王士贞教授从肝脾论治耳鸣的理论与临床用药研究
发布时间：2019-05-10 19:34
【摘要】：目的：耳鸣居耳科三大难题(耳鸣、耳聋、耳眩晕)之首。由于耳鸣的发病机制尚不明确,西医对此仍缺乏有效的治疗手段。中医对耳鸣的证型和治疗认识也存在很多分歧,同时疗效也有不如人意之处。在多年的临床实践中,导师王士贞教授对中医药治疗耳科疑难病积累了相当丰富的经验,尤其擅长从肝脾论治耳鸣。本研究旨在总结和整理王教授治疗耳鸣的常用中医用药规律以及中医药理论和学术思想,总结出一套中医临床安全有效的诊疗经验和方法,能够更好地促进中医临床疗效的提高,充分发挥中医治疗耳鸣的特色与优势。方法：本研究包括三个部分。第一部分是文献研究,主要是通过文献查阅和整理,总结出目前耳鸣在中西医病因机制和治疗手段方面的进展。第二部分是总结王士贞教授治疗耳鸣病的学术思想和临床经验。第三部分是以回顾性研究的方式,随机收集200例在王士贞教授就诊的耳鸣患者的首次就诊处方,将收集到的资料进行数据整理并输入计算机,运用Microsoft Office Excel软件进行统计分析。从用药频次、功效、归经、药性方面进行用药、组方的统计,从而总结出王士贞教授治疗耳鸣的用药和组方规律,分析其学术经验；另一方面,从中医理论的角度讨论和分析耳鸣与肝脾的生理病理关系和密切程度。结果：在第一部分的文献研究中,我们发现现代的名医专家很多都主张从肝或从脾论治耳鸣,认为肝胆或脾胃的功能失调是引起耳鸣的重要病机。在第二部分的经验总结中,王士贞教授认为耳鸣病的辨证应以中医整体观念为指导思想,以脏腑经络学说为理论基础,指出耳鸣病的发生主要责于肝脾。同时还特别重视中医外治法、针灸疗法和通窍法治的应用；王教授还擅长运用经方和对药治疗耳鸣,尤其还对耳鸣病的发病机制和中医治疗有着丰富的经验。第三部分,通过对耳鸣处方统计分析,发现王士贞教授治疗耳鸣侧重于使用具有健脾、养血、疏肝、通窍的药物,同时这些药物的归经也多以如肝、脾经为主,药性也侧重于温性和平性。最常用的耳鸣治疗经验方为柴胡、白芍、香附、川芎、葛根、石菖蒲、益智仁、黄芪(五爪龙)、党参、甘草。另一方面,无论是耳的生理功能及特点、耳与肝脾的生理关系、从肝脾认识耳鸣病因病机、肝脾之间的生理病理关系还是耳鸣病因与肝脾的关系等几方面,从中医理论分析发现,耳鸣与肝脾都有着密不可分的关系。结论：本研究验证了王士贞教授从肝脾论治耳鸣的学术思想,以调和肝脾作为治疗耳鸣的关键,而情志不畅、饮食不节、劳倦过度是引起肝脾失调引发或加重耳鸣的三个重要因素。大量临床病案也显示从肝脾论治耳鸣的疗效确切,值得临床推广。
[Abstract]:Objective: tinnitus is the first of three difficult problems (tinnitus, deafness and dizziness). Because the pathogenesis of tinnitus is not clear, western medicine still lacks effective treatment. There are also many differences in the understanding of syndrome type and treatment of tinnitus in traditional Chinese medicine, and the curative effect is not satisfactory. In the clinical practice for many years, Professor Wang Shizhen, his mentor, has accumulated a wealth of experience in the treatment of difficult otological diseases with traditional Chinese medicine, especially good at treating tinnitus from the point of view of liver and spleen. The purpose of this study is to summarize and sort out the law of traditional Chinese medicine used in the treatment of tinnitus by Professor Wang, as well as the theory and academic thought of traditional Chinese medicine, and to sum up a set of experiences and methods of clinical safety and effective diagnosis and treatment of traditional Chinese medicine. It can better promote the improvement of clinical curative effect of traditional Chinese medicine and give full play to the characteristics and advantages of traditional Chinese medicine in the treatment of tinnitus. Methods: this study consists of three parts. The first part is the literature research, mainly through the literature review and collation, summed up the current tinnitus in the etiological mechanism and treatment of traditional Chinese and western medicine progress. The second part is to summarize Professor Wang Shizhen's academic thought and clinical experience in the treatment of tinnitosis. In the third part, the first prescription of 200 patients with tinnitus treated in Professor Wang Shizhen was collected by retrospective study. The collected data were collected and input into the computer, and the data were analyzed by Microsoft Office Excel software. From the frequency of drug use, efficacy, meridian, medicinal properties of the use