中药治疗脑出血后脑水肿的文献研究及化痰通腑活血利水法治验总结
发布时间：2018-07-31 11:22
【摘要】：目的:通过文献研究结果与导师运用化痰通腑、活血利水法治疗脑出血后脑水肿治验总结的对比,以文献数据指导并验证临床用药,开拓诊疗思路,提供中药疗效的循证医学证据。材料与方法:收集近20年生物医学期刊上(包括中国生物医学文献数据库(CBM)、中国学术期刊网(CNKI)、重庆维普(VIP)等中文数据库)刊登的所有有关中药治疗脑出血后脑水肿的临床研究文献,对符合条件的文献进行综合分析,针对常见病机、主要治法、常见中药类别及中药、药性特点进行归纳分类总结;对导师应用化痰通腑、活血利水法治疗脑出血后脑水肿的治验进行总结。结果:1.脑出血后脑水肿常见病机包括痰瘀化水、痰热腑实、阴虚风动、气虚血瘀。2.常见治法为活血法(84.42%)、通腑法(68.83%)、化痰法(36.36%)、利水法(27.27%)、熄风法(25.97%)以及益气法(9.09%)。3.治疗脑出血后脑水肿常见中药类别为活血化瘀类(26.65%)、泻下类(10.54%)、熄风类(10.54%)、化痰类(7.32%)、利水类(6.3%)、清热凉血类(5.71%)、补气类(5.13%)等。应用频次较多的中药分别是:活血化瘀类-生水蛭38次、丹参30次;泻下类-大黄66次;平肝熄风类-地龙16次、天麻11次;化痰类-胆南星15次、瓜蒌13次;利水渗湿类-泽泻19次、茯苓10次;清热凉血类-赤芍14次、生地14次;补气类-白术10次、黄芪9次;补血类-当归15次;止血类-三七37次,开窍类-石菖蒲20次。清热类中药中以清热凉血类最多见;补益类中药中以补气类最多见。4.治疗脑出血后脑水肿中药药性方面:寒凉性质药物较常用(49.14%);苦味药最多见(40.17%);归经排在前2位的分别是肝(胆)经(33.43%)、脾(胃)经(27.54%)。结论:1.中医病机:文献研究结果显示痰瘀化水,停于脑府为本病主要病机,导师临证治验与该结论相吻合。2.中医治法:文献研究结果显示活血、通腑、化痰、利水法为本病主要治法,而导师根据该病的分期提出:急性期以痰热腑实为主,治疗上以清热化痰通腑为主,活血利水为辅;恢复期以痰瘀阻滞经络为主,治疗上化痰通络与活血利水并重。3.中药规律:文献研究结果显示治疗本病常见中药类别为活血化瘀类、泻下类、熄风类、化痰类、利水类、清热凉血类、补气类;以苦寒性质药物最常用;以归肝(胆)经、脾(胃)经药物最常见。4.文献研究结果与导师治验的结合在该病的诊治中疗效确切。
[Abstract]:Objective: to compare the results of literature research with that of tutor in treating cerebral edema after intracerebral hemorrhage by using the method of resolving phlegm and regulating fu-organs and activating blood circulation and promoting water, and to guide and verify the clinical use of drugs with literature data, and to develop the thinking of diagnosis and treatment. To provide evidence-based medical evidence for the efficacy of traditional Chinese medicine. Materials and methods: to collect all the Chinese medicine related to the treatment of cerebral water after intracerebral hemorrhage published in biomedical journals (including (CBM), China Biomedical Literature Database, (CNKI), Chongqing Weipu, (VIP), etc.) in the past 20 years. Literature on clinical studies of swelling, Comprehensive analysis of qualified literature, classification and summarization of common disease machines, main treatment methods, common types and characteristics of traditional Chinese medicine; application of Huatan to remove phlegm and entrails, The treatment of cerebral edema after cerebral hemorrhage by activating blood circulation and promoting water therapy was summarized. The result is 1: 1. The common pathogenesis of cerebral edema after intracerebral hemorrhage includes phlegm and stasis, phlegm and heat, Yin deficiency and wind movement, Qi deficiency and blood stasis. The common methods were promoting blood circulation (84.42%), clearing Fu organs (68.83%), resolving phlegm (36.36%), promoting water (27.27%), dispelling wind (25.97%) and benefiting qi (9.09%) .3. The common types of traditional Chinese medicine for cerebral edema after intracerebral hemorrhage were activating blood circulation and removing blood stasis (26.65%), diarrhea (10.54%), dispelling wind (10.54%), resolving phlegm (7.32%), promoting water (6.3%), clearing heat and cooling blood (5.71%), supplementing qi (5.13%) and so on. The frequently used Chinese medicines were 38 times of promoting blood circulation and removing blood stasis, 30 times of salvia miltiorrhiza, 66 times of diarrhea and rhubarb, 16 times of pinggan quilting-Dilong, 11 times of Gastrodia elata, 15 times of resolving phlegm, 15 times of Gentian Nanxing, 13 times of Trichosanthes; Rhizoma alisma 19 times, Poria cocos 10 times; Clearing heat and cooling blood type-red peony 14 times, raw land 14 times; tonifying qi-Atractylodes macrocephalae 10 times, Radix Astragali 9 times; Blood-tonifying type-Angelica sinensis 15 times; hemostasis-37 times-37 times, resuscitation-Acorus calamus 20 times. In Chinese medicine of clearing away heat and cooling blood, it is most common in Chinese medicine of clearing away heat and cooling blood, and that in Chinese medicine of tonifying and nourishing is mostly seen in the category of tonifying qi. 4. In the treatment of cerebral edema after intracerebral hemorrhage, Chinese medicine was more commonly used (49.14%), bitter drugs (40.17%), liver (gallbladder) (33.43%) and spleen (stomach) (27.54%). Conclusion 1. Pathogenesis of TCM: the results of literature study showed that phlegm and blood stasis were the main pathogenesis of the disease. TCM treatment: the results of literature study showed that promoting blood circulation, removing phlegm and promoting water were the main methods of treating the disease. According to the stages of the disease, the tutor put forward the following points: phlegm and heat in the acute stage, heat in the acute period, clearing heat, removing phlegm and removing the fu-organs in the treatment, activating blood and promoting water as the auxiliary; In convalescence stage, phlegm and blood stasis block meridian mainly, treatment of phlegm and circulation of collaterals and promoting blood circulation and promoting water equal emphasis. 3. Law of traditional Chinese Medicine: the results of literature study show that the common types of Chinese medicine for the treatment of this disease are promoting blood circulation and removing blood stasis, diarrhea, wind extinguishing, phlegm, promoting water, clearing away heat and cooling blood, replenishing qi; taking bitter and cold medicine as the most commonly used medicine; and returning the liver (gallbladder) to the meridian of liver (gallbladder). Spleen (stomach) meridian medicine is the most common. 4. The combination of literature research and tutors is effective in the diagnosis and treatment of the 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】：R277.7
