本文選題：經(jīng)驗研究 + 栗德林�。� 參考：《北京中醫(yī)藥大學(xué)》2017年博士論文

【摘要】：栗德林教授學(xué)術(shù)思想與臨床經(jīng)驗總結(jié)栗德林教授是全國老中醫(yī)藥專家學(xué)術(shù)經(jīng)驗繼承工作指導(dǎo)老師,教授、主任醫(yī)師、博士生指導(dǎo)教師、博士后指導(dǎo)教師。他從事臨床醫(yī)療、教學(xué)工作50年,熟讀中醫(yī)著作,博采眾長,醫(yī)術(shù)精湛,醫(yī)德高尚,中醫(yī)基礎(chǔ)理論知識雄厚,具有豐富的臨床經(jīng)驗。他既重視繼承,又提倡發(fā)揚創(chuàng)新,逐漸形成了"重視脾腎,扶正祛邪,以辨應(yīng)變,選經(jīng)方不拘病,擇時方審病性,寒熱多態(tài)尋病位,藥研成果要巧用"的學(xué)術(shù)思想及提出應(yīng)運用生物學(xué)方法研究、用生物學(xué)語言詮釋中醫(yī)理論與臨床等創(chuàng)新思想,為實現(xiàn)中醫(yī)現(xiàn)代化做出了新的探索和新的貢獻。學(xué)術(shù)淵源:通過對導(dǎo)師影響比較大的中醫(yī)著作及名老中醫(yī)的學(xué)術(shù)思想進行研究分析,以及了解導(dǎo)師的學(xué)醫(yī)經(jīng)歷,探求栗德林教授的學(xué)術(shù)淵源。中醫(yī)典籍1《黃帝內(nèi)經(jīng)》中病因病機、辨證論治理論對栗教授學(xué)術(shù)思想的形成有指導(dǎo)意義。①審察病機,治病求本—以辨應(yīng)變,辨證精確;②陰陽失調(diào),寒熱理論—寒熱多態(tài)尋病位;③《內(nèi)經(jīng)》中對消渴病的論述對栗德林教授認(rèn)識消渴病的病因病機和治療消渴病有重要指導(dǎo)作用。2《傷寒雜病論》中的辨證論治方法、寒熱錯雜理論對栗德林教授"以辨應(yīng)變"、"選經(jīng)方不拘病"、"寒熱錯雜尋病位"學(xué)術(shù)思想的形成有深遠影響。3《醫(yī)宗金鑒》中雜病心法要訣、婦科心法要訣和外科心法要訣對栗教授臨床治療經(jīng)驗的影響重大�！夺t(yī)宗金鑒·雜病心法要訣》中辨證論治理論和選方對栗教授治療內(nèi)科雜病有重要指導(dǎo)意義。栗教授治療婦科病重視調(diào)理氣血,疏肝理氣,健脾益氣,補血活血調(diào)經(jīng),選方亦多崇《醫(yī)宗金鑒·婦科心法要訣》;《醫(yī)宗金鑒·外科心法要訣》中皮膚病論治理論和選方對栗教授治療皮膚病頗有啟發(fā)。4《溫?zé)嵴摗分行l(wèi)氣營血辨證論治理論對栗教授治療溫?zé)岵∨R床經(jīng)驗的形成起著重要的指導(dǎo)作用。5《醫(yī)林改錯》中立足于氣血辨證而創(chuàng)制的諸多逐瘀方劑,對栗教授治療瘀血證有重要指導(dǎo)意義;《醫(yī)林改錯》"靈機記性,不在心在腦"之說,對栗教授辨治情志疾病(抑郁癥)及老年性腦病(腦萎縮、老年性癡呆)頗有啟發(fā)。6《醫(yī)學(xué)衷中參西錄》中衷中參西的治學(xué)觀點和實驗研究的方法對栗教授重視發(fā)揚創(chuàng)新、提倡藥研成果要巧用的學(xué)術(shù)思想的形成產(chǎn)生了深遠的影響;書中主治"虛勞"的十全育真湯對栗教授治療慢性原發(fā)性腎小球疾病有重要啟發(fā)意義。學(xué)醫(yī)經(jīng)歷栗德林教授的學(xué)醫(yī)經(jīng)歷可概括為"三階段、七從"。"三階段"即在校階段、臨床階段、提升階段;"七從"即從書本、從實踐、從中西融合、從醫(yī)案、從科研、從教學(xué)、從時勢。這些學(xué)習(xí)經(jīng)歷對他今后學(xué)術(shù)思想的形成打下堅實基礎(chǔ),并產(chǎn)生重要的影響。名老中醫(yī)學(xué)術(shù)思想1高仲山:受高老影響,栗教授重視運用《傷寒論》及《溫?zé)嵴摗分?重視西醫(yī)理論知識的學(xué)習(xí)和運用,巧妙運用藥理研究成果,積極進行科研試驗、開發(fā)新藥。2馬驥:治療腎系疾病多以扶正祛邪為原則,標(biāo)本兼顧;治療消渴病以益氣養(yǎng)陰、活血化瘀為基礎(chǔ),根據(jù)兼證配合其他治法。3張琪:治療腎病注重整體,尤以脾腎為重,辨治疑難病癥以氣血生變?yōu)橐?于盈科:在婦科病治療中重視調(diào)理氣血,善于運用蟲類藥,選方多崇《醫(yī)宗金鑒婦科心法要訣》。5白郡符:以臟腑、經(jīng)絡(luò)、氣血辨證為基礎(chǔ),選方用藥靈活多變,影響了栗教授"以辨應(yīng)變,選經(jīng)方不拘病,擇時方審病性"學(xué)術(shù)思想的形成。栗德林教授學(xué)術(shù)思想總結(jié):1重視脾腎,扶正祛邪重視調(diào)補脾腎,扶正祛邪。2以辨應(yīng)變,辨證精確強調(diào)要在病情變化中精確辨證,才能正確立法處方,取得佳效。3選經(jīng)方不拘病,擇時方審病性強調(diào)要在辨證精確的基礎(chǔ)上選用經(jīng)方、時方。4寒熱多態(tài)尋病位寒熱錯雜證廣泛存在并且形式多樣,在辨證上應(yīng)首先辨清寒熱的病位,然后正確立法遣方。5藥研成果要巧用重視對中藥現(xiàn)代藥理研究成果的運用,既重視辨證,又重視辨病。栗德林教授臨床經(jīng)驗整理與總結(jié)(附典型醫(yī)案)1肺系疾病:急性者以六經(jīng)、衛(wèi)氣營血與三焦辨證為主,慢性者以臟腑辨證分證論治為主。治法以宣、清、降、瀉、潤、補、斂、化為主,健脾補肺,通腑相濟為用。流感分邪在肺衛(wèi)型、肺熱雍盛型、胃腸失調(diào)型、邪在營血型論治。肺癰以成癰期與潰膿期多見,治療也最為關(guān)鍵。成癰期采用清熱解毒、肅肺化瘀之法,以千金葦莖湯加味治療。2脾胃病:構(gòu)建寒熱錯雜在疾病發(fā)展變化中多態(tài)性理論治療脾胃病。慢性萎縮性胃炎以寒熱并用、辛開苦降立法,用半夏瀉心湯加減治療。潰瘍性結(jié)腸炎以補中升陽兼清熱化濕為法,以升陽益胃湯為基礎(chǔ)加減,研制出腸炎寧膠囊治療。3腎系疾病:治療腎病攻補結(jié)合。慢性原發(fā)性腎小球疾病以益氣養(yǎng)陰、活血利濕為法,以十全育真湯為基礎(chǔ)加減研制出十全育真膠囊治療。慢性腎盂腎炎以益氣補腎為主,兼祛余邪,創(chuàng)立"益腎康方"治療。難治性腎病綜合征以通絡(luò)活血、祛瘀生新、泄?jié)窠舛緸榉?方選大黃嚺蟲丸治療。4郁證:分型論治:①肝氣郁結(jié),治以柴胡疏肝散加減;②血行郁滯,治以通竅活血湯合四逆散加減;③膽郁痰擾,治以溫膽湯加減;④憂郁傷神,治以甘麥大棗湯加味;⑤心脾兩虛,治以歸脾湯加減;⑥腎虛肝郁,治以六味地黃湯合柴胡疏肝湯加減。5痹證:痹證辨治首先應(yīng)分析病位深淺,其次辨識病性,包括新久虛實,體質(zhì)差異及病邪性質(zhì),分清風(fēng)寒濕痹和熱痹的不同。風(fēng)寒濕痹用自擬二龍蠲痹湯;風(fēng)濕熱痹用當(dāng)歸拈痛湯加減;正虛濕熱用木防己湯加減;久痹腎虛用獨活寄生湯加減。6癇證:癇證以心腦神機失用為本,風(fēng)火痰瘀致病為標(biāo),尤以瘀血痰邪作祟最為重要。