袁海波教授治疗心水病辨证思路研究

发布时间：2018-04-29 05:22

本文选题：袁海波 + 心水病　；参考：《河南中医药大学》2016年硕士论文

【摘要】：目的:以中医理论为指导,以导师袁海波教授门诊病例为依据,结合导师文献、著作、讲座等内容,运用相关统计学方法,深入探索名老中医袁海波教授诊疗心水病数十年的学术思想和临床经验,总结导师治疗心水病的辨证思路,使其得以传承发扬,有效指导临床,提高心水病辨证论治的临床疗效。方法:1.按纳入标准收集2010年4月07日至2015年12月02日的河南中医药大学第一附属医院袁海波教授亲诊的心水病病例,将其规范化以后,录入EXCEL表格,并保证数据准确性。运用频数方法统计舌诊、脉诊、望诊、证型、症状及主要证型的症状。运用SPSS19.0进行双变量相关性方法,统计年龄和性别与证型的关系。2.研读文献、著作、讲座等内容,并向导师请教,整理袁海波教授诊疗心水病的辨证思路。结果:1.共收集170例病人,男性63人,平均年龄60.24±14.672岁;女性107人,平均年龄63.77±11.212岁;总平均年龄62.46±12.679岁。2.常见脉象:沉、细、无力、结、细弦、弦细、左右不等。3.常见面色:暗黄,萎黄,晦暗。4.常见舌诊:舌质暗淡、舌质暗,舌质暗红。舌体适中,舌体瘦小,舌体胖大。苔白,苔薄,苔腻,苔厚。5.主要症状:胸闷、浮肿、乏力、心悸、气短。6.常见证型:血瘀水停证、心肝失和证、心脾虚弱证、湿瘀内阻证、心气虚弱证、气阴两虚证、瘀阻心脉证。7.血瘀水停证常见症状:浮肿、胸闷、乏力、心悸、气短、失眠、食欲不振、神疲、舌质暗淡、面色暗黄、脉沉、脉细。心肝失和证常见症状:浮肿、胸闷、心悸、乏力、气短、失眠、头晕、面色暗黄、舌质暗淡、苔腻、脉沉、脉细、脉细弦。心脾虚弱证常见症状:胸闷、浮肿、乏力、心悸、失眠、气短、神疲、头晕、面色暗黄、舌质暗淡、舌质暗、苔腻、脉沉、脉细、脉无力。湿瘀内阻证常见症状:胸闷、气短、浮肿、乏力、失眠、心悸、头晕、神疲、喘息、不耐疲劳、面色暗黄、舌质暗、舌质暗淡、苔腻、苔厚、脉沉、脉细。心气虚弱证常见症状:胸闷、乏力、心悸、气短、失眠、不耐疲劳、浮肿、面色萎黄、面色暗黄、舌质暗、舌质暗淡、苔腻、苔白、苔薄、脉沉、脉细、脉无力、脉细弦。气阴两虚证常见症状:浮肿、胸闷、心悸、乏力、失眠、神疲、食欲不振、气短、腹胀、胸痛、面色暗黄、舌质暗淡、舌质暗红、苔腻、苔薄、苔白、细弦。瘀阻心脉证常见症状:胸闷、浮肿、心悸、乏力、失眠、胸痛、气短、头晕、面色暗黄、舌质暗淡、苔薄、苔白、脉沉、脉细、脉无力。8.男性与心肺虚弱证;女性患者与心脾虚弱证;27岁至不满40岁的与痰瘀内阻证和瘀热内阻证;40岁至不满50岁的与阳虚水停证;50岁至不满60岁的与气滞血瘀证;60岁至不满70岁的与心肺虚弱证;70岁至不满80岁的与瘀阻心脉证;80岁至91岁的与气阴两虚证、心脾肾阳虚证、水气凌心证、瘀热水停证具有相关性。9.理论研究结果:(1)明确病因,知其所犯。(2)以气血津液辨证为主,确定基本病机。(3)结合脏腑辨证,整体论治。(4)谨守病机,明辨证型。(5)治法灵活,有的放矢。(6)基本病机,基础方药。(7)病证结合,中西合参。(8)中病即止,注重调护。结论:导师认为本病的致病因素繁多。心水病40岁以后发病率逐渐上升。导师诊疗心水病主要症状是胸闷、浮肿、乏力、心悸、气短,心水病的病机复杂,基本病机是初期气虚、后期阳虚,血瘀、水停,贯穿始终。又有五脏相关,气血阴阳亏虚。导师诊病注重四诊合参。望诊面色、脉诊多提示气血盛衰。舌诊多提示病邪性质。且常见面诊面色、脉象、舌诊与基本病机吻合。每个证型常见症状与证型基本吻合。治疗上,要灵活运用益气、助阳,理气、化瘀、行水的治疗大法。诊病治病不拘一格。中病即止,以求治疗的最大公约数;注重调护,提高生存质量和存活率。
[Abstract]:Objective: guided by the theory of traditional Chinese medicine, based on the outpatient cases of tutor Yuan Haibo, combined with the contents of tutor literature, book, lecture and so on, the academic thought and clinical experience of Professor Yuan Haibo of famous old Chinese medicine in diagnosis and treatment of heart water disease for decades are deeply explored, and the dialectical thought of mentor treatment of heart water disease is summed up to make it possible. Inherit and carry forward, effectively guide the clinical, improve the clinical curative effect of syndrome differentiation of hydroheart disease. Method: 1. according to the inclusion criteria, collect the pro - diagnosis of the heart water disease cases of Professor Yuan Haibo, the First Affiliated Hospital of Henan University of traditional Chinese medicine from 07 to December 2015 02 days from April 2010 to December 2015, and standardize them into the form, and ensure the accuracy of the data. Several methods were used to count the tongue diagnosis, pulse diagnosis, inspection, syndrome, symptoms and symptoms of main syndromes. Using SPSS19.0 to carry out bivariate correlation methods, statistics the relationship between age and sex and syndrome type.2. reading literature, books, lectures and other contents, and to instruct professor Yuan Haibo for diagnosis and treatment of heart water disease. Results: 1. a total of 170 patients were collected. 63 men, the average age of 60.24 + 14.672 years, 107 women, average age 63.77 + 11.212 years old, the average age 62.46 + 12.679 years.2. common pulse: sinking, thin, weak, knot, fine chord, chord,.3. common face color: dark yellow, yellow, dark.4. common tongue diagnosis: Dark tongue, dark tongue, dark red tongue. Tongue body medium, thin tongue body, body fat tongue body fat, body fat body The main symptoms of.5., such as moss, moss, moss and thickness: chest tightness, swelling, fatigue, palpitation, and shortness of breath.6.: blood stasis syndrome, heart and liver failure syndrome, weak syndrome of heart and spleen, damp stasis