基于文献分析的中药治疗内痔用药规律及相关对比研究

发布时间：2018-09-04 20:22

【摘要】：目的:通过检索古代医籍文献中以中药内治法、熏洗法、外用药物治疗法来治疗内痔的相关文献,探讨非手术疗法治疗内痔的用药规律,为临床治疗本病提供理论依据,为治愈或治疗本病、减轻患者病痛,献上新的思路。材料与方法:以《中华医典》为研究的主体资料,以“痔”为关键词进行目录搜索,依照选择方药的标准进行筛选,对符合标准的用药进行相关统计研究。结果:1.古代内治方药中符合录入标准的方剂316首,其中最大方剂用药23味,最小方剂用药仅1味,共涉及用药392味,符合计入频次统计的药物206味,其他药物187味,药物出现总频次1653次。2.古代内治药物中使用频次位于前三位的药物依次为:槐花、枳壳、当归;槐花用药96频次,相对频次5.8%;枳壳与当归二者用药均为86频次,相对频次5.2%。3.古代内治药物中使用频次居前三位的药物功效依次为:补虚药、清热药及止血药。补虚药用药总频次317次,占用药总频数的19.2%,其中,补气药与补血药的应用共占补虚药的85.5%,补气药以148味次居补虚药首位;清热药以总191味次居补虚药之后,占用药总频数的11.6%,其中,清热燥湿药、清热解毒药、清热凉血药三种类型以总频次178味次占清热药用药总频数的93.2%;止血药以总154味次居第三位,占用药总频次的9.3%,其中,凉血止血药以总频次124味次占止血药用药总频数的80.5%。4.古代外用熏洗药中符合录入标准的方剂92首,其中最大方剂用药17味,最小方剂用药仅1味,共涉及用药196味,符合计入频次统计的药物78味,其他药物118味,药物出现总频次263次。5.古代熏洗药物中使用频次位于前三位的药物依次为:荆芥、芒硝、白矾;其中,荆芥用药25频次,相对频次9.5%;芒硝用药23频次,相对频次8.7%;白矾用药17频次,相对频次6.5%,二者分居二、三位。6.古代熏洗药物中使用频次位居前三位的药物功效依次为:解表药、清热药、以及同居第三位的泻下药与攻毒杀虫止痒药;现代熏洗药中使用频次位居前三位的药物功效依次为:清热药、泻下药、攻毒杀虫止痒药。7.古代外用符合标准的方剂182首,其中最大方剂用药10味,最小方剂用药仅1味,共涉及用药272味,符合计入频次统计的药物100味,其他药物172味,药物出现总频次435次。8.古代外用药物中使用频次位于前三位的药物依次为:白矾、冰片、麝香;白矾用药44频次,相对频次10.1%;冰片用药31频次,相对频次7.1%;麝香用药22频次,相对频次5.1%。9.古代外用药物中使用频次位居前三位的药物功效依次为:攻毒杀虫止痒药、清热药及开窍药。结论:1.古代医家治疗内痔,以口服用药治疗为主。2.古代医家以内治法治疗内痔重在以清热凉血、止血、气血同补为主要的治疗方法。3.古代医家以熏洗法治疗内痔时注重以祛风解表、清热软坚、燥湿杀虫止痒为主要的治疗方法;现代医家对内痔的治疗思想同古代医家基本一致,而古代更注重解表,现代更注重燥湿。4.古代医家以外用药物治疗内痔时注重以杀虫止痒、清热、消肿生肌为主要的治疗方法。5.古代内治、熏洗、外用三类药物中排名前三位的药物各有异同,三者均包括清热药,治疗时取清热之意;内治药中同时注重补虚药与止血药的使用,意在清热止血与调补气血并行;熏洗药与外用药物二者均含有攻毒杀虫止痒药,意在杀虫解毒、燥湿止痒;其中熏洗药中除清热外,还注重解表药与泻下药的应用,意在解表、软坚;而外用药物治疗同时注重生肌、消肿、止痛疗法。
[Abstract]:OBJECTIVE: To explore the medication regularity of non-operative therapy for internal hemorrhoids by searching the ancient medical literature on internal treatment of traditional Chinese medicine, fumigation and washing, and external drug therapy, so as to provide theoretical basis for clinical treatment of internal hemorrhoids, and provide new ideas for curing or treating the disease and alleviating the pain of patients. Results: 1. There were 316 prescriptions in ancient internal medicine prescriptions which met the entry criteria, of which 23 were the largest prescriptions and only 1 was the smallest prescription. 392 kinds of medicines accorded with the statistics of frequency, 206 kinds of medicines accorded with the statistics, 187 kinds of other medicines, the total frequency of drug occurrence was 1653.2. The first three medicines used in ancient internal medicine were: Sophora japonica, Fructus aurantii, Angelica sinensis; Sophora japonica 96 times, the relative frequency was 5.8%; Fructus aurantii and Angelica sinensis were 86 times, the relative frequency was 5.2%. Among them, 85.5% of the drugs were used for invigorating qi, 148 for invigorating qi, 191 for clearing away heat and 19.2% for invigorating qi, and 148 for invigorating qi. The total frequency was 11.6%. Among them, 178 times of the total frequency of the three types of antipyretic drugs accounted for 93.2% of the total frequency of antipyretic drugs; 154 times of the