治療采用活血化瘀通竅、化痰豁痰通竅、疏肝柔肝熄風(fēng)、清肝鎮(zhèn)肝熄風(fēng)、益氣補血通絡(luò)之法。選方常用通竅活血湯、黃芪桂枝五物湯、補陽還五湯、礞石滾痰丸、溫膽湯。7癡呆:分型論治:①髓海不足,治以六味地黃丸加減;②氣虛血瘀,治以黃芪桂枝五物湯合補陽還五湯加減;③心肝火旺,治以龍膽瀉肝丸合牛黃清心丸(局方)加減;④痰濁阻竅,治以滌痰湯合溫膽湯加減;⑤瘀血阻竅,治以通竅活血湯加減。8脈痹(雷諾氏病):本病的發(fā)生多與血虛受寒,經(jīng)脈阻滯有關(guān),以活血補血、溫經(jīng)散寒為主要治法,以當(dāng)歸四逆湯為基礎(chǔ)方加減治療。9癭病:分型論治:①氣郁痰阻型,治以四海舒郁丸加減;②痰結(jié)血瘀型,治以海藻玉壺湯加減;③肝胃火盛型,治以梔子清肝湯合藻藥散加減;④心肝陰虛型,治以天王補心丹加減。10糖尿病及其并發(fā)癥:糖尿病基本病因病機可概括為"五臟柔弱、內(nèi)熱熏蒸、傷津耗氣、血稠液濃"。糖尿病并發(fā)冠心病病因病機為"五臟柔弱、內(nèi)熱熏蒸、傷津耗氣、血稠液濃、瘀阻痰凝",治以益氣養(yǎng)陰、活血化痰為法,方用自擬芪玄益心湯。糖尿病周圍神經(jīng)病變病因病機為"五臟柔弱、內(nèi)熱熏蒸、傷津耗氣、血稠液濃、瘀血阻絡(luò)",治以益氣養(yǎng)陰、活血通絡(luò),佐以燥濕祛痰化濁為法,方用自擬芪玄通絡(luò)湯。栗德林教授治療糖尿病用藥規(guī)律聚類分析背景:糖尿病作為一種終生進展性疾病,其防治工作面臨嚴(yán)峻挑戰(zhàn)。栗德林教授多年來潛心研究糖尿病及其并發(fā)癥的中醫(yī)藥治療,積累了豐富的臨床經(jīng)驗,其研究出自擬經(jīng)驗方,在治療糖尿病方面取得了顯著的療效。本研究收集整理了近3年來栗教授治療糖尿病的典型病例,利用頻次分析和聚類分析的方法總結(jié)其處方用藥規(guī)律。研究目的:采用數(shù)據(jù)挖掘方法分析栗德林教授治療糖尿病的治療思路和用藥規(guī)律,總結(jié)栗教授治療糖尿病的經(jīng)驗。研究方法:收集整理栗德林教授治療糖尿病的典型病例,通過數(shù)據(jù)庫對處方中使用的藥物進行頻次分析和聚類的方法分析,對栗教授治療糖尿病的經(jīng)驗進行總結(jié)。研究結(jié)果:選擇栗德林專家門診糖尿病患者80例(復(fù)診≥3次)、共計436診次的處方資料,其中單味藥使用頻率10%的中藥有29味,前5位分別為黃芪、黃連、丹參、葛根、靈芝。常用藥物中補虛藥、清熱藥、解表藥、收澀藥為常用類別,藥性中構(gòu)成比最高的為平性(31.03%),藥味中構(gòu)成比最高的為甘味(79.31%),藥物歸經(jīng)中構(gòu)成比最高的為肺經(jīng)(48.28%)。29味藥物按藥性聚為10類時臨床意義清晰。結(jié)論:通過對數(shù)據(jù)庫的挖掘,總結(jié)出自擬芪黃消渴湯為栗教授治療DM的核心處方,使用藥物多為平寒、甘苦之品,重視運用補法和清法,認(rèn)為氣陰兩虛兼燥熱血瘀為DM主要證型,以益氣養(yǎng)陰清熱、佐以活血化瘀為治療大法。三甲腎消湯治療氣陰兩虛瘀濁內(nèi)阻糖尿病腎臟病(Ⅲ～Ⅳ期)臨床研究第一部分文獻綜述(2篇):第1篇糖尿病腎臟病的現(xiàn)代醫(yī)學(xué)研究進展,對近十年來糖尿病腎臟病的發(fā)病機制、早期的診斷、西醫(yī)治療方面的研究進行回顧。第2篇中醫(yī)藥治療糖尿病腎臟病的研究進展,回顧了近十年來對糖尿病腎臟病的中醫(yī)病名探討、病因病機、辨證論治、問題與展望方面的研究。第二部分臨床研究:三甲腎消湯治療氣陰兩虛瘀濁內(nèi)阻糖尿病腎臟病(Ⅲ～Ⅳ期)臨床研究研究目的:觀察三甲腎消湯治療氣陰兩虛瘀濁內(nèi)阻糖尿病腎臟病(Ⅲ～Ⅳ期)的臨床療效及其使用的安全性。研究方法:80例患者按隨機數(shù)字表法分為對照組、治療組。對照組:基礎(chǔ)治療加洛汀新治療。治療組:基礎(chǔ)治療加三甲腎消湯治療。治療組和對照組分別治療8周。治療前后對兩組中醫(yī)癥狀體征積分、24小時尿蛋白定量、腎功能指標(biāo)、血糖、糖化血紅蛋白、血脂、血液流變學(xué)及安全性指標(biāo)進行觀察。研究結(jié)果:1、對照組的總有效率為70%,治療組的總有效率為85%,兩組比較差異有統(tǒng)計學(xué)意義(P＜0.05);2、治療組治療后CHOL、TG下降(P0.05),對照組治療后僅TG下降(P＜0.05),兩組TG下降的差值比較,有統(tǒng)計學(xué)意義(P0.05);3、治療后治療組全血低切相對粘度、全血低切還原粘度、血漿粘度、紅細(xì)胞聚集指數(shù)均下降(P0.05),對照組治療后全血低切相對粘度、血漿粘度下降(P0.05),兩組全血低切相對粘度、血漿粘度的下降差值比較,有統(tǒng)計學(xué)意義(P0.05);4、治療后兩組的24h尿蛋白定量與治療前比較均有下降,兩組下降差值比較有統(tǒng)計學(xué)意義(P0.05);5、治療組治療后血肌酐、血尿素氮較治療前下降,腎小球濾過率較治療前增加,差異有統(tǒng)計學(xué)意義(P0.05),對照組治療后腎小球濾過率、血肌酐、血尿素氮較治療前均無明顯變化(P0.05),兩組治療后血尿酸均無明顯變化;6、治療組的癥狀體征平均總積分較治療前明顯下降,有統(tǒng)計學(xué)意義(P0.05),對照組的癥狀體征平均總積分較治療前下降,但無統(tǒng)計學(xué)意義(P0.05);7、臨床觀察過程中未出現(xiàn)任何毒副作用。結(jié)論:栗德林教授經(jīng)驗方能夠明顯改善氣陰兩虛瘀濁內(nèi)阻糖尿病腎臟病(Ⅲ～Ⅳ期)患者的癥狀,顯著降低蛋白尿,改善腎功能,具有良好的安全性。
[Abstract]:Professor Li Delin's academic thought and clinical experience summed up professor chestling, a tutor, Professor, chief physician, doctoral instructor, postdoctoral instructor, and a postdoctoral instructor. He is engaged in clinical medical treatment, teaching work for 50 years. He is familiar with traditional Chinese medicine works. The basic theory is rich in knowledge and has rich clinical experience. He not only attaches importance to inheritance, but also advocates the development of innovation. He has gradually formed the academic thought of "attaching importance to the spleen and kidney, helping Zheng