庞安时温热病学术思想及证治规律研究

发布时间：2018-05-23 17:27

本文选题：庞安时 + 伤寒总病论　；参考：《湖北中医药大学》2017年硕士论文

【摘要】：目的:本文运用文献研究与现代统计学分析相结合的方法,系统整理庞安时《伤寒总病论》中关于温热病的条文,分析、归纳其对温热病病名、病因、病机及治法的论述,并进行数据挖掘,厘清庞氏治疗温热病的用药特点及方药配伍规律,研究庞安时的温热病学术思想,传承名家经验,指导温热病的临床辨证论治。方法:以《伤寒总病论》为研究对象,在筛选出庞安时治疗温热病的106首方剂基础上,建立庞氏治疗温热病的方剂数据库,利用SPSS21.0对其进行统计学处理,采用频数分析和因子分析,对所选方剂用药的频次、性味、归经、药物分类、配伍规律进行数据挖掘,并运用温病学理论对统计结果进行描述,分析、归纳庞安时关于温热病的病名、病因、病机、症候、治则、治法的相关论述,归纳总结出庞安时治疗温热病的用药规律,探究其温热病学术思想的渊源、理论内涵及对温病学说的影响。结果:1.庞安时明确提出伤寒与温病的不同;论述了诸多温热病的病种;认为温热病发生的外因是“伏气”致病和“异气”致病,内因是病人素体本虚或热盛;病机为外感邪气,内生郁热;治法上主张寒温分治,主要用清、下二法,并根据病情配合汗法、吐法等,善用表里双解剂,对刺法治疗温热病亦有建树;用药上擅长将寒凉药与辛温药配合应用,重视清热药与养阴药的运用,主张慎用煮散。2.对庞氏治疗温热病的106首方剂进行方剂来源分析,得出庞氏治疗温热病的方剂有自创方44首,其他方源频数较高的为《伤寒论》、《备急千金要方》、《外台秘要》。对106首方剂进行数据分析,得出庞安时用药频数较高的药物为甘草(46)、黄芩(28)、石膏(27)。按功效分,最常用的药物类别有清热药:黄芩、石膏、栀子、知母;解表药:麻黄、葛根、桂枝、升麻。四气中用药频数最高的是寒性药(286)、温性药(167),五味中频数最高的为苦味药(317)、辛味药(280),药物归经中频数最高的是肺经(379)、胃经(357)、脾经(293)。因子分析提取出的6个主因子为F1:甘草麻黄白芍知母葛根;F2:大青叶栀子石膏;F3:大黄黄芩;F4:黄芩黄连;F5:杏仁生姜白芍桂枝;F6:升麻甘草石膏葛根。结论:1.庞安时明确指出了温热病与伤寒的区别,并在前代医家的基础上发展了温热病病名、病因、病机、治法及用药的论述,阐述了温热病的辨证论治。2.庞安时认为温热病的病因主要为“伏气”致病、“异气”致病和体质因素,病机为外感邪气,内生郁热,治法主要包括清法、下法,善于辛温药与寒凉药配伍应用,倡辛凉解表法,重用苦寒清热药,重视顾护阴液。3.庞安时对传染性温病的特征、病因、病机、治疗及预防进行论述,收录和创制了许多预防和治疗瘟疫的方剂及方法,对现代传染病的防治具有一定的启迪作用。
[Abstract]:Objective: by using the method of literature research and modern statistical analysis, this paper systematically arranges the articles about warm fever in Pang Anshi's Theory of Total Disease of Typhoid Fever, analyzes the name, etiology, pathogenesis and treatment of the disease, and sums up its discussion on the name, etiology, pathogenesis and treatment of the disease. And data mining, to clarify the characteristics of Pang's treatment of febrile fever and the law of prescription compatibility, to study Pang Anshi's academic thought of warm fever, to pass on the experience of famous experts, to guide the clinical diagnosis and treatment of warm fever. Methods: taking total typhoid fever disease as the research object, on the basis of screening 106 prescriptions for treating febrile fever, the database of Pang's prescriptions for treating febrile fever was established, and SPSS21.0 was used to deal with them statistically. Frequency analysis and factor analysis were used to mine the frequency, taste, meridian, classification and compatibility of the selected prescriptions, and the statistical results were described and analyzed by using the theory of febrile disease. This paper summarizes Pang Anshi's related exposition on the name, etiology, pathogenesis, symptoms, treatment principles and treatment methods of the warm fever disease, sums up the law of using drugs to treat the warm fever disease, and probes into the origin of his academic thought on the warm fever disease. Theoretical connotation and its influence on febrile disease theory. The result is 1: 1. Pang An-shih clearly proposed the difference between typhoid fever and febrile disease; discussed many kinds of febrile diseases; and considered that the external causes of warm fever disease were "latent qi" and "abnormal qi", and the internal causes were the deficiency of the patient's body or heat, and the pathogenesis of the disease was exogenous evil gas. Endogenetic stagnation of heat; in the treatment of cold and heat, the two main methods are clear and lower, and according to the condition of the disease combined with sweating, spitting, and so on, to make good use of the epidermis and double antipyretic, there are also achievements in the treatment of febrile fever by needling; the medicine is good at combining the cold cooling medicine with the Xin Wen medicine. Attach importance to the use of heat-clearing medicine and yin-nourishing medicine, advocating careful use of boiled powder. 2. The sources of 106 prescriptions for treating febrile fever were analyzed. The results showed that 44 prescriptions of Pang's treatment for febrile fever were self-made, the other ones with higher frequency were Treatise of febrile typhoid, important prescription of preparing emergency, and secret of external station. According to the data analysis of 106 prescriptions, it was found that the drugs with higher frequency were Glycyrrhiza uralensis 46, Scutellaria baicalensis 28, gypsum 27. According to efficacy, the most commonly used drugs are: Radix Scutellariae, Gypsum, Gardenia, Anemarrhena; antipods: ephedra, Pueraria, Guizhi, Concha. The highest frequency of drug use in the four qi groups were cold drug (T286N), mild drug (167N), five flavors (the highest frequency was the bitter drug (317g), the Xin flavor medicine (280g), the highest frequency of the medicine was the lung meridian (379n), the stomach meridian (357N), the spleen meridian (2933ng). The six main factors extracted by factor analysis were F1: Radix Anemarrhenae Radix Radix Glycyrrhizae, Radix Anemarrhenae Alba, Radix Almond, Radix Ephedra, Radix Almond, Radix Paeoniae Alba, Radix Almond, Radix Paeoniae Alba. Conclusion 1. Pang Anshi clearly pointed out the difference between febrile fever and typhoid fever, and developed the name, etiology, pathogenesis, treatment method and medication of the disease on the basis of previous physicians, and expounded the differentiation of syndrome and treatment of warm fever disease. Pang An-shih believed that the main causes of warm fever were "latent qi", "different qi" and physical factors. The pathogenesis of the disease was exogenous evil qi, endogenetic stagnation of heat. The treatment mainly included the Qing method and the lower method, and was good at the combination of xingwen medicine and cold and cool medicine. The method of promoting Xin Liang and resolving table, reusing bitter cold and clearing heat medicine, paying attention to protecting Yin liquid. 3. Pang Anshi discussed the characteristics, etiology, pathogenesis, treatment and prevention of infectious febrile disease, collected and developed many prescriptions and methods for the prevention and treatment of plague, which has a certain enlightening effect on the prevention and treatment of modern infectious diseases.
【学位授予单位】：湖北中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R249;R254

【参考文献】