本文關(guān)鍵詞： 扶陽派 醫(yī)案 用藥規(guī)律 不同地域　出處：《廣州中醫(yī)藥大學(xué)》2017年博士論文　論文類型：學(xué)位論文

【摘要】：目的:本次研究立足于不同地域扶陽派醫(yī)家的醫(yī)案,對(duì)其用藥規(guī)律作出研究,結(jié)合扶陽派著作及《傷寒論》理論加以整合分析,比較不同地域扶陽派醫(yī)家用藥的共同與差異、綜合歸納其用藥思路與規(guī)律,為臨床辨證論治、遣方用藥提供思路,盼能有助扶陽理論在不同地域得到進(jìn)一步的推廣。方法:理論研究:運(yùn)用文獻(xiàn)計(jì)量學(xué)方法,對(duì)不同地域扶陽派醫(yī)家學(xué)術(shù)思想進(jìn)行研究的文獻(xiàn)、書籍進(jìn)行搜索、歸納、整理。分析中醫(yī)期刊文獻(xiàn)中對(duì)扶陽派用藥規(guī)律的認(rèn)識(shí)。此外,又通過對(duì)扶陽派專著的研究,總結(jié)扶陽派的核心扶陽辨證思維及用藥思維。醫(yī)案研究:收集6個(gè)地域的10位醫(yī)家共284個(gè)醫(yī)案進(jìn)行數(shù)據(jù)分析,醫(yī)家分別為:盧崇漢(四川)、范中林(四川)、唐步祺(四川)、吳佩衡(云南)、顧樹祥(云南)、傅文錄(河南)、李統(tǒng)華(河南)、祝味菊(上海)、李可(山西)、張存悌(遼寧)。運(yùn)用統(tǒng)計(jì)軟件,對(duì)所得數(shù)據(jù)進(jìn)行描述性分析、推斷性分析和數(shù)據(jù)挖掘,對(duì)不同地域的醫(yī)案的藥物配伍、方證關(guān)系、藥證關(guān)系、加減思路等進(jìn)行比較分析。結(jié)果:1.文獻(xiàn)研究部份:全面搜索中國學(xué)術(shù)期刊全文數(shù)據(jù)庫(CNM)、知網(wǎng)數(shù)據(jù)庫(CNKI)與扶陽派用藥規(guī)律相關(guān)的文獻(xiàn)共113篇,當(dāng)中屬理論探討的共48篇,醫(yī)家學(xué)術(shù)思想分析的共27篇,醫(yī)案賞析的共15篇,方證探討的共8篇,用藥劑量探討的共5篇,臨床研究的共3篇,藥理研究的1篇;含有統(tǒng)計(jì)數(shù)據(jù)的用藥規(guī)律研究共6篇。統(tǒng)計(jì)結(jié)果顯示與扶陽派用藥相關(guān)的文獻(xiàn)從2004年起出現(xiàn)并逐步增多,至2011年達(dá)到高峰21篇后文獻(xiàn)數(shù)目逐步回落至2015年的4篇,可見研究扶陽派用藥方面的相關(guān)文獻(xiàn)有減少跡象。而過去研究扶陽派的文獻(xiàn)大部份為理論研究,少有包含統(tǒng)計(jì)數(shù)據(jù)的研究,也未有提出地域因素對(duì)扶陽派用藥的影響。2.醫(yī)案研究部份:收納研究醫(yī)案284個(gè),包含137個(gè)病種;錄入癥狀174個(gè),累計(jì)頻數(shù)2190次;錄入藥物217種,累計(jì)頻數(shù)2804次;錄入舌象17種,累計(jì)頻數(shù)737次;錄入脈象18種,累計(jì)頻數(shù)622次。通過統(tǒng)計(jì)分析可知不同地域扶陽派醫(yī)家用藥共同特點(diǎn)(1)擅用姜桂附(2)善用經(jīng)方(3)少用苦寒藥物(4)常配伍健脾化濕藥。不同地域扶陽派醫(yī)家用藥的不同點(diǎn):四川醫(yī)家:(1)用藥精煉(2)廣用四逆湯、麻黃附子細(xì)辛湯(3)少用滋陰藥(4)善用溫?zé)崴幹委煼蜗挡�。云南醫(yī)家:(1)用藥精煉(2)廣用四逆湯、麻黃附子細(xì)辛湯(3)肉桂的特殊用法(4)獨(dú)創(chuàng)新方。河南醫(yī)家:(1)活血化瘀藥的應(yīng)用(2)善于融合各扶陽派醫(yī)家之經(jīng)驗(yàn)(3)善用溫潛法(4)不忌用補(bǔ)陰藥(5)獨(dú)創(chuàng)新方。上海醫(yī)家:(1)用藥量輕(2)善用溫潛法(3)廣用理氣化濕藥。山西醫(yī)家:(1)藥量偏大,藥味較多(2)多用補(bǔ)腎藥(3)善用溫潛法(4)不忌用補(bǔ)陰藥(5)獨(dú)創(chuàng)新方。遼寧醫(yī)家:(1)善于融合各扶陽派醫(yī)家之經(jīng)驗(yàn)。結(jié)論:研究結(jié)果顯示,各地域的扶陽醫(yī)家的用藥都有其顯著異別,受到三大因素所影響:(1)地域因素(2)師承因素(3)時(shí)代因素,而出現(xiàn)不同的用藥規(guī)律和特色。說明扶陽理論能夠在不同的地域,經(jīng)過適當(dāng)?shù)恼{(diào)整后發(fā)揮其優(yōu)勢(shì)。只要不脫離辨證論治的原則,不問病因病機(jī)而濫用附子,扶陽派醫(yī)理相信是可以在全國甚至全世界通行的。
[Abstract]:The purpose of this research is based on the different regions of Fuyang sent doctors medical case, make a study of the drug laws, school books and treatise on the theory of integration of < > analysis combined with the Fuyang, compare the different Fuyang sent physicians of the drug together with differences, summarized its drug ideas and rules for clinical treatment based on syndrome differentiation prescription, provide ideas, hoping to help Fuyang theory further in different