and dispel evil, choosing the time to be unconditional, choosing the time to examine the disease, the cold and heat polymorphic finding position, the research results should be used skillfully" and put forward to use biological methods to study and use biological language. It is a new exploration and new contribution to the realization of traditional Chinese medicine modernization. The academic origin: the research and analysis of the traditional Chinese medicine and the academic thought of the famous old Chinese medicine, and the academic history of the tutor, and the academic origin of Professor chestin, 1<. The theory of syndrome differentiation and treatment in the Yellow Emperor's internal classics has guiding significance for the formation of Professor Chestnut's academic thought. (1) examination of the pathogenesis and treatment of diseases, to distinguish the strain, and to distinguish the accurate; (2) the misalignment of yin and Yang, the cold and heat theory of cold and heat polymorphisms, and the discussion on the etiology, pathogenesis and treatment of Professor chestin's thirst disease in the inner Sutra Xiaoke disease has an important guiding role in the theory of syndrome differentiation and treatment in the theory of.2< typhoid and miscellaneous diseases. The theory of cold and heat miscellaneous miscellaneous theory has a profound influence on the academic thought of "identifying the strain", "choosing the classics to be ill" and "cold and hot miscellaneous finding the disease position", which has a profound influence on the heart law key of the.3< medical Zong Jinjian, the key formula of the heart law of the Department of gynaecology and the key of the surgical heart law to Professor Li Delin. The effect of bed treatment experience is very important. The theory of syndrome differentiation and treatment in the key to the heart law of miscellaneous diseases has important guiding significance to the treatment of medical miscellaneous diseases in Chinese medicine. Professor chestnut treats gynecologic diseases and attaches great importance to regulating qi and blood, dispersing the liver and regulating qi, strengthening the spleen and enriching qi, enriching blood and activating blood and regulating menstruation. The theory of Dermatology and treatment of dermatology in the theory of Dermatology and the selected prescription for the treatment of skin diseases by Professor chestnut, the theory of febrile fever in.4< > the theory of syndrome differentiation of Qi and blood in the middle Wei Qi Ying Xue's theory on the formation of the clinical experience of febrile diseases in Professor chestnut The treatment of blood stasis has important guiding significance; < medical forest error > > "spiritual memory, no heart in the brain", Professor Chestnut's identification and treatment of emotional diseases (depression) and senile encephalopathy (brain atrophy, senile dementia) is quite enlightening to the middle and western study viewpoint and experimental research method in.6< medicine. It is important for Professor chestnut to treat chronic primary glomerular