of drugs, group statistics, so as to sum up Professor Wang Shizhen treatment of tinnitus drugs and prescription rules, analysis of its academic experience; On the other hand, the physiological and pathological relationship and close degree between tinnitus and liver and spleen are discussed and analyzed from the point of view of traditional Chinese medicine theory. Results: in the first part of the literature study, we found that many modern famous medical experts advocated the treatment of tinnitus from the liver or spleen, and considered that the dysfunction of liver, gall, spleen and stomach was an important pathogenesis of tinnitus. In the second part of the experience, Professor Wang Shizhen thought that the syndrome differentiation of tinnitosis should be guided by the overall concept of traditional Chinese medicine and based on the theory of Zang-fu-meridian theory, and pointed out that the main responsibility for the occurrence of tinnitosis was on the liver and spleen. At the same time, special attention is paid to the application of external treatment of traditional Chinese medicine, acupuncture and moxibustion, and the rule of law through the passage of the orifice. Professor Wang is also good at treating tinnitus with classics and drugs, especially in the pathogenesis and treatment of tinnitus with rich experience in the pathogenesis and treatment of tinnitus. In the third part, through the statistical analysis of tinnitus prescription, it is found that Professor Wang Shizhen's treatment of tinnitus focuses on the use of drugs with spleen invigorating, nourishing blood, soothing the liver and dredging orifice. At the same time, the meridians of these drugs are mainly liver and spleen meridians. The medicine also focuses on warmth and peace. The most commonly used prescription for tinnitus treatment is Bupleurum, Paeonia lactiflora, Xiangfu, Ligusticum chuanxiong, Pueraria lobata, Acorus calamus, Yizhiren, Astragalus membranaceus (five claw Dragon), Codonopsis pilosula and Glycyrrhiza uralensis Fisch. On the other hand, no matter the physiological function and characteristics of the ear, the physiological relationship between the ear and the liver and spleen, the understanding of the etiology and pathogenesis of tinnitus from the liver and spleen, the physiological and pathological relationship between the liver and spleen, and the relationship between the etiology of tinnitus and the liver and spleen, From the analysis of traditional Chinese medicine theory, it is found that tinnitus and liver and spleen are closely related. Conclusion: this study verifies Professor Wang Shizhen's academic thought of treating tinnitus from liver and spleen, and takes reconciling liver and spleen as the key to the treatment of tinnitus, but the emotion is not smooth and the diet is not good. Overwork is the three important factors causing or aggravating tinnitus caused by liver and spleen disorders. A large number of clinical records also show that the treatment of tinnitus from the liver and spleen is effective and worthy of clinical promotion.
