發(fā)布時(shí)間：2018-01-17 12:27

  本文關(guān)鍵詞：畢朝忠運(yùn)用益氣升陽(yáng)法臨床經(jīng)驗(yàn)總結(jié)　出處：《成都中醫(yī)藥大學(xué)》2016年碩士論文　論文類(lèi)型：學(xué)位論文

  更多相關(guān)文章： 畢朝忠 益氣升陽(yáng) 學(xué)術(shù)經(jīng)驗(yàn) 臨床研究

【摘要】：目的：畢朝忠主任中醫(yī)師,1966年畢業(yè)于貴陽(yáng)中醫(yī)學(xué)院,曾任江西國(guó)營(yíng)七二礦職工醫(yī)院中醫(yī)科主任、業(yè)務(wù)副院長(zhǎng),1991年至1998年任重慶市沙坪壩區(qū)中醫(yī)院任業(yè)務(wù)副院長(zhǎng)、院長(zhǎng)。曾任重慶市沙坪壩區(qū)第九屆政協(xié)委員,重慶市沙坪壩區(qū)醫(yī)藥學(xué)會(huì)副會(huì)長(zhǎng),重慶市中西醫(yī)結(jié)合學(xué)會(huì)理事,重慶市中醫(yī)學(xué)會(huì)熱病專(zhuān)委,重慶市中醫(yī)高級(jí)職稱(chēng)評(píng)審委員會(huì)委員。2000年評(píng)選為重慶市名中醫(yī)。2003年任重慶市首批老中醫(yī)藥專(zhuān)家學(xué)術(shù)繼承工作指導(dǎo)老師。從醫(yī)四十載,孜孜求索,勤求古訓(xùn),博采眾方,以中醫(yī)內(nèi)科、兒科、皮膚科見(jiàn)長(zhǎng),在治療肺系疾病、腎臟疾病、脾胃疾病、心腦疾病、皮膚疾病等方面頗有建樹(shù)。畢朝忠老師臨床中以望、聞、問(wèn)、切四診為本,結(jié)合現(xiàn)代診療手段,辯證與辯病相結(jié)合,學(xué)術(shù)上注重整體觀念,治病必求其本,臨床療效好；其深諳李東垣益氣升陽(yáng)法的運(yùn)用,臨證善用升陽(yáng)益胃湯、補(bǔ)中益氣湯等益氣升陽(yáng)方劑治療諸多常見(jiàn)病、疑難病,其法師古而不泥古,加減時(shí)有神來(lái)之筆,往往能立起沉疴。曾在《中醫(yī)雜志》、《中國(guó)中醫(yī)急癥》、《新中醫(yī)》等發(fā)表論文20余篇,自擬方“宣肺止咳合劑”,作為院內(nèi)制劑廣泛運(yùn)用于臨床,療效確切,該項(xiàng)目的臨床及實(shí)驗(yàn)研究,獲1996年重慶市衛(wèi)生科技進(jìn)步三等獎(jiǎng)。本論文主要通過(guò)對(duì)畢朝忠主任中醫(yī)師的臨床醫(yī)案進(jìn)行整理研究,通過(guò)系統(tǒng)的整理、挖掘、研究,收集整理畢老臨證運(yùn)用益氣升陽(yáng)法的臨床寶貴資料,探索一種主觀與客觀相結(jié)合的方法,深入挖掘畢朝忠老師運(yùn)用益氣升陽(yáng)法治療常見(jiàn)病、疑難病的學(xué)術(shù)經(jīng)驗(yàn)和診療規(guī)律,較為客觀地總結(jié)畢老臨證運(yùn)用益氣升陽(yáng)法加減規(guī)律的臨床經(jīng)驗(yàn),為進(jìn)一步推廣其學(xué)術(shù)經(jīng)驗(yàn)和發(fā)展創(chuàng)新提供理論依據(jù),促進(jìn)畢朝忠老中醫(yī)學(xué)術(shù)經(jīng)驗(yàn)的繼承和發(fā)揚(yáng)。方法：通過(guò)系統(tǒng)的文獻(xiàn)復(fù)習(xí),對(duì)古代和現(xiàn)代中醫(yī)學(xué)家對(duì)益氣升陽(yáng)法資料疾病的著作和經(jīng)典醫(yī)案進(jìn)行整理,系統(tǒng)總結(jié)益氣升陽(yáng)法現(xiàn)代研究進(jìn)展和近現(xiàn)代益氣升陽(yáng)法臨床應(yīng)用現(xiàn)狀與趨勢(shì),闡述益氣升陽(yáng)法的治療疾病的重要意義,為臨床研究提供重要的理論依據(jù)。通過(guò)對(duì)畢朝忠老師2012年8月至2015年6月臨床運(yùn)用益氣升陽(yáng)法治療疾病的100例回顧性門(mén)診病例資料和200例前瞻性病例資料進(jìn)行收集、整理,建立數(shù)據(jù)信息庫(kù),用數(shù)據(jù)挖掘的方法,應(yīng)用數(shù)據(jù)挖掘軟件Spss clmentine,采用頻數(shù)法、聚類(lèi)法、相關(guān)性分析等手段對(duì)畢朝忠老中醫(yī)運(yùn)用益氣升陽(yáng)法治療相關(guān)疾病的治法治則、臨床療效和用藥頻次進(jìn)行分析處理研究,總結(jié)出其證候診斷思路、基本方及加減用藥規(guī)律,進(jìn)一步總結(jié)名老中醫(yī)學(xué)術(shù)思想和提高運(yùn)用益氣升陽(yáng)法的臨床療效。運(yùn)用深度訪談的研究方法探討數(shù)據(jù)挖掘結(jié)果中隱含的學(xué)術(shù)思想內(nèi)涵。深度訪談的研究在數(shù)據(jù)統(tǒng)計(jì)與挖掘的基礎(chǔ)上進(jìn)行,其內(nèi)容圍繞挖掘的結(jié)果與數(shù)據(jù)統(tǒng)計(jì),以名老中醫(yī)畢朝忠的觀點(diǎn)為主,結(jié)合運(yùn)用中醫(yī)理論知識(shí)分析判斷進(jìn)行。訪談的內(nèi)容圍繞畢朝忠老中醫(yī)運(yùn)用益氣升陽(yáng)法的臨床體會(huì)、用藥經(jīng)驗(yàn)、辨證思路、以往的科研成果、發(fā)表的論文、論著以提交紙質(zhì)文檔請(qǐng)其審閱批改的方式進(jìn)行,每次訪談結(jié)束后及時(shí)加以總結(jié)。訪談的內(nèi)容逐漸深入,從辨證方法、辨證思維模式、藥物配伍特點(diǎn)、對(duì)藥應(yīng)用經(jīng)驗(yàn)、經(jīng)方應(yīng)用體會(huì)、臨床療效總結(jié)到最終概括出畢朝忠名老中醫(yī)運(yùn)用益氣升陽(yáng)法的臨證經(jīng)驗(yàn)。結(jié)果：運(yùn)用數(shù)據(jù)挖掘技術(shù)分析得出畢朝忠老師治療常見(jiàn)病善用益氣升陽(yáng)法,其數(shù)據(jù)結(jié)果如下：1.運(yùn)用頻次法分析得出畢朝忠老中醫(yī)在治療常見(jiàn)病是最常使用的方劑有升陽(yáng)益胃湯、補(bǔ)中益氣湯、升陽(yáng)散火湯以及歸脾湯加減。2.運(yùn)用頻次法分析得出畢朝忠老師在相關(guān)疾病治療中了；臨床最常用的藥物有黃芪、白術(shù)、黨參(人參、太子參)、甘草、陳皮、法半夏、當(dāng)歸、茯苓、川芎、防風(fēng)、羌活、獨(dú)活、威靈仙、葛根、黃連、柴胡、白芍、黃芩、神曲、麥芽、谷芽、山楂、雞內(nèi)金、何首烏、丹參、枸杞、鉤藤、砂仁、川木香等27味,使用頻次均在50%以上,用藥的特點(diǎn)具有健脾、運(yùn)脾、除濕、理氣、化痰、平肝、升陽(yáng)、散火、活血等功效。充分驗(yàn)證了畢朝忠老師益氣升陽(yáng)、重視脾胃的學(xué)術(shù)經(jīng)驗(yàn)。3.