disease. The experience of Professor Li dlin's medical experience can be summed up as "three stages, seven from". "Three stages", at the school stage, clinical stage, Seven from the book, from the book, from the practice, from the Chinese and Western integration, from the medical case, from the scientific research, from the teaching to the current situation. These learning experiences have laid a solid foundation for the formation of his future academic thought and have an important influence. The famous old Chinese traditional Chinese medicine academic thought 1 Gao Zhongshan: under the influence of high old, Professor chestnut attaches importance to the use of the theory of typhoid and warm heat. According to the study and application of the theoretical knowledge of Western medicine, the results of pharmacological research are skillfully used, the scientific research experiment is actively carried out, and the new medicine.2 Ma Ji is developed. The treatment of kidney diseases is mainly based on the principle of eliminating evil and eliminating evil. The treatment of thirst disease is based on Supplementing Qi and nourishing Yin, promoting blood circulation and removing stasis, and combining with the other treatment methods, according to the syndrome, the treatment of kidney disease is focused on the whole, especially the whole, especially nephrosis. Especially the whole disease. The spleen and kidney is heavy, and the diagnosis and treatment of the difficult disease with Qi and blood is changed into.4. In the treatment of gynecopathy, it pays attention to regulating qi and blood, and is good at using insect medicine. The selection side is more highly praised for the >.5 white county character of the gynecologic center of gynaecology: Based on the viscera, meridian, Qi and blood, the selection prescription is flexible and changeable. The academic thought of "choosing the timing of the disease" is a summary of the academic thought of Professor randlin: 1 to pay attention to the spleen and kidney, to attach importance to the spleen and kidney, to pay attention to the spleen and kidney of the spleen, to correct the.2 in order to distinguish the strain, and to accurately emphasize the exact differentiation of the disease in the condition of the disease, and to obtain the right legislative prescription, to obtain the good effect of.3 to choose the classics, and to emphasize the accuracy of the syndrome differentiation and accuracy. On the basis of it, the syndrome of cold and heat disorder of the.4 cold and heat polymorphism is widely existed and varied in form. In the syndrome differentiation, the disease position of cold and heat should be identified first, and then the correct legislation for.5 research results should be used to use the modern pharmacological research results of traditional Chinese medicine. 