基于医案对叶天士诊治妇科疾病的用药特色研究

发布时间：2018-05-16 04:41

本文选题：叶天士 + 妇科　；参考：《长春中医药大学》2016年硕士论文

【摘要】：目的:通过对叶天士诊治妇科疾病的医案进行整理,探讨叶天士在临床中诊治妇科疾病时的用药规律以及用药特色,以期能够对现今妇科临床用药起到一定的启发和借鉴意义。方法:整理现阶段对叶天士妇科诊疗经验的成果,遴选《临证指南医案》、《叶氏医案存真》、《种福堂公选良方·附医案》、《叶天士晚年方案真本》、《未刻本叶氏医案》、《三家医案合刊·叶氏医案》、《眉寿堂方案选存》等7本医案中的妇科医案,整理其中叶天士处方中使用到的药物,并将其按照频次高低进行排序,探究叶天士临床用药的基本规律。就叶氏妇科医案中颇具特色的用法进行整理,探究叶天士用药的基本特色。结果:以《叶天士医学全书》为底本,整理叶天士各个医案集中的妇科医案并将其中涉及到的药物按照频次高低进行排序,发现《临证指南医案》中共涉及药物234味,《叶案存真》中共涉及药物114味,《叶天士晚年方案真本》中共涉及药物120味,《种福堂公选良方·续医案》中共涉及药物68味,《眉寿堂方案选存》共涉及药物181味;《三家医案合刻·叶天士医案》中涉及药物87味,《未刻本叶天士医案》涉及药物90味。综合7种医案,使用频次前十的药物分别是:当归、人参、茯苓、白芍、甘草、生地黄、阿胶、茯神、香附、小茴香。结论:叶天士妇科用药注重补益气血,重视脾胃;其妇科用药推重气味、善调奇经、注重血肉有情之品的应用、善用络药、注重四时阴阳、药分三焦以及善用炭药。
[Abstract]:Objective: through sorting out the medical records of Ye Tianshi in the diagnosis and treatment of gynecological diseases, to discuss the law and characteristics of the medication of Ye Tianshi in the diagnosis and treatment of gynecological diseases, so as to provide some inspiration and reference for the clinical use of gynecological drugs in modern gynecology. Methods: the results of gynecological diagnosis and treatment of Ye Tianshi at the present stage were summarized. Selection of "Clinical evidence Guide Medical record", < Ye's Medical record stored in Truth >, "Variety Futang Public Choice of good prescription with Medical record", "True version of Ye Tianshi's Old Age Plan", < unengraved Ye's Medical case >, < three Medical cases jointly published in Ye's Medical case >, "Mei Shoutang Scheme selection and Survival" and other 7 copies Gynecological medical records in medical records, The drugs used in the prescription of Yetianshi were sorted according to the frequency to explore the basic law of the clinical drug use. The characteristic usage of Ye Tianshi's gynecologic medical case was arranged, and the basic characteristics of Ye Tianshi's medicine were explored. Results: taking Ye Tianshi Medical Book as the base, the gynecological medical records of Ye Tianshi were arranged and the drugs involved were sorted according to the frequency. It was found that 234 kinds of drugs were involved in the Medical record of Clinical practice, 114 kinds of drugs were involved in Ye case, 120 kinds of drugs were involved in the plan of Ye Tianshi's old age, and 120 kinds of drugs were involved in the trial. 68 taste, "Mei Shoutang scheme selection" involved 181 kinds of drugs, "three medical records combined engraved Ye Tianshi medical case" involved 87 kinds of drugs, < unengraved Ye Tianshi medical case > involving 90 kinds of drugs. Comprehensive 7 kinds of medical cases, the use of the first ten drugs are: angelica, ginseng, Poria cocos, Radix Paeoniae Alba, Glycyrrhiza, Rehmannia, Ejiao, Fuzhuan Shen, Xanthoxylum, fennel. Conclusion: Ye Tianshi's gynaecological medicine pays attention to replenishing qi and blood, attaching importance to spleen and stomach, and its gynecological drugs push heavy smell, adjust Qi meridian, pay attention to the application of blood and flesh, make good use of collaterals, pay attention to 04:00 yin and yang, divide medicine into three Jiao and make good use of charcoal medicine.
【学位授予单位】：长春中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R249;R271.1

【参考文献】