本文關(guān)鍵詞：李德新教授辨治郁病臨床經(jīng)驗(yàn)研究　出處：《遼寧中醫(yī)藥大學(xué)》2016年碩士論文　論文類型：學(xué)位論文

  更多相關(guān)文章： 郁病 病因病機(jī) 辨證論治 經(jīng)驗(yàn)研究 李德新教授

【摘要】：目的:本文旨在總結(jié)李德新教授對(duì)郁病病因病機(jī)的認(rèn)識(shí),歸納臨床辨證思路,診治經(jīng)驗(yàn)及特色,有效的提高郁病臨床療效。材料與方法:1.通過回顧性查閱大量相關(guān)文獻(xiàn),整理古代醫(yī)家對(duì)郁病的認(rèn)識(shí)及現(xiàn)代醫(yī)家在汲取理論精華的基礎(chǔ)上借助實(shí)驗(yàn)手段研究郁病的進(jìn)展,總結(jié)發(fā)展現(xiàn)狀及存在問題,撰寫文獻(xiàn)綜述;2.跟師侍診,收集、整理、分析郁病患者病歷百余例,將經(jīng)典理論與臨床實(shí)踐相結(jié)合,總結(jié)李師對(duì)郁病病因病機(jī)的認(rèn)識(shí),臨床辨證及治療特色。結(jié)果:1.李德新教授推崇朱丹溪之六郁學(xué)說,認(rèn)為氣郁是六郁發(fā)生的前提和核心,分析郁病的病機(jī)特點(diǎn)當(dāng)從氣機(jī)升降的角度出發(fā),并應(yīng)首先辨清“病”與“郁”的對(duì)立統(tǒng)一關(guān)系。2.在辨證時(shí),一方面要辨清疾病的發(fā)展階段,分析氣郁而濕滯,濕滯而成熱,熱郁而生痰,痰滯而血不行,血滯而食不化,六郁常常相兼為患的特點(diǎn),根據(jù)每個(gè)階段的癥候特征,了解疾病的所處階段。另一方面,結(jié)合“肝為五臟之賊”易受邪而傳它臟的生理特性及五行傳變規(guī)律,通過四診合參判斷疾病的發(fā)展及轉(zhuǎn)歸,先安未受邪之地,防患于未然。3.治療上,重視脾胃與郁病發(fā)病之間的密切關(guān)系,以六郁為要,權(quán)其輕重,氣郁時(shí)以柴胡疏肝散為基礎(chǔ),化火、化熱予丹梔逍遙散,氣郁痰阻,治以半夏厚樸湯,痰郁而血不行,出現(xiàn)瘀滯之象,佐以血府逐瘀湯化裁。根據(jù)“左升右降”理論注重氣機(jī)的調(diào)暢,善于調(diào)理脾胃氣血、陰陽(yáng)、升降、燥濕,以蘊(yùn)諸腑,共達(dá)安心神之旨。4.用藥擅長(zhǎng)從脾胃入手,用白術(shù)、茯苓、甘草等助土得以升木,以培其本;根據(jù)肝臟本身的生理特征,在疏肝理氣之時(shí)注意肝陰肝血的保護(hù),巧用當(dāng)歸、芍藥等榮血養(yǎng)肝而補(bǔ)肝之體;柴胡、薄荷、升麻等辛散升發(fā)之品以順肝之性,復(fù)肝之用。5.根據(jù)脾胃的生理功能及在五臟之中的重要地位,以調(diào)理脾胃為中心多臟并調(diào),結(jié)合臟腑之間的生克制化關(guān)系,調(diào)整五臟功能及十二經(jīng)氣血,使整個(gè)機(jī)體氣機(jī)條暢,氣血沖和,郁滯自開。結(jié)論:通過對(duì)李德新教授辨治郁病的經(jīng)驗(yàn)研究,得出以下結(jié)論:1.以氣郁為要,辨清“因郁致病”或“因病致郁”,標(biāo)本緩急以治之。2.辨別疾病的所處階段、傳變、轉(zhuǎn)歸,防患于未然。3.從調(diào)脾胃而治郁的角度出發(fā),善調(diào)氣機(jī),療效顯著。4.培土以固其本,疏肝不忘柔肝,尤為注重肝陰、肝血的顧護(hù)。5.在調(diào)脾胃為中心的基礎(chǔ)上多臟并調(diào),以達(dá)氣機(jī)條暢,氣血沖和的理想狀態(tài)。
[Abstract]:Objective: This paper aims to summarize professor Li Dexin's understanding of etiology and pathogenesis of depression, summarize clinical thinking, diagnosis and treatment experience and characteristics, and effectively improve the clinical efficacy of depression. Materials and methods: 1. through retrospective consulting a number of literature, experimental research progress of depression by means of arranging ancient physicians understanding of depression and modern physicians based on absorbing the essence of the theory, and summarize the existing problems of current development, writing literature review; 2. with sommelier diagnosis, collect and analyze records of depression patients with more than 100 cases, the classic combination of theory and practice, summed up the teacher Li on the etiology and pathogenesis of depression disease, clinical diagnosis and treatment characteristics. Results: 1.. Professor Li Dexin praised Zhu Danxi's theory of "six depression". He thought that qi depression is the premise and core of the occurrence of six depression. The pathogenesis of depression is analyzed. When we start from the angle of air lift, we should first distinguish the unity of opposites between "disease" and "depression". 