本文關(guān)鍵詞： 錢靜華 膏方 辨證思路 用藥規(guī)律 臨床研究　出處：《浙江中醫(yī)藥大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：目的對錢靜華教授門診膏方病例的收集、整理和總結(jié),分別從辨證思路和處方用藥規(guī)律等方面深入剖析導(dǎo)師應(yīng)用膏方調(diào)治體質(zhì)的獨特經(jīng)驗,對各種辨證的膏方處方與用藥規(guī)律進(jìn)行歸類與統(tǒng)計,總結(jié)錢教授用藥特點、規(guī)律及經(jīng)驗,為中醫(yī)膏方的臨床治療提供臨床參考。方法本研究收集2014年11月1日至2016年12月22日這期間錢靜華教授親診的膏方門診患者病案,內(nèi)容包括患者一般情況、既往史、體質(zhì)、治療原則、治法、膏方處方等,從中隨機(jī)選取300例。結(jié)果1.在本研究中,錢教授膏方門診患者男性有111例,占37%,女性有189例,占63%。2.錢靜華教授膏方門診年齡段在20-80歲之間,其中40-60歲的人群居多。3.本研究中發(fā)現(xiàn)女性體質(zhì)分布較多的分型分別為陽虛體質(zhì)、陰虛體質(zhì)、氣虛體質(zhì)、氣郁體質(zhì);男性為陽虛體質(zhì)、氣虛體質(zhì)、痰濕體質(zhì)。4.患者的體質(zhì)分布與年齡有密切關(guān)系,青壯年人多痰濕質(zhì)、濕熱質(zhì)、氣郁質(zhì)等,中老年人多陽虛質(zhì)、氣虛質(zhì)、陰虛質(zhì)等。5.高頻使用藥物共計12種,分別為枸杞子、鐵皮石斛、黃芪、炒白術(shù)、炒杜仲、防風(fēng)、靈芝、炒山楂、黨參、紅景天、炒續(xù)斷、仙靈脾,以補脾腎藥為主。中頻使用藥物有益智、狗脊、巴戟天等共十種,以調(diào)陰陽為主。低頻使用藥物有茵陳、廣藿香等共計23種,以化濕藥為主,佐以行氣、活血等。使用頻率20%的藥物多為對癥加減藥物。結(jié)論1.從本研究中,患者性別和年齡關(guān)系來看,女性四十歲,男性五十歲開始出現(xiàn)腎氣衰弱,正氣衰退,陽氣不足,機(jī)體免疫功能下降,易因受各種致病因素侵襲而導(dǎo)致發(fā)病,所以女子41-60歲,男子51-60歲年齡段分布較高,更宜膏方調(diào)養(yǎng)。2.膏方患者因地理位置、飲食習(xí)慣、生活習(xí)慣等原因,陽虛體質(zhì)最多,女性多于男性。3.體質(zhì)與年齡有著密切關(guān)系,平和質(zhì)和濕熱質(zhì)分布在31-40歲之間較多,氣郁質(zhì)、血瘀質(zhì)、陰虛質(zhì)、陽虛質(zhì)均分布在51-60間,氣虛質(zhì)多見于61-70歲,41-50歲之間人群痰濕質(zhì)較多。特稟質(zhì)在個年齡段分布較均勻。4.錢教授的用藥以補脾腎為主,隨證加減,以調(diào)節(jié)機(jī)體陰陽平衡。5.錢教授膏方組方思路有明察體質(zhì),因勢制宜,糾其偏正,平衡為宗,扶脾健胃,共補個調(diào),用藥考究,兼取其長。
[Abstract]:Objective to collect, sort out and summarize the cases of professor Qian Jinghua's out-patient ointment prescription, and to analyze the unique experience of tutors in regulating their physique from the aspects of syndrome differentiation and prescription drug use respectively. Classifying and statistics the prescriptions and law of different kinds of plaster prescriptions, summing up professor Qian's characteristics, rules and experiences of drug use, Methods during the period from November 1st 2014 to December 22nd 2016, this study collected the medical records of the outpatients who had been diagnosed by Professor Qian Jinghua, including the general situation of the patients, past history, physique, etc. Results 1. In this study, there were 111 male (37 female) outpatients and 189 female (63.2.) the age of Professor Qian Jinghua's outpatient clinic was between 20 and 80 years old. In this study, we found that the distribution of female physique was divided into three types: Yang deficiency, Yin deficiency, Qi deficiency, Qi depression, male Yang deficiency, Qi deficiency, male, Yang deficiency, Qi deficiency, male, Yang deficiency, Yin deficiency, Qi deficiency, and so on. Phlegm and dampness constitution .4.The distribution of patients' physique is closely related to their age. There are 12 kinds of drugs used in high frequency, such as phlegm and dampness, dampness and heat, qi stagnation, and so on, and the middle and old people have many yang deficiency, qi deficiency, yin deficiency and so on. Dendrobium candidum, Astragalus membranaceus, Atractylodes macrocephala, Eucommia ulmoides, Fangfeng, Ganoderma lucidum, fried Hawthorn, Codonopsis, Rhodiola, Fried Dipsacus, Xianling spleen, mainly invigorating spleen and Kidney. In order to regulate yin and yang, there are 23 kinds of drugs used in low frequency, such as Yinchen, patchouli and so on, which are mainly used to reduce dampness, to add qi, to promote blood circulation, etc. The drugs with frequency of 20% are mostly symptomatic drugs. Conclusion: 1. According to the relationship between sex and age of the patients, the female is 40 years old, the male is 50 years old, the kidney qi begins to debilitate, the positive qi declines, the yang qi is insufficient, the body immune function drops, and is easily caused by various pathogenic factors, so the female is 41-60 years old. The distribution of male 51-60 years old age group is higher, it is more suitable to take care of. 2. Due to geographical location, diet habits, life habits and other reasons, Yang deficiency constitution is the most, and female is more than male .3.Physique has close relationship with age. The distribution of calmness and dampness and heat were between 31 and 40 years old, Qi was stagnation, blood stasis, yin deficiency and yang deficiency were between 51-60 years old. Qi deficiency is more common in the population aged between 61 and 70 years old and aged between 41 and 50 years old than in the population with phlegm and dampness. The specific substance is more evenly distributed in each age group .4.Professor Qian's medication is mainly used to supplement the spleen and kidney, to adjust the balance of yin and yang in the body with syndrome, and to adjust the balance of yin and yang. 5. Professor Qian's ointment formula has clear constitution. Because of the power system, correct its bias, balance for the Zong, Fu spleen and stomach, a total of tonics, medication, and take its long.
【學(xué)位授予單位】：浙江中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R249

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