李维贤治疗痛经经验探究及虚寒痛经方的临床疗效观察
发布时间：2018-07-28 14:09
【摘要】：目的:通过对名老中医李维贤治疗痛经的病案进行回顾性临床研究,以中医药理论为指导,采用观察法、比较法及数理统计等法来完成此文,从而探析和归纳李维贤治疗痛经的临床经验;同时通过前瞻性临床研究,采用自身前后对照试验方法,观察分析李老自拟验方虚寒痛经方治疗虚寒型痛经的临床疗效,以进一步为中医药治疗痛经提供指导。方法:通过痛经文献学研究,归纳古代中医家对痛经的病名、病因病机、辨证论治等方面的认识,整理现代中医家对痛经的中医药内、外治疗方法的研究,概括现代西医学对痛经的病因病机、分型及治疗手段的研究及进展,为整理和研究李维贤治疗痛经的辨证治法及用药规律打好理论基础。通过分析李老门诊62例痛经患者病案的辨证及论治方法,并对李老治疗各证型痛经的25首处方进行分类及频次统计、归纳比较与分析讨论,将常用的117味中药进行功效分类、归经及性味统计分析,以了解其用药规律,最后概括总结李维贤诊治痛经的临床经验及一般特点。同时收集纳入2015年12月至2017年1月在广东省中医院妇科门诊就诊诊断为虚寒型痛经的49例患者,予以李老自拟验方虚寒痛经方加减,患者经期服药5天,治疗3个月经周期,观察记录治疗前后痛经症状评分及VAS评分,分析对比治疗前后各评分的差异,分析年龄、病程、病情与疗效的相关性,观察虚寒痛经方的整体临床疗效。结果:李老辨证治疗痛经处方情况比较分析:肝气郁滞型:调经种玉汤加味主治肝郁血虚夹有气滞之痛经;开郁种子汤加味主治肝郁兼肝脾不调型痛经;宣郁通经汤加味主治肝郁夹瘀热之痛经;解肝煎加味主治肝郁兼脾胃郁滞之痛经;当归芍药散加味主治肝郁脾虚兼有血水郁滞之痛经。寒凝血瘀型:通卵种育丹加味主治少腹寒凝血瘀兼气滞型痛经;温脐化湿汤加味主治下焦寒湿型痛经;金匮之温经汤加味主治冲任血虚、寒凝血瘀型痛经。气血亏虚型:人参养荣汤加味主治气血俱虚型痛经。脾胃虚弱型:七味白术散加味活血调经之药主治脾胃虚弱型痛经。肾气不足型:调肝汤加味主治肾精虚少、肝血不足之痛经。常用中药分类统计结果显示前五类依次为补气药、补血药、活血化瘀药、理气药、助阳药;中药归经排在前三位的依次为归脾经、肝经、心经。常用中药的药性前两位依次为温性、平性;药味前两位依次为辛味、甘味。李老验方虚寒痛经方治疗虚寒型痛经疗效观察:治愈6例,显效16例,有效18例,无效9例,总有效率为81.63%。患者治疗前后痛经症状评分及VAS评分对比,治疗后明显下降,差异有统计学意义。患者各年龄组间比较有统计学意义,患者各病程组间、各病情组间疗效疗效比较均无统计学意义。结论:李维贤教授临床常见痛经辨证分型:肝气郁滞型、寒凝血瘀型、气血亏虚型、脾胃虚弱型、肾气不足型。经验特点:推崇古方,辨证施治;善理脏腑,重调肝脾;气血为要,通补兼施;温散寒邪,通化血瘀。李老经验方—虚寒痛经方加减对虚寒型痛经具有较好的治疗作用,可温经散寒止痛,有效缓解患者的痛经症状,且对年轻痛经患者疗效相对较好。
[Abstract]:Objective: to carry out a retrospective clinical study on the case of dysmenorrhea treated by Li Weixian, an old Chinese medicine, with the guidance of the theory of traditional Chinese medicine, with the methods of observation, comparison and mathematical statistics to complete this article, so as to explore and summarize the clinical experience of Li Weixian in the treatment of dysmenorrhea. Methods: To observe and analyze the clinical effect of Li Lao's own prescription of deficiency cold and dysmenorrhea in treating dysmenorrhea of deficiency cold type, and to provide guidance for the treatment of dysmenorrhea by traditional Chinese medicine. Methods: through the study of dysmenorrhea literature, summarize the understanding of the name of the dysmenorrhea, the pathogenesis, the syndrome differentiation and treatment of the ancient Chinese medicine family, and collate the traditional Chinese medicine for the dysmenorrhea. The study of internal and external treatment methods summarized the research and progress of modern western medicine on the etiology, pathogenesis, classification and treatment of dysmenorrhea, and made a theoretical basis for sorting out and studying Li Weixian's treatment of dysmenorrhea and the rule of drug use. Through analysis of the syndrome differentiation and treatment methods of 62 cases of dysmenorrhea in Li Lao outpatient clinic, and the treatment of Li Lao's various syndromes, the treatment of dysmenorrhea in Li Lao clinic was analyzed. The 25 prescriptions of type dysmenorrhea were classified and analyzed, compared with the analysis and discussion. The commonly used 117 herbs were classified, classified and analyzed in order to understand the rule of drug use. Finally, the clinical experience and general characteristics of Li Weixian's treatment and treatment of dysmenorrhea were summarized and summarized in Guangdong from December 2015 to January 2017. 