本文编号：2155428
[Abstract]:Objective: to compare the results of literature research with that of tutor in treating cerebral edema after intracerebral hemorrhage by using the method of resolving phlegm and regulating fu-organs and activating blood circulation and promoting water, and to guide and verify the clinical use of drugs with literature data, and to develop the thinking of diagnosis and treatment. To provide evidence-based medical evidence for the efficacy of traditional Chinese medicine. Materials and methods: to collect all the Chinese medicine related to the treatment of cerebral water after intracerebral hemorrhage published in biomedical journals (including (CBM), China Biomedical Literature Database, (CNKI), Chongqing Weipu, (VIP), etc.) in the past 20 years. Literature on clinical studies of swelling, Comprehensive analysis of qualified literature, classification and summarization of common disease machines, main treatment methods, common types and characteristics of traditional Chinese medicine; application of Huatan to remove phlegm and entrails, The treatment of cerebral edema after cerebral hemorrhage by activating blood circulation and promoting water therapy was summarized. The result is 1: 1. The common pathogenesis of cerebral edema after intracerebral hemorrhage includes phlegm and stasis, phlegm and heat, Yin deficiency and wind movement, Qi deficiency and blood stasis. The common methods were promoting blood circulation (84.42%), clearing Fu organs (68.83%), resolving phlegm (36.36%), promoting water (27.27%), dispelling wind (25.97%) and benefiting qi (9.09%) .3. The common types of traditional Chinese medicine for cerebral edema after intracerebral hemorrhage were activating blood circulation and removing blood stasis (26.65%), diarrhea (10.54%), dispelling wind (10.54%), resolving phlegm (7.32%), promoting water (6.3%), clearing heat and cooling blood (5.71%), supplementing qi (5.13%) and so on. The frequently used Chinese medicines were 38 times of promoting blood circulation and removing blood stasis, 30 times of salvia miltiorrhiza, 66 times of diarrhea and rhubarb, 16 times of pinggan quilting-Dilong, 11 times of Gastrodia elata, 15 times of resolving phlegm, 15 times of Gentian Nanxing, 13 times of Trichosanthes; Rhizoma alisma 19 times, Poria cocos 10 times; Clearing heat and cooling blood type-red peony 14 times, raw land 14 times; tonifying qi-Atractylodes macrocephalae 10 times, Radix Astragali 9 times; Blood-tonifying type-Angelica sinensis 15 times; hemostasis-37 times-37 times, resuscitation-Acorus calamus 20 times. In Chinese medicine of clearing away heat and cooling blood, it is most common in Chinese medicine of clearing away heat and cooling blood, and that in Chinese medicine of tonifying and nourishing is mostly seen in the category of tonifying qi. 4. In the treatment of cerebral edema after intracerebral hemorrhage, Chinese medicine was more commonly used (49.14%), bitter drugs (40.17%), liver (gallbladder) (33.43%) and spleen (stomach) (27.54%). Conclusion 1. Pathogenesis of TCM: the results of literature study showed that phlegm and blood stasis were the main pathogenesis of the disease. TCM treatment: the results of literature study showed that promoting blood circulation, removing phlegm and promoting water were the main methods of treating the disease. According to the stages of the disease, the tutor put forward the following points: phlegm and heat in the acute stage, heat in the acute period, clearing heat, removing phlegm and removing the fu-organs in the treatment, activating blood and promoting water as the auxiliary; In convalescence stage, phlegm and blood stasis block meridian mainly, treatment of phlegm and circulation of collaterals and promoting blood circulation and promoting water equal emphasis. 3. Law of traditional Chinese Medicine: the results of literature study show that the common types of Chinese medicine for the treatment of this disease are promoting blood circulation and removing blood stasis, diarrhea, wind extinguishing, phlegm, promoting water, clearing away heat and cooling blood, replenishing qi; taking bitter and cold medicine as the most commonly used medicine; and returning the liver (gallbladder) to the meridian of liver (gallbladder). Spleen (stomach) meridian medicine is the most common. 4. The combination of literature research and tutors is effective in the diagnosis and treatment of the 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】：R277.7
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