本文關(guān)鍵詞：糖尿病腎病的古今用藥思維研究　出處：《北京中醫(yī)藥大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

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【摘要】：目的:糖尿病腎病是糖尿病的常見并發(fā)癥,屬于傳統(tǒng)醫(yī)學(xué)"腎消"的范疇,中藥在其治療上發(fā)揮著不可替代的作用。本文以糖尿病腎病為研究對象,系統(tǒng)收集古今方劑,統(tǒng)計(jì)分析古今治療糖尿病腎病的用藥特點(diǎn)和配伍規(guī)律,對比古今治療原則及配伍用藥的不同,以期對臨床運(yùn)用中藥治療糖尿病腎病提供參考。方法:以《中華醫(yī)典》、中醫(yī)世家網(wǎng)絡(luò)數(shù)據(jù)庫為檢索途徑,檢索治療糖尿病腎病的古代方劑;以中國知網(wǎng)、萬方數(shù)據(jù)庫、維普數(shù)據(jù)庫、中國學(xué)術(shù)會議論文全文數(shù)據(jù)庫、中國學(xué)位論文全文數(shù)據(jù)庫作為檢索庫檢索現(xiàn)代治療糖尿病腎病的方劑。運(yùn)用基本的統(tǒng)計(jì)方法統(tǒng)計(jì)各個(gè)時(shí)期藥物的性味、功效類別使用頻次、劑量及在總藥物中的占比,統(tǒng)計(jì)各個(gè)時(shí)期使用頻次較高的藥物;分析歸納各個(gè)時(shí)期糖尿病腎病的治療原則及用藥規(guī)律。結(jié)果:從整體來看,明代以前治療糖尿病腎病的藥物以溫性藥居多,溫性、寒性比例相差不大,平性藥使用較少;明代至清及民國時(shí)期治療糖尿病腎病使用寒性藥超過溫性藥,平性藥的使用較少;現(xiàn)代治療糖尿病腎病使用寒性藥與溫性藥的比例差距不大,平性藥較少。從藥味來講,古代治療糖尿病腎病以甘味藥使用最多,在各朝代均遠(yuǎn)遠(yuǎn)超過其他各味藥,甘寒藥、甘溫藥、甘平藥的使用頻次占比均較多,且三者差距不明顯;苦味藥使用其次,其中苦寒藥的占比最大,且整體呈增加趨勢;辛味藥和酸味藥的使用占比較甘味藥和苦味藥小,清及民國時(shí)期酸溫藥物使用超過辛溫藥的比例;現(xiàn)代治療糖尿病腎病以甘味藥最多,其次為苦味藥,其中甘平藥、甘溫藥、苦寒藥的頻次及劑量較多,甘寒藥占比較古代減少,辛味藥和酸味藥占比較甘味藥和苦味藥少。從藥物功效角度講,古代和現(xiàn)代均以補(bǔ)益藥的使用最多,清熱藥其次,收澀藥和去濕藥的使用也占到一定比例。其中補(bǔ)益藥的使用頻次占比在清及民國時(shí)期使用最多;清熱藥的使用在明代以后增多,至現(xiàn)代使用頻次占比又有所下降;收澀藥的使用在宋金元時(shí)期占比最大,其他各個(gè)時(shí)期較均勻,祛濕藥的使用在清及民國時(shí)期使用最少,現(xiàn)代使用較多;而活血藥使用現(xiàn)代遠(yuǎn)遠(yuǎn)超過古代�？傮w來看,古代治療糖尿病腎病注重滋補(bǔ)腎之元?dú)�、精�?清熱養(yǎng)陰,兼以利水、固腎;而宋金元時(shí)期更加注重腎的陰陽雙補(bǔ),明清時(shí)期則注重補(bǔ)益氣血�，F(xiàn)代治療糖尿病腎病以補(bǔ)益脾腎、清熱化瘀,兼以利水、固腎為整體治療思路。結(jié)論:古今治療糖尿病腎病的思路相近,均以補(bǔ)氣滋腎、養(yǎng)陰清熱,兼以利水固腎為治療思路,但具體用藥上有差別�，F(xiàn)代治療糖尿病腎病在繼承前人經(jīng)驗(yàn)的基礎(chǔ)上結(jié)合現(xiàn)代醫(yī)學(xué)研究結(jié)果,對于古代治療的用藥思維在傳承的基礎(chǔ)上又有所發(fā)展。
[Abstract]:Objective: diabetic nephropathy is a common complication of diabetes, which belongs to the category of "kidney elimination" in traditional medicine, and Chinese medicine plays an irreplaceable role in its treatment. Taking diabetic nephropathy as the research object, this paper systematically collects ancient and modern prescriptions, and statistically analyzes the medication characteristics and compatibility rules of ancient and modern treatment of diabetic nephropathy, contrasts the difference between ancient and modern treatment principles and compatibility, so as to provide reference for clinical application of traditional Chinese medicine to treat diabetic nephropathy. Methods: the "Chinese medical classics", Chinese family network database retrieval, the retrieval of ancient prescription in the treatment of diabetic nephropathy; to Chinese CNKI, Wanfang database, VIP database, China academic conference papers database, China dissertations full text database as prescription retrieval database retrieval of modern treatment of diabetic nephropathy. The basic statistics method was used to analyze the sex odor, efficacy category, frequency and dosage of drugs in different periods and the proportion in total drugs. The drugs with high usage frequency in different periods were analyzed. The principles and rules of medication in different stages of diabetic nephropathy were analyzed and summarized. Results: