本文關(guān)鍵詞：于凱成教授治療冠心病及心臟神經(jīng)官能癥的臨證經(jīng)驗(yàn)挖掘研究　出處：《長春中醫(yī)藥大學(xué)》2016年碩士論文　論文類型：學(xué)位論文

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【摘要】：目的:總結(jié)于凱成教授治療冠心病及心臟神經(jīng)官能癥的臨床診療經(jīng)驗(yàn)和思辨特點(diǎn),使名老中醫(yī)工作經(jīng)驗(yàn)更好的傳承和發(fā)揚(yáng),為年輕醫(yī)生提供豐富的臨床診療經(jīng)驗(yàn),進(jìn)一步提高對冠心病及心臟神經(jīng)官能癥的治療水平。方法:收集于凱成教授以2014年11月-2015年12月于凱成教授門診患者,冠心病合格病例總數(shù)為209例,722診次;心臟神經(jīng)官能癥合格病例總數(shù)為327例,共1079診次。通過名老中醫(yī)醫(yī)案管理系統(tǒng)進(jìn)行數(shù)據(jù)采集,直接將采集的病例導(dǎo)入到當(dāng)代名老中醫(yī)議案分析挖掘系統(tǒng)中進(jìn)行挖掘,經(jīng)分析的結(jié)果再次與于老探討并總結(jié)其診療經(jīng)驗(yàn)、思辨特點(diǎn)及用藥規(guī)律。結(jié)果:327名冠心病患者的辨證分型結(jié)果顯示氣陰兩虛、心血瘀阻居多,其次是腎陰虧虛、腎虛血瘀、痰阻血瘀;治法主要以養(yǎng)陰、化瘀、通絡(luò)、益氣為主要治法,補(bǔ)腎、清熱、除煩、止痛等法也常見;心臟神經(jīng)官能癥的分析辨證結(jié)果為:腎陰虧虛為主,腎虛血瘀、肝郁氣滯也頗為常見證型;治法主要以補(bǔ)腎、除煩、滋陰、清熱為主要治法,常見的還有安神、寧心、活血、化瘀、解郁、疏肝治法等。冠心病用藥出現(xiàn)頻次排名前30名的藥有:黃芪、丹參、川芎、百合、麥冬、太子參、白芍、山茱萸、地龍、生牡蠣、淫羊藿、酸棗仁、生龜板、生龍骨、熟地黃、青皮、紅花、郁金、葛根、當(dāng)歸、合歡花等藥物為主;其性味選擇甘溫最多,歸經(jīng)主要?dú)w肝經(jīng)。心臟神經(jīng)官能癥用藥出現(xiàn)頻次排名前30名的藥有:百合、熟地黃、青皮、生牡蠣、山茱萸、生龜板、葛根、生龍骨、丹參、地龍、白芍、酸棗仁、合歡花、川芎、夜交藤、枸杞子、淫羊藿、磁石、天麻、宧蘞草、骨碎補(bǔ)、珍珠母、土鱉蟲、郁金、杜仲、遠(yuǎn)志等藥物為主;其性味選擇甘平最多,歸經(jīng)主要?dú)w肝經(jīng)。結(jié)論:于凱成教授診療冠心病常以氣陰兩虛、心血瘀阻為多見,用藥特色于老認(rèn)為安神方能養(yǎng)陰血,用補(bǔ)陽藥以陽中求陰,使滋陰而不膩,加以補(bǔ)氣藥使氣機(jī)升降出入運(yùn)行暢通,氣行則血行,血行則瘀散,通則不痛的特點(diǎn);治療心臟神經(jīng)官能癥常以滋補(bǔ)腎陰為主,用藥特色為從腎論治,利用腎主沖任,肝腎同源、乙癸同源、精血同源為特點(diǎn),心腎關(guān)系(精血關(guān)系),心血依賴于腎之陰精的補(bǔ)充,則常用滋補(bǔ)腎陰藥物來治療本病。
[Abstract]:Objective: to summarize the clinical diagnosis and treatment experience of Professor Yu Kaicheng in the treatment of coronary heart disease and cardiac neurosis, so as to better inherit and carry forward the working experience of famous old Chinese medicine. To provide a wealth of clinical experience for young doctors. To further improve the treatment of coronary heart disease and cardiac neurosis. Methods: professor Yu Kaicheng from November 2014 to December 2015 in the outpatient clinic. The total number of eligible cases of coronary heart disease was 722; The total number of qualified cardiac neurosis cases was 327, a total of 1079 visits. The collected cases were directly introduced into the analysis and mining system of the motion of famous old Chinese medicine. The results of the analysis were again discussed with the elderly and summarized their experience in diagnosis and treatment. Results the results of syndrome differentiation of 327 patients with coronary heart disease showed that deficiency of qi and yin, blood stasis of heart, deficiency of kidney yin, blood stasis of kidney, phlegm and blood stasis; The main methods of treatment are nourishing yin, removing blood stasis, unblocking collaterals, benefiting qi, tonifying the kidney, clearing away heat, removing annoyance, relieving pain and so on. The results of analysis and differentiation of cardiac neurosis are as follows: deficiency of kidney yin, deficiency of kidney and blood stasis, stagnation of liver and qi are common syndromes; The main treatment method is to tonify the kidney, except vexation, nourishing yin, clearing heat as the main treatment method, the common treatment is also tranquilizing the mind, calming the heart, activating blood circulation, removing stasis, relieving depression, soothing the liver, and so on. The drugs in the top 30 of the frequency of the treatment for coronary heart disease are: astragalus membranaceus (Astragalus membranaceus). Salvia miltiorrhiza, Chuanxiong, Lily, Ophiopogon, Radix Pseudostellariae, Radix Paeoniae Alba, Fructus Corni, Rhizoma Rehmanniae, Raw Oyster, Epimedium, Sweet Jujube Kernel, Turtle Plate, Raw keel, ripe Rehmannia, Green Peel, Red Flower, Tujin, Pueraria root, The main drugs such as acacia flower; The most frequently used drugs for cardiac neurosis are lily, ripe Rehmannia glutinosa, green skin, raw oyster, Cornus officinalis, tortoise shell, pueraria root and keel. Salvia miltiorrhiza, Rhizoma Rehmanniae, Radix Paeoniae Albiziae, Jujube seed, Ligusticum chuanxiong, Rhizoma Lycii, Herba Epimedii, Magnolium, Gastrodia elata, Ampelopsis japonica, Dioscorea chinensis, Tulip, Eucommia ulmoides, Radix Polygoni and so on; Conclusion: professor Yu Kaicheng often treats coronary heart disease with deficiency of qi and yin, blood stasis of heart and blood stasis, and the medicine is characterized by the old thought that the formula of soothing the spirit can nourish yin and blood. The characteristics of invigorating Yang and seeking yin in yang, nourishing yin but not greasy, making Qi machine move up and down and running smoothly, blood flow, blood stasis, and general principle are not painful; The treatment of cardiac neurosis is usually based on nourishing the kidney yin. The characteristics of medication are from the kidney, using the kidney, liver and kidney, liver and kidney, and essence and blood as the characteristics, and the relationship between heart and kidney (essence and blood). The heart blood depends on the supplement of the kidney yin essence, then it is commonly used to nourish the kidney yin medicine to treat this disease.
【學(xué)位授予單位】：長春中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2016
【分類號】：R249;R259

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