田玉美教授治疗肝病的临床经验研究

发布时间：2018-10-15 12:09

【摘要】：目的探讨田玉美教授对于肝病的认识,梳理其辨证论治的思路,总结其学术思想,为编撰完整的田老学术思想与临床经验著作奠定基础。使广大医学工作者在治疗肝病的临床实践中更好的学习传承及运用名医经验。方法利用Excel录入收集的病案数据,包括姓名、性别、主诉、症状、病因、病机、证型、治则治法、方药组成等,建立名医经验数据库,将数据库导入SPSS软件,对其进行归纳、分析、总结,从而挖掘田教授临床诊疗用药经验。结果1.肝病常见症状有:乏力、胁痛、纳呆、腹胀、口苦、小便黄、大便溏、寐差、眼干、头昏、苔黄、苔腻、苔暗红、舌裂纹、舌紫色、舌淡红、舌齿痕、舌淡胖、脉弦滑或细数、口干、眼干、目黄、身黄等。2.肝病常见病机:湿热毒邪侵袭、肝郁脾虚、湿热蕴结、气滞血瘀、湿热中阻、肝胃不和、肝肾阴虚等。其中,湿热毒邪为主因、湿热蕴结或阻滞中焦,气滞血瘀为病理因素。3.肝病常见证型:肝胆湿热证、肝郁脾虚证、热毒内结证、肝郁气滞证、肝肾阴虚证、肝胃不和证、湿浊内蕴证、气滞血瘀证等。4.田玉美教授治疗肝病常用治则治法:清热解毒、健脾利湿、疏肝解郁、滋养肝肾、活血化瘀、调肝运脾、疏肝健脾、清热燥湿、清热养阴、清热利湿、清肝泻火、利胆退黄、健脾和胃、化瘀通络等。5.田玉美教授治疗肝病常用方剂:茵陈蒿汤、柴胡舒肝散、逍遥散、四逆散、一贯煎、龙胆泻肝汤、四君子汤、滋水清肝饮、茵陈五苓散。6.田玉美教授治疗肝病常用药对:柴胡、丹参、郁金;苍术与厚朴;黄芩与郁金。结论1.湿、热、毒、瘀、郁等为肝病主要致病因素。2.病位主要在肝脾,多累及胆、胃、肾。3.肝病病性复杂多变,常常虚实夹杂。4.田老治疗肝病常以祛邪与补虚为原则,祛邪主在清热解毒利湿退黄,补虚主在健脾补气养阴。
[Abstract]:Objective to probe into Professor Tian Yumei's understanding of liver disease, sort out his thinking of syndrome differentiation and treatment, summarize his academic thought, and lay a foundation for compiling the complete works of Tian Lao's academic thought and clinical experience. So that the majority of medical workers in the treatment of liver disease in clinical practice better learning inheritance and use of famous medical experience. Methods the data of medical records recorded by Excel, including name, sex, main complaint, symptom, etiology, pathogenesis, syndrome type, treatment principle, prescription and drug composition, were used to establish the database of famous doctors' experiences, and the database was imported into SPSS software and summarized. Analysis, summary, thus excavating professor Tian clinical diagnosis and treatment drug experience. Result 1. Common symptoms of liver disease include: fatigue, hypochondria, anorexia, abdominal distension, bitter mouth, yellow urine, loose stool, poor sleep, dry eyes, dizziness, yellow fur, greasy moss, dark red fur, crack tongue, purple tongue, pale red tongue, tongue teeth mark, pale fat tongue, smooth veins or thin count. Dry mouth, dry eyes, yellow body, etc. Common pathogenesis of liver disease: damp-heat toxin evil invasion, liver stagnation and spleen deficiency, damp-heat accumulation knot, Qi stagnation and blood stasis, damp-heat resistance, liver and stomach disharmony, liver and kidney yin deficiency. Among them, dampness and heat toxin evil is the main cause, damp-heat accumulation knot or block middle coke, Qi stagnation and blood stasis are pathological factors. Common syndrome types of liver disease: liver dampness and heat syndrome, liver stagnation and spleen deficiency syndrome, heat toxin internal knot syndrome, liver stagnation qi stagnation syndrome, liver and kidney yin deficiency syndrome, liver and stomach disharmony syndrome, dampness and turbid internal accumulation syndrome, qi stagnation and blood stasis syndrome, etc. 4. Professor Tian Yumei's common principles for treating liver diseases are as follows: clearing heat and detoxifying toxin, invigorating spleen and dampness, soothing liver and relieving depression, nourishing liver and kidney, activating blood circulation and removing blood stasis, regulating liver and spleen, soothing liver and spleen, clearing heat and dampness, clearing heat and nourishing yin, clearing away heat and dampness, clearing liver and reducing fire, promoting gallbladder and retreating yellow. Invigorating spleen and stomach, removing blood stasis and unblocking collaterals, etc. Professor Tian Yumei treatment of liver diseases commonly used prescriptions: Yinchen Artemisia decoction, Chaihu Shugan Powder, Xiaoyao San, Sini San, consistent decoction, Longdan Xiegan decoction, Sijunzi decoction, Zishui Qinggan drink, Yinchen Wuling Powder. 6. Professor Tian Yumei treatment of liver diseases: Bupleurum, Salvia miltiorrhiza, Tujin; Atractylodes and Magnolia; Scutellaria baicalensis and Tujin. Conclusion 1. Dampness, heat, toxin, blood stasis and depression are the main pathogenic factors of liver disease. 2. The disease is mainly located in the liver and spleen, involving gallbladder, stomach, kidney. 3. Liver disease is complex and changeable, often with a mixture of deficiency and substance. 4. Tian Lao's treatment of liver disease is often based on the principle of dispelling evil and tonifying deficiency. The main dispelling evil is clearing heat and detoxifying dampness and removing yellow and tonifying deficiency and nourishing spleen and qi and nourishing yin.
【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】：2016
【分类号】：R259;R249

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