通過(guò)復(fù)雜系統(tǒng)熵聚類(lèi)分析方法得到的畢朝忠老師益氣升陽(yáng)的核心藥物組合為：參+白術(shù)+黃芪為健脾益氣常用組合；陳皮+半夏為化痰理氣常用組合；防風(fēng)、羌活、獨(dú)活、柴胡、升麻、威靈仙、葛根為升陽(yáng)常用組合。結(jié)論：1.畢朝忠老中醫(yī)在常見(jiàn)病的診治中深受李東垣、施今墨及貴州名中醫(yī)石玉書(shū)的影響,善用大處方,雖藥品繁多,但搭配配合得體,法度嚴(yán)謹(jǐn),毫無(wú)繁瑣冗贅之感。他強(qiáng)調(diào)脾胃的重要,注重調(diào)理脾胃,不僅從脾胃入手治療多種疾病,而且在治療疾病的同時(shí)不忘顧護(hù)脾胃。2.畢朝忠老師重視人體的整體動(dòng)態(tài)平衡,并結(jié)合重慶地區(qū)地理、氣候因素,提出脾胃失調(diào)、痰濕內(nèi)停、陽(yáng)氣閉郁為重慶地區(qū)常見(jiàn)病多發(fā)的主要病機(jī),治療上需注重顧護(hù)脾胃、調(diào)整陰陽(yáng)、扶正糾偏、益氣升陽(yáng)。其益氣升陽(yáng)的學(xué)術(shù)經(jīng)驗(yàn),反映了重慶地區(qū)常見(jiàn)病發(fā)病的病機(jī)特點(diǎn),對(duì)臨床有很好的指導(dǎo)意義。3.畢朝忠老師的“益氣升陽(yáng)法”治療常見(jiàn)病的經(jīng)驗(yàn)療效滿(mǎn)意,并長(zhǎng)于使用風(fēng)藥,強(qiáng)調(diào)調(diào)整氣機(jī)的升降和出入,值得推廣和應(yīng)用。4.通過(guò)數(shù)據(jù)挖掘技術(shù)整理畢朝忠老師的益氣升陽(yáng)學(xué)術(shù)經(jīng)驗(yàn),揭示了畢朝忠老師的遣方用藥規(guī)律,印證了畢老師顧護(hù)脾胃、調(diào)整氣機(jī)升降出入、益氣升陽(yáng)的的學(xué)術(shù)經(jīng)驗(yàn),充分說(shuō)明計(jì)算機(jī)技術(shù)在整理名老中醫(yī)學(xué)術(shù)經(jīng)驗(yàn)中具有重要意義。
[Abstract]:Objective: Bi Zhaozhong, director of Chinese medicine, graduated from Guiyang College of Traditional Chinese Medicine in 1966, served as director of the Department of traditional Chinese medicine of Jiangxi No. 72 mine workers hospital, vice president of business, 1991 to 1998, Shapingba District Hospital of Chongqing city served as vice president, Dean of business. He served in the Chongqing District of Shapingba City, the ninth session of the CPPCC National Committee, vice president of the Chongqing District of Shapingba City, the Institute of medicine. Institute of Chongqing traditional Chinese medicine, Chongqing Academy of traditional Chinese medicine fever special commission, Chongqing Chinese senior assessment committee.2000 named the Chongqing city Chongqing City, the first Chinese.2003 years old Chinese medicine experts in the academic inheritance to guide the work of teacher. Doctor forty years, diligently seeking, ground for old, from aspects, based on traditional Chinese Medicine Department of Pediatrics, Department of Dermatology and in the treatment of lung disease, kidney disease, stomach disease, cardiovascular disease, skin disease and other clinical successes. Bi Zhaozhong teacher In order to look, smell, ask, cut four oriented, combined with modern treatment methods, the combination of dialectical and argue disease academic attention to the overall concept, this will seek medical treatment, clinical curative effect is good; the well versed in Li Dongyuan Yiqi Shengyang method, clinical use of shengyangyiwei decoction, Buzhongyiqi decoction, Yiqi Shengyang the prescription difficult disease to treat many diseases, and the master of the ancient and not imitation, and have often set up an inspired passage, ills. In "Journal of traditional Chinese Medicine >, < < New > Chinese emergency medicine, Chinese Medicine > and published more than 20 papers, since" xuanfeizhike mixture ", as in the hospital agents are widely used in clinical, curative effect, clinical and experimental research of the project, third-prize won the 1996 Chongqing Health Science and technology progress. This thesis mainly through the clinical medical records of Bi Zhaozhong, director of Chinese medicine for research, through the system