syndrome, weak syndrome of heart qi, two deficiency syndrome of Qi Yin, blood stasis and blood stasis syndrome of.7. blood stasis syndrome: swelling, chest tightness, weakness, palpitation, shortness of breath, insomnia and anorexia, God Weakness of the tongue, dark yellow, dyke and pulse. The common symptoms of heart and liver syndrome: edema, chest tightness, palpitation, weakness, shortness of breath, dizziness, dark yellow, dark tongue, greasy fur, pulse sinks, pulse fine, pulse fine chords. The common symptoms of heart and spleen weakness: chest tightness, swelling, weakness, palpitation, insomnia, shortness, faint yellow, dim tongues, dark tongue, The common symptoms: chest tightness, shortness of breath, swollen, asthenia, insomnia, palpitation, dizziness, fatigue, asthenia, dark yellow, dark tongue, dull tongue, greasy fur, thick fur, pulse, pulse, weakness, heart palpitations, palpitations, insomnia, fatigue, swollen and yellowing face Dark yellow color, dark tongue, dark tongue, greasy tongue, moss white, thin moss, pulse sink, pulse thin, pulse weakness, pulse fine chord. The common symptoms of Qi Yin two deficiency syndrome: edema, chest tightness, palpitation, weakness, insomnia, fatigue, shortness, shortness of appetite, shortness of appetite, dysphasia, chest pain, dark yellow, tongue quality, dark red tongue, tongue coating, thin moss, fine chords, thin chords, common symptoms of stasis and heart pulse: chest tightness, floating Swelling, palpitation, fatigue, insomnia, chest pain, shortness of breath, dark yellow, dim tongues, thin fur, moss, pulse depression, weak pulse, pulse weakness.8. and weakness of heart and lung syndrome; female patients and weak heart and spleen syndrome; 27 to 40 years old with phlegm stasis syndrome and blood stasis syndrome; 40 to 50 years old and yang deficiency syndrome; 50 to 60 years old and qi stagnation Blood stasis syndrome; the syndrome of heart and lung weakness from 60 to 70 years old; the syndrome of blood stasis and heart pulse from 70 to 80 years old; 80 to 91 years old with Qi Yin deficiency syndrome, heart spleen and kidney yang deficiency syndrome, water and Qi Lingxin syndrome, blood stasis hot water stop syndrome related.9. theory research results: (1) clear cause and know it. (2) based on Qi and blood body fluid syndrome differentiation, determine basic pathogenesis. (3) knot Combining the viscera syndrome differentiation, holistic treatment. (4) keep the disease machine and discernment syndrome type. (5) the treatment method is flexible and has a definite target. (6) basic disease machine, basic prescription medicine. (7) combination of disease and syndrome, Chinese and Western joint ginseng. (8) disease is stop, and attention is paid to the disease. The guidance is that the pathogeny factors of this disease are various. After 40 years of heart water disease, the incidence of disease is gradually rising. Main symptoms of diagnosis and treatment of heart water disease are the main symptoms of mentor and treatment of mentor Chest tightness, swelling, fatigue, palpitation, shortness of breath, complex pathogenesis of heart water disease, basic pathogenesis is the initial Qi deficiency, the later Yang deficiency, blood stasis, water stop, through all the time. There are five organs related, Qi and blood Yin and yang deficiency. The common symptoms of each syndrome are consistent with the syndrome type. In the treatment, we should use the flexible use of Qi, Yang, Qi, blood stasis, the treatment of water. The diagnosis and treatment of diseases are not restricted.

【学位授予单位】：河南中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R249;R259

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