1 lung diseases were collated and summed up (with typical medical cases): the acute one was based on six meridians, Wei Qi camp blood and three focal syndrome differentiation, and the chronic patients were mainly treated with syndrome differentiation and differentiation of Zang Fu organs. The treatment method was used in Xuan, Qing, descending, diarrhea, moistening, supplementing and converging. The lung carbuncle is more common in the period of carbuncle and depuration, and the treatment is also the most important. The treatment of carbuncle by clearing heat and detoxification, eliminating the blood stasis and treating.2 spleen and stomach disease with Qianjin reed stem soup is used to Treat Spleen and stomach disease. The treatment of ulcerative colitis with supplementing Yang and clearing heat and humidities with Shengyang Yigan Decoction on the treatment of.3 kidney disease: treatment of kidney disease and tapping and supplementing. Chronic primary glomerular diseases are treated with nourishing qi and nourishing Yin, activating blood and dampness, and taking Shiquan Zhen Tang as the basis and reducing the treatment of Shiquan Yu Zhen capsule. The treatment of chronic pyelonephritis is mainly to replenish qi and nourish the kidney and establish "Yishen Kang Fang" treatment. Refractory nephrotic syndrome is treated with dredging collaterals and activating blood, removing blood stasis and relieving detoxification as a method. The treatment of.4 depression syndrome: (1) liver qi stagnation, treatment with Radix Bupleuri, stagnation of liver and stagnation of blood, treatment with Tongqiao Huoxue Decoction and four converse powder Plus and subtract; (3) cholera phlegm disturbing, treatment with Wendan soup plus or minus; (4) melancholy and injury, treated with manmai zizzao soup plus flavor; 5 heart spleen two deficiency, treatment with Guipi Decoction plus subtraction, kidney deficiency liver depression, treatment with six flavour of Rehmannia soup combined with Chaihu Shugan soup.5 arthralgia syndrome: arthralgia syndrome differentiation and treatment first should be analyzed the depth of the disease, secondly identification of the disease, including new long and real, physical differences and pathogenic evil nature Quality, divide the wind cold wet arthralgia and heat arthralgia. The rheumatism and damp arthralgia with the self-made two dragon Juan Juan soup; rheumatism and heat arthralgia with Danggui Tong Tong Decoction plus subtract; the deficiency and damp heat use the wooden prevention soup to add and subtract; the long arthralgia kidney deficiency with the single live parasitic soup adds and subtract the.6 epilepsy syndrome: the epilepsy syndrome is lost the heart and the phlegm and blood stasis to be the mark, especially the blood stasis phlegm evil is most important. The treatment mining is most important. The method of activating blood and removing blood stasis, eliminating phlegm and phlegm, clearing the liver and extinguishing the wind, clearing the liver to extinguish the wind, improving Qi and enriching blood and dredging the blood and collaterals of blood, enriching the blood and enriching the blood and dredging the blood and collaterals of the Qi, huangqi and cinnamon branch, the five soup of the Huangqi and cinnamon branch, the Five Decoction of tonifying stone, the.7 dementia of the Wendan soup, the treatment of the