49 cases of deficiency cold type dysmenorrhea were diagnosed in the gynecologic outpatient clinic of the provincial hospital of traditional Chinese medicine. The patients were treated with Li Lao's own prescription for deficiency cold and pain. The patients were treated with medicine for 5 days and 3 menstrual cycles. The scores of dysmenorrhea and VAS scores before and after treatment were observed, and the differences of the scores before and after the treatment were analyzed, and the age, course, condition and curative effect were analyzed. Correlation, observe the overall clinical effect of deficiency cold and pain menstrual prescription. Results: Li Lao syndrome differentiation and treatment of dysmenorrhea prescription comparison analysis: liver qi stagnation type: regulating meridian seed jade soup supplemented with liver qi stagnation and stagnation of qi stagnation of dysmenorrhea; Kai Yu seed soup to treat liver qi stagnation and liver spleen non adjustable dysmenorrhea; Xuan Yu Tong Jing Decoction for liver qi stagnation and stasis heat menstruation; solution The liver decoction is used to treat the dysmenorrhea of liver depression and spleen and stomach stagnation; the decoction of Angelica peony is used to treat liver depression and spleen deficiency with blood stasis of dysmenorrhea. Blood stasis type dysmenorrhea and deficiency of Qi and blood deficiency type: the ginseng nourishing and Rong Rong decoction is the main treatment of Qi and blood deficiency type dysmenorrhea. Spleen and stomach weak type: the medicine of seven flavour of Baizhu powder is used to treat the spleen and stomach weak type of dysmenorrhea. The kidney qi deficiency type is the kidney essence deficiency and the deficiency of the liver blood. The classification statistics of common Chinese medicine show that the first five categories are the Qi supplementing medicine in turn, Blood enriching medicine, activating blood and removing blood stasis medicine, regulating qi medicine and helping Yang medicine; the first three cases of traditional Chinese medicine are the order of the spleen meridian, the liver meridian and the heart meridian. The first two places of the traditional Chinese medicine are warm and flat in turn; the two places in the front of the medicine are successively bitter and sweet. 6 cases are cured, 16 cases are cured and 18 cases are effective. Effect of 9 cases, the total effective rate of 81.63%. patients before and after the treatment of dysmenorrhea symptom score and VAS score comparison, after treatment significantly decreased, the difference is statistically significant. The patients of all age groups have statistical significance, the patient's various course groups, the curative effect of each disease group has no statistical significance. Conclusion: Professor Li Weixian's clinical common dysmenorrhea differentiation Syndrome classification: liver qi stagnation type, cold coagulation and stasis type, Qi and blood deficiency deficiency type, spleen and stomach weak type, kidney qi deficiency type. Experience characteristics: admired ancient recipe, syndrome differentiation and treatment; good reason viscera, resetting liver and spleen; Qi and blood to be used; Qi and blood stasis, Tonghua blood stasis. The experience prescription of deficiency cold pain has good therapeutic effect on deficiency cold type dysmenorrhea, can warm the temperature. It is effective to relieve dysmenorrhea symptoms and relieve dysmenorrhea in young patients with dysmenorrhea.