【学位授予单位】：广州中医药大学
【学位级别】：博士
【学位授予年份】：2016
【分类号】：R249;R276.1
本文编号：2473940
[Abstract]:Objective: tinnitus is the first of three difficult problems (tinnitus, deafness and dizziness). Because the pathogenesis of tinnitus is not clear, western medicine still lacks effective treatment. There are also many differences in the understanding of syndrome type and treatment of tinnitus in traditional Chinese medicine, and the curative effect is not satisfactory. In the clinical practice for many years, Professor Wang Shizhen, his mentor, has accumulated a wealth of experience in the treatment of difficult otological diseases with traditional Chinese medicine, especially good at treating tinnitus from the point of view of liver and spleen. The purpose of this study is to summarize and sort out the law of traditional Chinese medicine used in the treatment of tinnitus by Professor Wang, as well as the theory and academic thought of traditional Chinese medicine, and to sum up a set of experiences and methods of clinical safety and effective diagnosis and treatment of traditional Chinese medicine. It can better promote the improvement of clinical curative effect of traditional Chinese medicine and give full play to the characteristics and advantages of traditional Chinese medicine in the treatment of tinnitus. Methods: this study consists of three parts. The first part is the literature research, mainly through the literature review and collation, summed up the current tinnitus in the etiological mechanism and treatment of traditional Chinese and western medicine progress. The second part is to summarize Professor Wang Shizhen's academic thought and clinical experience in the treatment of tinnitosis. In the third part, the first prescription of 200 patients with tinnitus treated in Professor Wang Shizhen was collected by retrospective study. The collected data were collected and input into the computer, and the data were analyzed by Microsoft Office Excel software. From the frequency of drug use, efficacy, meridian, medicinal properties of the use of drugs, group statistics, so as to sum up Professor Wang Shizhen treatment of tinnitus drugs and prescription rules, analysis of its academic experience; On the other hand, the physiological and pathological relationship and close degree between tinnitus and liver and spleen are discussed and analyzed from the point of view of traditional Chinese medicine theory. Results: in the first part of the literature study, we found that many modern famous medical experts advocated the treatment of tinnitus from the liver or spleen, and considered that the dysfunction of liver, gall, spleen and stomach was an important pathogenesis of tinnitus. In the second part of the experience, Professor Wang Shizhen thought that the syndrome differentiation of tinnitosis should be guided by the overall concept of traditional Chinese medicine and based on the theory of Zang-fu-meridian theory, and pointed out that the main responsibility for the occurrence of tinnitosis was on the liver and spleen. At the same time, special attention is paid to the application of external treatment of traditional Chinese medicine, acupuncture and moxibustion, and the rule of law through the passage of the orifice. Professor Wang is also good at treating tinnitus with classics and drugs, especially in the pathogenesis and treatment of tinnitus with rich experience in the pathogenesis and treatment of tinnitus. In the third part, through the statistical analysis of tinnitus prescription, it is found that Professor Wang Shizhen's treatment of tinnitus focuses on the use of drugs with spleen invigorating, nourishing blood, soothing the liver and dredging orifice. At the same time, the meridians of these drugs are mainly liver and spleen meridians. The medicine also focuses on warmth and peace. The most commonly used prescription for tinnitus treatment is Bupleurum, Paeonia lactiflora, Xiangfu, Ligusticum chuanxiong, Pueraria lobata, Acorus calamus, Yizhiren, Astragalus membranaceus (five claw Dragon), Codonopsis pilosula and Glycyrrhiza uralensis Fisch. On the other hand, no matter the physiological function and characteristics of the ear, the physiological relationship between the ear and the liver and spleen, the understanding of the etiology and pathogenesis of tinnitus from the liver and spleen, the physiological and pathological relationship between the liver and spleen, and the relationship between the etiology of tinnitus and the liver and spleen, From the analysis of traditional Chinese medicine theory, it is found that tinnitus and liver and spleen are closely related. Conclusion: this study verifies Professor Wang Shizhen's academic thought of treating tinnitus from liver and spleen, and takes reconciling liver and spleen as the key to the treatment of tinnitus, but the emotion is not smooth and the diet is not good. Overwork is the three important factors causing or aggravating tinnitus caused by liver and spleen disorders. A large number of clinical records also show that the treatment of tinnitus from the liver and spleen is effective and worthy of clinical promotion.
【学位授予单位】：广州中医药大学
【学位级别】：博士
【学位授予年份】：2016
【分类号】：R249;R276.1
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1 何伟平;王士贞教授从肝脾论治耳鸣的理论与临床用药研究[D];广州中医药大学;2016年
，本文编号：2473940
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