regions. Methods: theoretical research: using the method of bibliometrics, in different areas of Fuyang school academic thought of doctors research literature, books for search, induction, consolidation. Analysis of the understanding of drug laws of Fuyang school Chinese Journal of literature. In addition, through the study of Fu Yang sent a book, send the summary Fuyang core Fuyang dialectical thinking and medication thinking. Case study: 10 physicians from 6 regions and a total of 284 medical records for data analysis, Doctors are: Lu Chonghan (Sichuan), Fan Zhonglin (Sichuan), Tang Buqi (Sichuan), Wu Peiheng (Yunnan), Gu Shuxiang (Yunnan), Fu Wenlu (Henan), Li Tonghua (Henan), to Weiju (Shanghai), Li Ke (Shanxi), Zhang Cunti (Liaoning). Using statistical software, descriptive analysis of income data analysis and data mining, inference, drug compatibility, different regions of medical prescription and syndrome relationship, prescription, and ideas were compared and analyzed. Results: 1. literature research part: comprehensive search Chinese Academic Journal Full-text Database (CNM), CNKI database (CNKI) and Fuyang School of literature related to drug law a total of 113 articles, which belongs to the theory of the total of 48, analysis of the doctor's academic thought consists of 27 parts, a total of 15 cases of the syndrome, to a total of 8, a total of 5 doses of clinical research, a total of 3 papers, 1 papers of pharmacological research; medication compliance with statistical data. The law of a total of 6 articles. The statistical results show and Fuyang sent the drug related documents from 2004 to 2011 and gradually increased, reached a peak in 21 after a number of literature gradually declined to 4 in 2015, the related literature of Fuyang sent medication visible have reduced signs. In the past research of Fu Yang school most of the literature is the theoretical research, few studies have included statistical data, also did not put forward regional factors on the Fuyang send medication effect of.2. case study: 284 cases included studies, including 137 disease symptoms; input 174, cumulative frequency 2190 times; input 217 kinds of drugs, the cumulative frequency of 2804 times; the entry of tongue as of 17, the cumulative frequency of 737 times; 18 kinds of input pulse, cumulative frequency 622 times. Through statistical analysis of different regions of Fu Yang sent physicians of the drug (1) using common ginger Guifu (2) by use of (3) with less bitter cold drugs (4) is often combined with spleen 婀胯嵂.涓嶅悓鍦板煙鎵墮槼媧懼尰瀹剁敤鑽殑涓嶅悓鐐，

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