deficiency of the medullary sea, the addition and subtraction of the six flavored Rehmannia pills, and the Qi deficiency and blood stasis, five Astragalus cinnamon branch Material soup combined Buyang five soup addition and subtraction; (3) the heart liver fire flourishing, treatment with dragon gentian Xie Gan pill combined with Niuhuang Qingxin pill (bureau) to add and subtract; (4) phlegm turbidity obstructing orifices, treatment with polyester phlegm soup combined with Wendan Decoction; stasis of Blood Stasis Decoction, treatment with Tongqiao activating blood soup to reduce.8 pulse Bi (Reno's disease): the occurrence of this disease is mostly with blood deficiency cold, meridian block related, blood activating blood, warm meridian spread cold On the basis of the main treatment, the treatment of.9 gall disease with Danggui four reverse decoction was treated as a basis for treatment: (1) qi stagnation and phlegm resistance type, treatment with Sihai Shu Yu pill plus reduction; (2) phlegm knot blood stasis type, treatment with seaweed jade kettle soup; (3) liver stomach fire type, treatment with gardenia Qinggan soup combined alga medicine; 4. Complications: the basic pathogenesis of diabetes can be summed up as "five dirty weak, internal heat fumigation, injury of oxime gas, thick liquid thick liquid". The pathogenesis of diabetes complicated with coronary heart disease is "five dirty weak, internal heat fumigation, injury of oxaline gas, thick liquid, blood stasis phlegm coagulation", treatment with nourishing qi and nourishing Yin, activating blood and phlegm, using self-made Qi Xuan Yixin soup. Diabetic peripheral neuropathy. The pathogenesis is "five dirty weak, internal heat fumigation, injuring oxaline consumption, thick liquid, blood stasis obstructing collaterals", treatment with nourishing qi and nourishing Yin, activating blood and dredging collaterals, using the method of drying dampness, eliminating phlegm and removing turbidity, using self-made Qi Xuan Tongluo soup. In recent years, Professor chestling has studied the TCM treatment of diabetes and its complications and has accumulated rich clinical experience. This study has made a significant effect on the treatment of diabetes. This study collects and collates the typical cases of Professor chestnut in treating diabetes in the past 3 years. The method of clustering analysis was used to summarize the rule of prescription drug use. The purpose of this study was to use data mining method to analyze the treatment ideas and rules of treatment of diabetes by Prof. chestin, and to summarize the experience of Professor chestnut in the treatment of diabetes. The experience of Professor chestnut in the treatment of diabetes was summed up by the analysis of frequency analysis and clustering method. The results were as follows: 80 cases of diabetic patients in chestnut specialist outpatient (more than 3 times) were selected, with a total of 436 times of the prescription, of which 10% of traditional Chinese Medicine had 29 flavors and the first 5 were Astragalus, Rhizoma Coptidis, Salvia miltiorrhiza, and pueraria