宋元明清时期阴黄证候规律、证候要素及应证组合研究

发布时间：2018-06-25 09:55

本文选题：阴黄 + 证候要素　；参考：《湖南中医药大学》2016年硕士论文

【摘要】：目的:本研究以宋元明清时期阴黄证医案为研究对象,从文献原文中提取相关信息进行整理及分析,探索阴黄的学术思想及证候规律。方法:收集整理宋元明清期间阴黄相关医案,提取其中的脉象、症状、证候要素并进行标准化处理后,建立数据库,运用SPSS17.0统计软件对症状、脉象进行频数、因子及聚类统计分析,对证候要素及证候靶位进行频数及应证组合规律研究后结合中医学理论综合分析。结果:搜集阴黄文献213条,符合纳入标准166条,记录94个症状变量,20个脉象变量,得出证候要素共25个、证候要素靶位10个和证候组合69个。通过频数分析及因子分析发现,宋元明清医案中阴黄证主要症状有身黄、目黄、尿黄、腹胀满、面色晦暗、纳差食少、发热、肢倦乏力、畏寒等33个;脉象以细、虚、弱、沉、迟脉等为主;常见证候要素为:气虚、内湿、阳虚、内寒、血瘀、阴虚、内热、寒、血虚、湿、气郁、精髓亏虚等,其中气虚最为多见;病位主要位于脾肾肝胃,与心、肺、小肠、大肠亦有联系。通过应证组合得到五大证型即:脾虚湿阻证、寒湿困脾证、脾肾阳虚湿困证、气血亏虚证、阴虚血瘀证,是临床常见的阴黄证型。结论:宋元明清医家认为阴黄乃虚实夹杂之证,其病因病机主要有:寒湿蕴脾、脾虚湿盛、脾肾阳虚、气滞血瘀、气血两虚、肝肾阴虚、肝脾血瘀,五脏六腑、气血阴阳亏虚为本,寒、湿、气、痰、火、瘀互结为标。阴黄起病症状虽呈多样化表现,但多归于阴证、虚证范畴,证候要素以两两组合为主要形式,气虚湿阻、阳虚内湿是最常见组合。
[Abstract]:Objective: this study took the case of Yin and Yellow Syndrome in Song, Yuan, Ming and Qing dynasties as the research object, extracted the relevant information from the original literature for collation and analysis, and explored the academic thought and syndromes of Yin-Huang. Methods: collect and sort out the related medical records of Yin and Yellow in Song, Yuan, Ming and Qing dynasties, extract the pulse, symptoms, syndromes and standardized treatment, set up the database, and use SPSS 17.0 statistical software to carry on the frequency of symptom and pulse. Factor and cluster statistical analysis, syndromes and syndromes target of the frequency and syndrome combination of the study combined with the theory of traditional Chinese medicine comprehensive analysis. Results: 213 yin-yellow literature were collected, 166 were in accordance with inclusion criteria, 94 symptom variables and 20 pulse variables were recorded, 25 syndromes were obtained, 10 target sites of syndromes and 69 syndromes combinations were obtained. Through frequency analysis and factor analysis, it was found that the main symptoms of Yin-Huang syndrome in the medical records of Song, Yuan, Ming and Qing dynasties were yellow of body, yellow of eyes, yellow of urine, full of abdominal distension, dark complexion, little appetite, fever, fatigue of limbs, cold, etc. The pulse was fine, weak, heavy, etc. The common syndromes are qi deficiency, internal dampness, yang deficiency, internal cold, blood stasis, yin deficiency, internal heat, cold, blood deficiency, dampness, qi depression, essence deficiency, etc. The small intestine and the large intestine are also associated. Five types of syndrome were obtained through the combination of syndromes: spleen deficiency and dampness obstruction syndrome, cold and dampness syndrome, spleen and kidney yang deficiency syndrome, qi and blood deficiency syndrome, yin deficiency and blood stasis syndrome, which are common type of yin and yellow syndrome in clinic. Conclusion: the doctors of Song Yuan, Ming and Qing dynasties thought that the syndrome of Yin Huang Nai deficiency and excess was mainly caused by cold dampness and spleen, spleen deficiency and dampness, spleen and kidney yang deficiency, qi stagnation and blood stasis, qi and blood deficiency, liver and kidney yin deficiency, liver and spleen blood stasis, and five viscera and six Fu organs. Qi-blood yin-yang deficiency for this, cold, dampness, qi, phlegm, fire, blood stasis is the standard. Although the symptoms of yin-yellow onset are diversified, most of them belong to the category of Yin syndrome, deficiency syndrome, syndrome elements are mainly in the form of two combinations, Qi deficiency and dampness block, Yang deficiency internal dampness is the most common combination.
【学位授予单位】：湖南中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R259

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