本文關鍵詞： 痤瘡 中醫(yī) 證素 用藥規(guī)律 文獻研究　出處：《山西中醫(yī)學院》2016年碩士論文　論文類型：學位論文

【摘要】：目的:基于現代文獻的回顧性研究,歸納探討?zhàn)畀徶嗅t(yī)證候分布特點、證素分布特點及組合規(guī)律、臨床基本用藥特點,為痤瘡的進一步規(guī)范化研究和臨床治療提供參考。方法:課題采用文獻回顧性研究方法,在中國學術期刊全文數據庫(CNKI)中檢索近20年關于中醫(yī)藥治療痤瘡的相關文獻,參照納入標準和排除標準,選出合格文獻;在納入的文獻中提取證型、證素及臨床用藥等信息并進行量化,建立數據庫,利用統(tǒng)計軟件,進行頻數、頻率、構成比的描述性統(tǒng)計分析,并聯(lián)系中醫(yī)理論進行概括、分析。結果:1.本課題入選文獻72篇,涉及到的證候名稱有72種,經過合并整理,共歸納出痤瘡的證候類型48種,其中常見證型有肺經風熱型、胃腸濕熱型、痰瘀互結型、肺胃蘊熱型、脾胃濕熱型、沖任不調型。2.提取出證候要素共21個,分別為病位證素8個:肺、胃、肝、脾、大腸、腎、胞宮、心;病性證素13個:熱(火)、濕、痰、瘀血、(外)風、陰虛、氣虛、氣滯、毒、血熱、血虛、寒、燥,病性證素包括10個實性證素和3個虛性證素。結果顯示痤瘡發(fā)病多在肺、胃,與肝、脾有關,最常見的致病因素為熱(火)、濕,兼見痰、瘀血,發(fā)病多為實證。3.痤瘡的證素組合形式共5種,以兩證素組合和三證素組合較多,表明痤瘡常為證素組合的聯(lián)合發(fā)病;所有組合中以肺+風+熱最多;病位證素的組合以肺、肺+胃較多;病性證素組合以熱+濕、熱+風為多;表明痤瘡發(fā)病與肺、熱(火)關系最密切,與胃、濕、(外)風有關,一般為致病因素聯(lián)合作用導致,發(fā)病機制較為復雜。4.本課題涉及治療痤瘡常用藥物分類為清熱藥、補虛藥、活血化瘀藥、化痰止咳平喘藥、利水滲濕藥,以清熱藥的使用頻率最高,達44.47%;常用藥物依次為甘草、黃芩、連翹、丹參、蒲公英、梔子、生地、赤芍、牡丹皮、桑白皮、金銀花、白花蛇舌草、黃連、當歸、枇杷葉,以清熱藥最多,加補虛藥、活血化瘀藥、化痰止咳平喘藥、利水滲濕藥等,由此看出痤瘡的治療以清熱為主,兼以補益、化痰、活血、利水;以藥測證,可見熱(火)在痤瘡的發(fā)病及發(fā)展過程中影響最大。結論:通過對痤瘡證素特征的初步探討,發(fā)現痤瘡多為致病因子共同作用導致,致病機制比較復雜。痤瘡的中醫(yī)辨證方法較為繁多,涉及的證候類型名稱不統(tǒng)一、不規(guī)范,證候分布離散性大。以證素為核心的辨證方法提取的證候要素涵蓋了辨證所需的病變部位、病性性質的大部分信息,而且直觀、方便,利于規(guī)范化研究。因此,從證素入手,對痤瘡的規(guī)范化研究有積極地作用。
[Abstract]:Objective: based on the retrospective study of modern literature, the characteristics of TCM syndromes distribution, syndromes distribution and combination law, clinical characteristics of basic drug use were summarized and discussed. To provide a reference for the further standardized study and clinical treatment of acne. Methods: literature review method was used. In CNKI, a full text database of Chinese academic journals was used to search the relevant literature on the treatment of acne by traditional Chinese medicine (TCM) in the past 20 years, and to select qualified documents according to the inclusion criteria and exclusion criteria. The information of syndromes, syndromes and clinical use of drugs were extracted and quantified in the literature. Database was established, and the frequency, frequency and composition ratio were analyzed by statistical software. And combined with the theory of TCM to summarize and analyze. Results: 1. This paper selected 72 papers, involving 72 syndromes, through the consolidation, a total of 48 types of acne syndrome types. The common syndromes were lung meridian wind-heat type, gastrointestinal damp-heat type, phlegm and blood stasis type, lung and stomach heat accumulation type, spleen and stomach damp-heat type and Chong-Ren non-regulation type .2. 21 syndromes were extracted, respectively, 8 syndromes were from disease position: lung. Stomach, liver, spleen, large intestine, kidney, uterus, heart; Disease syndrome factors 13: heat (fire, dampness, phlegm, blood stasis) wind, yin deficiency, qi deficiency, Qi stagnation, poison, blood heat, blood deficiency, cold, dryness. The results showed that acne was mostly related to lung, stomach, liver and spleen. The most common pathogenic factors were heat (Huoxue, dampness, phlegm and blood stasis). There are 5 types of acne syndromes, including two syndromes and three syndromes, indicating that acne is often a combination of syndromes. The lung wind heat was the most in all combinations. The combination of syndrome factors in the disease position was lung and stomach. The combination of disease syndrome factors is heat and dampness, heat wind is more; It is suggested that acne is most closely related to lung, heat (fire), stomach and wet wind, which is generally caused by the combined effect of pathogenic factors. This topic involves the treatment of acne commonly used drugs classified as heat-clearing drugs, tonifying drugs, promoting blood circulation and removing blood stasis drugs, phlegm, cough, asthma, water and infiltration drugs, the highest frequency of use of heat-clearing drugs. Up to 44.47; The commonly used drugs are liquorice, baicalin, forsythia, salvia miltiorrhiza, dandelion, gardenia, raw land, Radix Paeoniae rubra, peony peel, mulberry peel, honeysuckle, Flos Lonicerae, Radix angelicae Sinensis, loquat leaf, and most of them are heat-clearing drugs. Add tonifying medicine, promoting blood circulation and removing blood stasis, eliminating phlegm and relieving cough and relieving asthma, and so on. From this, we can see that the treatment of acne is mainly to clear heat, but also to tonify, dissipate phlegm, promote blood circulation, and promote water; Heat (fire) is the most important factor in the pathogenesis and development of acne. Conclusion: through the preliminary study on the characteristics of acne syndromes, it is found that acne is mostly caused by the co-action of pathogenic factors. The pathogenesis of acne is more complex. Acne syndrome differentiation methods are more numerous, involving the syndromes type names are not uniform, non-standard. The syndrome elements extracted by the dialectical method with syndrome element as the core cover the location of pathological changes needed for differentiation, most of the information of the disease nature, and intuitive, convenient, conducive to standardized research. Starting with syndrome factors, the standardization study of acne has positive effect.
【學位授予單位】：山西中醫(yī)學院
【學位級別】：碩士
【學位授予年份】：2016
【分類號】：R275.9

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