Overall, the Ming Dynasty before drug treatment of diabetic nephropathy with warm medicine mostly, warm and cold sex ratio had little difference, peaceful property of drug use less; the Ming Dynasty to the Qing and the Republic of the treatment of diabetic nephropathy using cold medicine more than warm drugs, drug use less flat; little gap between the proportion of modern treatment diabetic nephropathy using cold drugs and warm drugs, even less medicine. From the formula, the ancient treatment of diabetic nephropathy with sweet medicine use most in all dynasties are far more than other drugs, cold medicine, sweet medicine, sweet medicine Ganping use frequency were accounted for more, and the gap between the three is not obvious; the use of bitter cold medicine secondly, which accounted for the largest, and the whole increased use of drugs and medicine; pungent sour and bitter sweet medicine accounted for a relatively small drug, Qing and the Republic of the acid temperature medication use over the proportion of modern medicine drugs; treatment of diabetic nephropathy with sweet medicine most, followed by bitter medicine, including medicine, sweet medicine, gamping cold medicine frequency and dose more, Gansu cold medicine accounted for relatively ancient reduction, pungent drugs and sour sweet herbs and bitter medicine accounted for relatively little medicine. From the perspective of drug efficacy, the use of tonifying drugs is the most used in ancient and modern times, followed by antipyretic drugs, and the use of astringent drugs and dehumidifiers also accounts for a certain proportion. One of the most frequently used tonic than that used in the Qing and the Republic of China; the use of heat clearing drugs increased in the Ming Dynasty, to the modern frequency of use and the proportion descended; use astringent drug in the Song Jinyuan era, the largest proportion of each period, the other is uniform, Qushi drug use in the Qing Dynasty and the Republic of China use at least, the use of more modern and modern medicine; blood use far more than the ancient. Overall, the ancient treatment of diabetic nephropathy, kidney nourishing Qi on blood, Yin heat, and water, solid kidney; and Song Jinyuan time pay more attention to kidney nourishing yin and Yang, Ming and Qing Dynasties focus on tonifying qi and blood. The modern treatment of diabetic nephropathy is to replenishing spleen and kidney, clearing heat and removing blood stasis, and Taking Lishui and kidney as a whole treatment. Conclusion: the thought of treating diabetic nephropathy in ancient and modern times is similar, and all of them are treated with nourishing qi and nourishing kidney, nourishing yin and clearing heat, and using Li Shui to fix the kidney as the treatment idea, but the specific drug use is different. The modern treatment of diabetic nephropathy is based on previous experience and modern medical research results.
【學(xué)位授予單位】：北京中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R259

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