【学位授予单位】：广州中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R249;R271.113
，
本文编号：2150462
[Abstract]:Objective: to carry out a retrospective clinical study on the case of dysmenorrhea treated by Li Weixian, an old Chinese medicine, with the guidance of the theory of traditional Chinese medicine, with the methods of observation, comparison and mathematical statistics to complete this article, so as to explore and summarize the clinical experience of Li Weixian in the treatment of dysmenorrhea. Methods: To observe and analyze the clinical effect of Li Lao's own prescription of deficiency cold and dysmenorrhea in treating dysmenorrhea of deficiency cold type, and to provide guidance for the treatment of dysmenorrhea by traditional Chinese medicine. Methods: through the study of dysmenorrhea literature, summarize the understanding of the name of the dysmenorrhea, the pathogenesis, the syndrome differentiation and treatment of the ancient Chinese medicine family, and collate the traditional Chinese medicine for the dysmenorrhea. The study of internal and external treatment methods summarized the research and progress of modern western medicine on the etiology, pathogenesis, classification and treatment of dysmenorrhea, and made a theoretical basis for sorting out and studying Li Weixian's treatment of dysmenorrhea and the rule of drug use. Through analysis of the syndrome differentiation and treatment methods of 62 cases of dysmenorrhea in Li Lao outpatient clinic, and the treatment of Li Lao's various syndromes, the treatment of dysmenorrhea in Li Lao clinic was analyzed. The 25 prescriptions of type dysmenorrhea were classified and analyzed, compared with the analysis and discussion. The commonly used 117 herbs were classified, classified and analyzed in order to understand the rule of drug use. Finally, the clinical experience and general characteristics of Li Weixian's treatment and treatment of dysmenorrhea were summarized and summarized in Guangdong from December 2015 to January 2017. 49 cases of deficiency cold type dysmenorrhea were diagnosed in the gynecologic outpatient clinic of the provincial hospital of traditional Chinese medicine. The patients were treated with Li Lao's own prescription for deficiency cold and pain. The patients were treated with medicine for 5 days and 3 menstrual cycles. The scores of dysmenorrhea and VAS scores before and after treatment were observed, and the differences of the scores before and after the treatment were analyzed, and the age, course, condition and curative effect were analyzed. Correlation, observe the overall clinical effect of deficiency cold and pain menstrual prescription. Results: Li Lao syndrome differentiation and treatment of dysmenorrhea prescription comparison analysis: liver qi stagnation type: regulating meridian seed jade soup supplemented with liver qi stagnation and stagnation of qi stagnation of dysmenorrhea; Kai Yu seed soup to treat liver qi stagnation and liver spleen non adjustable dysmenorrhea; Xuan Yu Tong Jing Decoction for liver qi stagnation and stasis heat menstruation; solution The liver decoction is used to treat the dysmenorrhea of liver depression and spleen and stomach stagnation; the decoction of Angelica peony is used to treat liver depression and spleen deficiency with blood stasis of dysmenorrhea. Blood stasis type dysmenorrhea and deficiency of Qi and blood deficiency type: the ginseng nourishing and Rong Rong decoction is the main treatment of Qi and blood deficiency type dysmenorrhea. Spleen and stomach weak type: the medicine of seven flavour of Baizhu powder is used to treat the spleen and stomach weak type of dysmenorrhea. The kidney qi deficiency type is the kidney essence deficiency and the deficiency of the liver blood. The classification statistics of common Chinese medicine show that the first five categories are the Qi supplementing medicine in turn, Blood enriching medicine, activating blood and removing blood stasis medicine, regulating qi medicine and helping Yang medicine; the first three cases of traditional Chinese medicine are the order of the spleen meridian, the liver meridian and the heart meridian. The first two places of the traditional Chinese medicine are warm and flat in turn; the two places in the front of the medicine are successively bitter and sweet. 6 cases are cured, 16 cases are cured and 18 cases are effective. Effect of 9 cases, the total effective rate of 81.63%. patients before and after the treatment of dysmenorrhea symptom score and VAS score comparison, after treatment significantly decreased, the difference is statistically significant. The patients of all age groups have statistical significance, the patient's various course groups, the curative effect of each disease group has no statistical significance. Conclusion: Professor Li Weixian's clinical common dysmenorrhea differentiation Syndrome classification: liver qi stagnation type, cold coagulation and stasis type, Qi and blood deficiency deficiency type, spleen and stomach weak type, kidney qi deficiency type. Experience characteristics: admired ancient recipe, syndrome differentiation and treatment; good reason viscera, resetting liver and spleen; Qi and blood to be used; Qi and blood stasis, Tonghua blood stasis. The experience prescription of deficiency cold pain has good therapeutic effect on deficiency cold type dysmenorrhea, can warm the temperature. It is effective to relieve dysmenorrhea symptoms and relieve dysmenorrhea in young patients with dysmenorrhea.
【学位授予单位】：广州中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R249;R271.113
，
本文编号：2150462
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