total number of hemostatic drugs accounted for the third place, accounting for 9.3% of the total frequency of drugs, of which, 124 times of the total frequency of cold blood hemostatic drugs accounted for 80.5% of the total frequency of hemostatic drugs in ancient times. Among the 92 prescriptions that met the entry criteria, 17 were the largest prescriptions and only 1 was the smallest prescription. There were 196 prescriptions involved, 78 were the medicines that accorded with the frequency statistics, and 118 were the other medicines. The total frequency of occurrence of the medicines was 263. Among them, there were 25 times, 9.5% relative frequency, 23 times, 8.7% relative frequency of mirabilite, 17 times, 6.5% relative frequency of alum, which were in the second and third place respectively. Among the 182 prescriptions used for external use in ancient times, 10 prescriptions were the largest and only 1 prescription was the smallest, involving 272 medicines, 100 medicines accorded with the statistics of frequency, 172 other medicines, and drugs. The frequencies of the first three drugs used in ancient external medicines were alum, borneol and musk, 44 times used in alum, 10.1% in relative frequencies, 31 times used in borneol, 7.1% in relative frequencies, 22 times used in musk, 5.1% in relative frequencies. Conclusion: 1. Ancient physicians treated internal hemorrhoids mainly by oral medication. 2. Ancient physicians treated internal hemorrhoids mainly by internal treatment with the methods of clearing away heat and cooling blood, stopping bleeding, reinforcing qi and blood. 3. Ancient physicians treated internal hemorrhoids by fumigation and washing, focusing on dispelling wind and relieving superficial symptoms, clearing away heat, softening firmness, drying dampness and killing. Ancient physicians pay more attention to relieving itching, clearing away heat, detumescence and muscle growth. 5. Ancient internal treatment, fumigation and washing, external use of three drugs in the treatment of internal hemorrhoids. The top three drugs have their own similarities and differences, all of them include antipyretic drugs, take the meaning of clearing away heat while treating; internal medicine at the same time pay attention to the use of tonifying deficiency drugs and hemostatic drugs, intended to clear away heat and hemostasis and regulating qi and blood at the same time; fumigation and lotion drugs and external medicine both contain poisonous insecticidal and itching drugs, intended to insecticidal detoxification, dryness and dampness; fumigation and washing drugs in which the elimination of Qingqing. In addition to heat, it also pays attention to the application of antiphlogistic and diarrheal drugs, intended to relieve the surface, soft and firm; while external medicine treatment at the same time pay attention to muscle, swelling, analgesic therapy.
【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】：R266

【参考文献】