arrangement, mining, research, collection of Bi Lao syndrome The clinical use of valuable information Yiqi Shengyang method, explore a method combining subjective and objective, in-depth excavation of Bi Zhaozhong teacher treatment of common diseases by Reinforcing Qi, academic experience and rule of diagnosis and treatment of difficult diseases, objectively summarize Bi Lao's clinical experience in the use of the clinical method of Reinforcing Qi Decoction, and provide a theoretical basis for further to promote the academic experience and innovation, promote the inheritance and development of the academic experience of Bi Zhaozhong old Chinese medicine. Methods: through literature review, the ancient and modern medical works of Yiqi Shengyang disease and classical medical data collation, systematically summarize the modern research progress of modern law and Reinforcing Qi reinforcing Qi clinical application method with the trend, this paper expounds the significance of the method of Yiqi Shengyang disease treatment, provide important theoretical basis for clinical research. Based on the Bi direction of Zhong Lao From August 2012 to June 2015 normal treatment in clinical application of 100 cases of disease by Yiqi Shengyang retrospective clinic cases and 200 cases of prospective data collection, collation, establishment of data base, data mining method, application of data mining software Spss clmentine, using the frequency method, clustering analysis, correlation analysis and other means of old Chinese Bi Zhaozhong treatment of related diseases by Reinforcing Qi method rule, clinical efficacy and drug use frequency analysis research, summed up the basic ideas of syndrome diagnosis, and the prescription law, further summarizes the old Chinese academic thought and improve the clinical curative effect of Yiqi Shengyang study method. Using the method of depth interview data mining results the connotation of implicit academic thought. Based on the statistics and data mining research in depth interviews on the content around the mining results and The statistical data in old Chinese medicine Bi Zhaozhong's point of view, combined with the use of theoretical knowledge of traditional Chinese medicine. The interview content analysis on clinical experience, Bi Zhaozhong old Chinese medicine experience using Yiqi Shengyang method, dialectical thinking, previous research results, published papers, works to submit a paper document please review the correct way. Every time after the end of the interview time is summarized. The interview content gradually, from the dialectical method, dialectical thinking mode, characteristics of drugs, drug application experience, experience in clinical application of classical prescriptions, finally summarizes the total node to complete Zhaozhong old Chinese medicine use method of Yiqi Shengyang clinical experience. Results: the data mining analysis the teacher Bi Zhaozhong treatment of common diseases using Yiqi Shengyang method, the results are as follows: 1. using frequency analysis method in traditional Chinese medicine in the treatment of Bi Zhaozhong disease is the most common The frequently used prescriptions with shengyangyiwei