陈民教授治疗肝郁血虚型失眠用药规律分析

发布时间：2018-05-12 00:14

本文选题：失眠 + 肝郁血虚型　；参考：《辽宁中医药大学》2017年硕士论文

【摘要】：目的:通过收集导师门诊临证病例资料,将其所用方剂,按用药频次,中药四气、五味、归经、类别等进行统计,并且对使用频率较高的药物进行聚类分析,研究陈民教授治疗肝郁血虚型失眠用药规律,为临床治疗该病提供思路与方法。材料与方法:收集2015年7月1日至2016年12月30日来辽宁中医药大学附属医院老年病科门诊,由陈民教授诊治的患者,按照纳入和排除标准筛选而得的门诊病例。采集性别、年龄、方药等信息,统一录入Excel表以建立数据库,运用Excel表格及应用SPSS22.0统计分析软件分析处方用药频次和使用频率,选定25%以上作为药物使用的高频率,并对这些药物的药性、药味经、功效进行分类,聚类成方。结果:按中医四气、五味、归经、药类统计用药频次,比较其频次高低。一.1.依据纳入的120例病例,病例中应用中药共104味,使用频率大于45%共12味,分别为柴胡、黄芩、白术、白芍、当归、陈皮、川芎、合欢花、茯苓、百合、甘草、酸枣仁。2.四气:温性药频次最多,其余依次为平性,寒性,凉、热性使用较少。3.五味:甘味药应用最多,频次为1283次,其余依次为苦味,辛味,酸味,其余药味应用较少。4.归经:脾经药物应用1187次,次数最多,其余依次为肝经药,肺经药,心经药。5.药类:常用药类第一位为补虚药,第二位为解表药,第三位为安神药,清热药位排第四,第五位为活血化瘀药,第六位为利水渗湿药,第七位为理气药。二.聚类成方:通过SPSS22.0分析用药频率大于25%的药物,得到两个聚类方。结论:1.恩师在治疗肝郁血虚型失眠时,以疏肝解郁,养血宁神为主要治法,具体用方常以逍遥散加减合酸枣仁汤加减治疗。2.本病易出现肝盛乘脾,气郁化火,虚火扰心,气郁血瘀等病理变化,治以平肝柔肝,补中理气,滋阴泄火,清心除烦,活血化瘀之法。3.通过分析得到的统计数据与聚类方剂,研究恩师的治法与用药规律,为治疗本病提供一定的参考意义。
[Abstract]:Objective: to collect the data of clinical cases of mentors' outpatient clinic and analyze the prescriptions according to the frequency of medication, the four qi of Chinese medicine, the five flavors, the meridians, the categories and so on, and cluster analysis of the drugs with high frequency of use. To study the rule of professor Chen Min in treating insomnia with liver depression and blood deficiency, and to provide ideas and methods for clinical treatment of this disease. Materials and methods: from July 1, 2015 to December 30, 2016, the outpatients of geriatric department of affiliated hospital of Liaoning University of traditional Chinese Medicine were collected and selected according to the criteria of inclusion and exclusion. The data of gender, age, prescription medicine were collected, and the Excel table was entered to establish the database. The frequency and frequency of prescription drug use were analyzed by Excel table and SPSS22.0 statistical analysis software. More than 25% was selected as the high frequency of drug use. The medicinal properties, taste and efficacy of these drugs are classified and clustered into prescriptions. Results: according to TCM four qi, five flavors, return to the meridian, medicine statistics frequency, compare its frequency. One. According to 120 cases, 104 kinds of Chinese medicine were used in the cases, the frequency of which was more than 45%, 12 were Radix Bupleurum, Radix Scutellariae, Atractylodes macrocephala, Radix Paeoniae Alba, Radix angelica sinensis, Chen Pei, Ligusticum chuanxiong, Huanhuan, Poria cocos, Lily, Glycyrrhiza, Zizyphus jujube. Four gas: the frequency of warm drugs is the most, the rest is flat, cold, cool, heat use less. 3. Five flavors: sweet flavor medicine is the most frequently used, frequency is 1283, the rest is bitter taste, symplectic taste, sour taste, the other taste application is less. 4. Gui Jing: spleen meridian drugs 1187 times, the most times, the rest followed by liver medicine, lung medicine, heart meridian drug .5. Drugs: the first is tonifying medicine, the second is antidote, the third is antipsychotic, the fourth is heat clearing drug, the fifth is promoting blood circulation and removing blood stasis, the sixth is promoting water and infiltrating dampness, and the seventh is regulating qi. II. Cluster prescription: two clusters were obtained by SPSS22.0 analysis of drugs whose frequency was more than 25%. Conclusion 1. In treating insomnia of stagnation of liver and blood deficiency, the main treatment method is to soothe the liver and relieve the depression, nourish the blood and Ningshen as the main treatment method, and the specific prescription is often treated with Xiaoyao San and Suanzaoren decoction. 2. This disease is prone to liver Sheng by spleen, Qi stagnation fire, fire disturbance heart, Qi stagnation and blood stasis and other pathological changes, to calm the liver and liver, tonify Qi, nourish yin and vent fire, clear the heart to remove annoyance, blood stasis method. 3. Through the analysis of the statistical data and cluster prescription, this paper studies the law of treatment and medication of Enshi University, which provides some reference significance for the treatment of this disease.
【学位授予单位】：辽宁中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R249;R256.23

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