温胆汤治疗痰火扰心心悸的证治规律的探讨

发布时间：2019-02-21 08:52

【摘要】：目的：通过现代科学的方法收集整理温胆汤治疗心悸的文献,确立温胆汤治疗心悸的主治病证和药物配伍以及现代方证的要点,以更加准确的应用于临床实践。方法：通过文献收集温胆汤治疗心悸的经验资料,对主治疾病典型指征以及用药加味等方面进行归纳、分析、统计以探讨其辨治规律指导临床应用。结果：1.痰火扰心型心悸以50-59岁年龄段的患者发病率最高。女性患者比男性患者多。2.温胆汤治疗心悸的主症是：心悸,不寐,胸闷,纳差,眩晕,烦燥,口苦；温胆汤治疗心悸的兼症是：疲劳,气短,恶心,痞满,口渴,汗出,尿赤黄,便秘,便溏。3.温胆汤治疗心悸的舌象为舌质红,苔黄腻、薄黄或黄厚；脉象为数脉、弦脉、滑脉这三部脉象的组合,以脉弦数、脉滑数为主。4.温胆汤用药以寒、温、平性药物最为多见,在加味药中以补虚药的应用最多,而安神药次之。补虚药中,以甘草,白术补气药用得最多。在安神药中,以远志,酸枣仁养心安神药为应用最多的药物。5.温胆汤的加味药归经上以肝、脾、胃最为常见。结论1.本研究在立足于近代温胆汤治疗心悸医案资料的基础上,建立了温胆汤治疗中医证候信息数据、方药信息数据和一般资料之数据。各种数据解读其中蕴含信息,为温胆汤资料心悸的证候和方药规律奠定了基础。2.痰火扰心型心悸中女性患者比男性患者多。在各个年龄段均可出现心悸,以50-59岁年龄段的患者为发病率最高。3.温胆汤治疗心悸的主症是：心悸,不寐,胸闷,纳差,眩晕,烦燥,口苦；温胆汤治疗心悸的兼症是：疲劳,气短,恶心,痞满,口渴,汗出,尿赤黄,便秘,便溏。4.温胆汤治疗心悸的舌象为舌质红,苔黄腻、薄黄或黄厚；脉象为数脉、弦脉、滑脉这三部脉象的组合,以脉弦数、脉滑数为主。5.温胆汤用药以寒、温、平性药物最为多见,但治疗应“凉而不遏,温而不热”为宜。6.在加味药中以补虚药的应用最多,而安神药次之。补虚药中,以甘草,白术补气药用得最多。在安神药中,以远志,酸枣仁养心安神药为应用最多的药物。在本研究过程中,可以发现很多时候用温胆汤治疗心悸的加减方剂多数以温胆汤合方的形式出现的,这些方剂大多选取主要药物配伍入温胆汤方中,故能体现所合之方的特点以及在新组方剂中发挥最大的功效。7.以上研究为温胆汤的治疗提供了依据,使临床实践更为准确。
[Abstract]:Objective: to collect and sort out the literature on the treatment of palpitation with Wendan decoction by modern scientific method, and to establish the main treatment syndrome, the compatibility of medicine and the key points of modern prescription syndrome for the treatment of palpitation by Wendan decoction, so as to apply it more accurately in clinical practice. Methods: through collecting the experience data of Wendan decoction in treating palpitation, the typical indications of main diseases and the modified drugs were summarized and analyzed, and the clinical application was discussed by statistics. Results: 1. The incidence of phlegm-fire disturbing heart palpitations was the highest in 50-59 years old patients. There are more women than men. The main symptom that Wendan decoction treats palpitations is: palpitation, insomnia, chest tightness, dysphoria, dizziness, irritability, bitter mouth; Wendan decoction treating palpitation is fatigue, shortness of breath, nausea, fullness, thirst, sweating, urine red yellow, constipation, loose stools. Wendan decoction treatment of palpitation tongue for tongue red, fur yellow greasy, thin yellow or Huang Hou; pulse number of pulse, string pulse, smooth pulse these three pulse combination, to pulse string number, pulse slip number mainly. 4. Wendan decoction is used in cold, warm and flat medicine, and tonifying deficiency medicine is the most used in the added medicine, followed by tranquilizing medicine. In tonifying deficiency medicine, licorice, Atractylodes macrocephala tonify qi medicinal most. In the medicine of tranquilizing spirit, Yuan Zhi, Zizyphus jujuba kernel nourishing heart and tranquilizing spirit medicine are the most used drugs. 5. Wendan decoction added medicine to the liver, spleen, stomach is the most common. Conclusion 1. Based on the medical records of modern Wendan decoction treating palpitations, the information data of TCM syndromes, the information data of prescription drugs and the data of general data were established in this study. A variety of data interpretation of the information contained therein, for the data of Wendan decoction palpitation syndromes and prescription law laid a foundation. 2. There are more women than men in phlegm and fire disturbing heart palpitations. Palpitations can occur in all age groups, with the highest incidence in the 50-59 age group. The main symptom that Wendan decoction treats palpitations is: palpitation, insomnia, chest tightness, dysphoria, dizziness, irritability, bitter mouth; Wendan decoction treats palpitations of heart palpitations with symptoms: fatigue, shortness of breath, nausea, fullness, thirst, sweating, urine redness and yellow, constipation, loose stools. Wendan decoction treatment of palpitation tongue for tongue red, fur yellow greasy, thin yellow or Huang Hou; pulse number of pulse, string pulse, smooth pulse these three pulse combination, to pulse string number, pulse slip number mainly. 5. Wendan decoction used in cold, warm, flat drugs is the most common, but the treatment should be "cool and not repress, warm but not hot" is appropriate. 6. In addition, tonifying medicine is the most, followed by tranquilizing drugs. In tonifying deficiency medicine, licorice, Atractylodes macrocephala tonify qi medicinal most. In the medicine of tranquilizing spirit, Yuan Zhi, Zizyphus jujuba kernel nourishing heart and tranquilizing spirit medicine is the most used medicine. In the course of this study, it can be found that most of the addition and subtractive prescriptions used in the treatment of palpitation with Wendan decoction are in the form of Wendan decoction, and most of these prescriptions are mixed into Wendan decoction. Therefore, can reflect the characteristics of the formula and in the new formulation to play the greatest effect. 7. The above research provides the basis for the treatment of Wendan decoction and makes the clinical practice more accurate.
【学位授予单位】：黑龙江中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R256.21

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