2., when differentiating syndromes, we should identify the development stages of diseases on the one hand, analyze the stagnation of Qi and stagnation of dampness, heat from stagnation and heat, heat stagnation and phlegm, phlegm stagnation and blood failure, blood stagnation and food consumption. Six depression is often accompanied by the characteristics of disease. According to the symptomatic characteristics of each stage, we can understand the stage of disease. On the other hand, combined with the physiological characteristics of the liver to 5 of the thief "vulnerable to evil and pass it dirty and five line transmission rules, and outcome of development through the combination of all the judgment of disease, first an unaffected evil, nip in the bud. 3. treatment, pay attention to the close relationship between the incidence of depression and spleen and stomach disease, with six Yu to the right degree of Qi when using Chaihushugansan as the foundation, fire, heat to Danzhixiaoyao powder, qi stagnation of phlegm, treated by Banxia Houpu decoction, phlegm depression and blood stasis can occur lag image, combined with Xuefuzhuyu decoction. According to the "left right up down" theory on the smooth transfer of Qi, spleen and stomach qi and blood, yin and Yang, good at lifting, dampness, in the Fu Yun, amounting to the purpose of peace of mind of god. 4. good medication from the spleen and stomach of Atractylodes, Poria, licorice and other soil to help rose wood, in order to improve the; according to the physiological characteristics of liver itself, pay attention to the protection of liver Yin liver blood in liver Qi when using angelica, peony and blood and tonifying liver and nourishing liver Rong body; bupleurum root, mint, when the goods Sansheng cohosh to shun the liver, liver with complex. 5. according to the important physiological function of the spleen and stomach and internal organs in the spleen and stomach as the center, with more dirty and adjustable, with the restraint of the relationship between the internal organs, adjust the function of internal organs and twelve by the blood, make the whole body Qi smooth, blood stasis and flushing, self opening. Conclusion: through the empirical research of Professor Li Dexin in treating depression, draws the following conclusions: 1. to Qi to discern for stagnation of pathogenic or illness caused by the depression, Biao to cure. 2. to identify the stages, changes and outcomes of the disease, and to prevent the disease. 3. from the angle of regulating spleen and stomach and treating depression, the effect of good air conditioner is remarkable. 4. in the solid earth, don't forget the liver and liver, particularly on liver yin, liver blood nursing care. 5. on the basis of regulating the spleen and stomach on the basis of many dirty and adjustable, to reach the Qi, Qi and blood flow and the ideal state.
【學(xué)位授予單位】：遼寧中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2016
【分類號(hào)】：R249;R277.7
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本文編號(hào)：1346638