lobata. Ganoderma lucidum. It is commonly used in commonly used drugs, heat clearing drugs, antipyretic drugs, and astringent drugs as the most common categories. The composition of the drug is the highest level (31.03%), the highest in the drug taste is sweetness (79.31%), and the highest ratio of the drug to the meridian is the clear clinical significance of the lung meridian (48.28%).29 flavors in accordance with the drug property. To sum up the core prescription of Professor chestnut in the treatment of DM by Professor Li Qi Huang Xiaoke soup, the use of drugs mostly flat cold, bitter taste, pay attention to the use of supplementation and clear method, think that Qi Yin deficiency and dryness heat blood stasis is the main syndrome type of DM, with nourishing Qi Nourishing Yin Clearing Heat and promoting blood circulation and removing blood stasis as treatment Dafa. The first part of the clinical study of urinary nephrotic disease (stage III to IV): the first part of the literature review (2): the progress in the modern medical research of first diabetic kidney diseases, review the pathogenesis, early diagnosis and Western medicine treatment of diabetic kidney disease in the last ten years. The research progress of second Chinese medicine in the treatment of diabetic kidney disease is reviewed. Ten years of diabetes kidney disease of Chinese medicine name, pathogenesis, pathogenesis, syndrome differentiation, problems and prospects of research. The second part of clinical study: three a kidney elimination soup treatment of Qi Yin deficiency and stagnation of kidney disease (stage III to IV) clinical study of kidney disease (stage III to IV): observation of three a kidney elimination Decoction for the treatment of Qi Yin deficiency and stagnation of internal resistance diabetes kidney The clinical efficacy and safety of the disease (stage III to IV). Study methods: 80 patients were divided into the control group, the treatment group, the control group, the control group, the base therapy gallulin new treatment. The treatment group was treated with the basic treatment and the three nail kidney elimination decoction. The treatment group and the control group were divided into 8 weeks. The symptoms and signs of the two groups of Chinese medicine were accumulated before and after the treatment. 24 hours urine protein quantitative, renal function index, blood sugar, glycated hemoglobin, blood lipid, blood rheology and safety indexes. The results were as follows: 1, the total effective rate of the control group was 70%, the total effective rate of the treatment group was 85%, and the two groups were statistically significant (P < 0.05); 2, the treatment group was reduced (P0.05) after treatment (P0.05), and the control group. After treatment, only TG decreased (P < 0.05), and the difference of TG in two groups was statistically significant (P0.05); 3, after treatment, the whole blood in the treatment group was relatively low cut and relatively sticky.
【學(xué)位授予單位】：北京中醫(yī)藥大學(xué)
【學(xué)位級別】：博士
【學(xué)位授予年份】：2017
【分類號】：R249;R259

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