decoction, Buzhongyiqi decoction, shengyangsanhuo Decoction and Guipi Decoction on.2. using frequency analysis method in the treatment of diseases related to teacher Bi Zhaozhong; the most commonly used clinical drugs with Astragalus, Atractylodes, Codonopsis (Radix ginseng, Radix Pseudostellariae), liquorice, tangerine peel, pinellia tuber, angelica, poria, chuanxiong, Fangfeng, angelica, notopterygium, Radix Clematidis, radix puerariae, Rhizoma Coptidis, Radix Paeoniae Alba, Radix Scutellariae, Radix Bupleuri, medicated leaven, malt, rice malt, hawthorn, Gallus gallus, Polygonum multiflorum, Salvia miltiorrhiza, medlar, uncaria, Amomum, Kawa Kika and other 27 kinds, the frequency of use of drugs were more than 50%, has the characteristics of spleen, spleen, dampness, Qi, phlegm, calming the liver, sun, scattered fire, blood and other effects. Fully verify the teacher Bi Zhaozhong Yiqi Shengyang drug combination, core academic experience.3. the stomach through a complex system entropy clustering analysis method to get the Bi Zhaozhong teacher for Yiqi Shengyang: Ginseng + + Astragalus Atractylodes For the common combination of Spleen Qi + phlegm and Qi for Pinellia; peel common combination; wind, notopterygium, angelica, bupleurum, Cimicifuga, Clematis chinensis, Radix Puerariae for sun common combination. Conclusion: 1. Bi Zhaozhong old Chinese medicine in diagnosis and treatment of common diseases by Li Dongyuan, Shi Jinmo and Guizhou in the medical stone Yushu, use the prescription, though the drug is various, but with proper collocation, testimonies rigorous, no cumbersome feeling. He stressed that the redundancy of the spleen and stomach, pay attention not only from the spleen and stomach, spleen and stomach treatment of diseases, but also in the treatment of diseases at the same time did not forget the nursing care of the spleen and stomach.2. Bi Zhaozhong teachers pay more attention to the overall dynamic balance of human body, and combined with the Chongqing geographical, climatic factors the spleen and stomach, disorder, phlegm stop, Yang obstruction is the main pathogenesis of common diseases in Chongqing multiple treatment, need to focus on the nursing care of the spleen and stomach, regulating yin and Yang, Fu is correct, the Qi Reinforcing Qi. The sun's academic experience, reflect the disease pathogenesis characteristic in Chongqing area, to have a good clinical significance of.3. Bi Zhaozhong's "Yiqi Shengyang law" treatment of common disease experience satisfactory curative effect, and longer than the use of wind medicine, emphasize the adjustment of the air lift and entry, it is worthy of promotion and application of.4. through the data mining consolidation Bi Zhaozhong teacher Yiqi Shengyang academic experience, reveals the rules of prescriptions after Zhaozhong teacher, Mr. Bi confirmed the spleen and stomach qi is adjusted, the Yiqi Shengyang academic experience shows that computer technology plays an important role in the consolidation of old Chinese academic experience.

【學(xué)位授予單位】：成都中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2016
【分類(lèi)號(hào)】：R249;R242

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