fried Trichosanthes seeds, fried purple perilla, ochre, the sun to explain the syndrome with Rehmannia glutinosa, yam, Chinese wolfberry fruit, Ejiao, Radix bassiae, licorice, Yangming heat syndrome commonly used licorice, gypsum, yam, white peony, Anemarrhena. Yang Ming empirical common gypsum, licorice, Codonopsis, Anemarrhena, yam, japonica rice, Yangming Shaoyang syndromes commonly used gypsum, licorice, Radix Paeoniae Alba, yam, Yang Ming Jueyin syndromes commonly used licorice, white peony, yam, gypsum, Codonopsis pilosula. Shaoyin syndrome commonly used in root, Codonopsis, licorice, gypsum, chicken yellow, yam, Jueyin syndrome with white tiger and ginseng soup.
【学位授予单位】：黑龙江中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R254.2

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