钱静华教授膏方辨证思路和处方用药规律研究

发布时间：2018-02-24 16:26

本文关键词： 钱静华膏方辨证思路用药规律临床研究　出处：《浙江中医药大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的对钱静华教授门诊膏方病例的收集、整理和总结,分别从辨证思路和处方用药规律等方面深入剖析导师应用膏方调治体质的独特经验,对各种辨证的膏方处方与用药规律进行归类与统计,总结钱教授用药特点、规律及经验,为中医膏方的临床治疗提供临床参考。方法本研究收集2014年11月1日至2016年12月22日这期间钱静华教授亲诊的膏方门诊患者病案,内容包括患者一般情况、既往史、体质、治疗原则、治法、膏方处方等,从中随机选取300例。结果1.在本研究中,钱教授膏方门诊患者男性有111例,占37%,女性有189例,占63%。2.钱静华教授膏方门诊年龄段在20-80岁之间,其中40-60岁的人群居多。3.本研究中发现女性体质分布较多的分型分别为阳虚体质、阴虚体质、气虚体质、气郁体质;男性为阳虚体质、气虚体质、痰湿体质。4.患者的体质分布与年龄有密切关系,青壮年人多痰湿质、湿热质、气郁质等,中老年人多阳虚质、气虚质、阴虚质等。5.高频使用药物共计12种,分别为枸杞子、铁皮石斛、黄芪、炒白术、炒杜仲、防风、灵芝、炒山楂、党参、红景天、炒续断、仙灵脾,以补脾肾药为主。中频使用药物有益智、狗脊、巴戟天等共十种,以调阴阳为主。低频使用药物有茵陈、广藿香等共计23种,以化湿药为主,佐以行气、活血等。使用频率20%的药物多为对症加减药物。结论1.从本研究中,患者性别和年龄关系来看,女性四十岁,男性五十岁开始出现肾气衰弱,正气衰退,阳气不足,机体免疫功能下降,易因受各种致病因素侵袭而导致发病,所以女子41-60岁,男子51-60岁年龄段分布较高,更宜膏方调养。2.膏方患者因地理位置、饮食习惯、生活习惯等原因,阳虚体质最多,女性多于男性。3.体质与年龄有着密切关系,平和质和湿热质分布在31-40岁之间较多,气郁质、血瘀质、阴虚质、阳虚质均分布在51-60间,气虚质多见于61-70岁,41-50岁之间人群痰湿质较多。特禀质在个年龄段分布较均匀。4.钱教授的用药以补脾肾为主,随证加减,以调节机体阴阳平衡。5.钱教授膏方组方思路有明察体质,因势制宜,纠其偏正,平衡为宗,扶脾健胃,共补个调,用药考究,兼取其长。
[Abstract]:Objective to collect, sort out and summarize the cases of professor Qian Jinghua's out-patient ointment prescription, and to analyze the unique experience of tutors in regulating their physique from the aspects of syndrome differentiation and prescription drug use respectively. Classifying and statistics the prescriptions and law of different kinds of plaster prescriptions, summing up professor Qian's characteristics, rules and experiences of drug use, Methods during the period from November 1st 2014 to December 22nd 2016, this study collected the medical records of the outpatients who had been diagnosed by Professor Qian Jinghua, including the general situation of the patients, past history, physique, etc. Results 1. In this study, there were 111 male (37 female) outpatients and 189 female (63.2.) the age of Professor Qian Jinghua's outpatient clinic was between 20 and 80 years old. In this study, we found that the distribution of female physique was divided into three types: Yang deficiency, Yin deficiency, Qi deficiency, Qi depression, male Yang deficiency, Qi deficiency, male, Yang deficiency, Qi deficiency, male, Yang deficiency, Yin deficiency, Qi deficiency, and so on. Phlegm and dampness constitution .4.The distribution of patients' physique is closely related to their age. There are 12 kinds of drugs used in high frequency, such as phlegm and dampness, dampness and heat, qi stagnation, and so on, and the middle and old people have many yang deficiency, qi deficiency, yin deficiency and so on. Dendrobium candidum, Astragalus membranaceus, Atractylodes macrocephala, Eucommia ulmoides, Fangfeng, Ganoderma lucidum, fried Hawthorn, Codonopsis, Rhodiola, Fried Dipsacus, Xianling spleen, mainly invigorating spleen and Kidney. In order to regulate yin and yang, there are 23 kinds of drugs used in low frequency, such as Yinchen, patchouli and so on, which are mainly used to reduce dampness, to add qi, to promote blood circulation, etc. The drugs with frequency of 20% are mostly symptomatic drugs. Conclusion: 1. According to the relationship between sex and age of the patients, the female is 40 years old, the male is 50 years old, the kidney qi begins to debilitate, the positive qi declines, the yang qi is insufficient, the body immune function drops, and is easily caused by various pathogenic factors, so the female is 41-60 years old. The distribution of male 51-60 years old age group is higher, it is more suitable to take care of. 2. Due to geographical location, diet habits, life habits and other reasons, Yang deficiency constitution is the most, and female is more than male .3.Physique has close relationship with age. The distribution of calmness and dampness and heat were between 31 and 40 years old, Qi was stagnation, blood stasis, yin deficiency and yang deficiency were between 51-60 years old. Qi deficiency is more common in the population aged between 61 and 70 years old and aged between 41 and 50 years old than in the population with phlegm and dampness. The specific substance is more evenly distributed in each age group .4.Professor Qian's medication is mainly used to supplement the spleen and kidney, to adjust the balance of yin and yang in the body with syndrome, and to adjust the balance of yin and yang. 5. Professor Qian's ointment formula has clear constitution. Because of the power system, correct its bias, balance for the Zong, Fu spleen and stomach, a total of tonics, medication, and take its long.
【学位授予单位】：浙江中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R249

【参考文献】