本文選題：袁海波 + 心水病�。� 參考：《河南中醫(yī)藥大學(xué)》2016年碩士論文

【摘要】：目的:以中醫(yī)理論為指導(dǎo),以導(dǎo)師袁海波教授門診病例為依據(jù),結(jié)合導(dǎo)師文獻(xiàn)、著作、講座等內(nèi)容,運(yùn)用相關(guān)統(tǒng)計(jì)學(xué)方法,深入探索名老中醫(yī)袁海波教授診療心水病數(shù)十年的學(xué)術(shù)思想和臨床經(jīng)驗(yàn),總結(jié)導(dǎo)師治療心水病的辨證思路,使其得以傳承發(fā)揚(yáng),有效指導(dǎo)臨床,提高心水病辨證論治的臨床療效。方法:1.按納入標(biāo)準(zhǔn)收集2010年4月07日至2015年12月02日的河南中醫(yī)藥大學(xué)第一附屬醫(yī)院袁海波教授親診的心水病病例,將其規(guī)范化以后,錄入EXCEL表格,并保證數(shù)據(jù)準(zhǔn)確性。運(yùn)用頻數(shù)方法統(tǒng)計(jì)舌診、脈診、望診、證型、癥狀及主要證型的癥狀。運(yùn)用SPSS19.0進(jìn)行雙變量相關(guān)性方法,統(tǒng)計(jì)年齡和性別與證型的關(guān)系。2.研讀文獻(xiàn)、著作、講座等內(nèi)容,并向?qū)熣?qǐng)教,整理袁海波教授診療心水病的辨證思路。結(jié)果:1.共收集170例病人,男性63人,平均年齡60.24±14.672歲;女性107人,平均年齡63.77±11.212歲;總平均年齡62.46±12.679歲。2.常見(jiàn)脈象:沉、細(xì)、無(wú)力、結(jié)、細(xì)弦、弦細(xì)、左右不等。3.常見(jiàn)面色:暗黃,萎黃,晦暗。4.常見(jiàn)舌診:舌質(zhì)暗淡、舌質(zhì)暗,舌質(zhì)暗紅。舌體適中,舌體瘦小,舌體胖大。苔白,苔薄,苔膩,苔厚。5.主要癥狀:胸悶、浮腫、乏力、心悸、氣短。6.常見(jiàn)證型:血瘀水停證、心肝失和證、心脾虛弱證、濕瘀內(nèi)阻證、心氣虛弱證、氣陰兩虛證、瘀阻心脈證。7.血瘀水停證常見(jiàn)癥狀:浮腫、胸悶、乏力、心悸、氣短、失眠、食欲不振、神疲、舌質(zhì)暗淡、面色暗黃、脈沉、脈細(xì)。心肝失和證常見(jiàn)癥狀:浮腫、胸悶、心悸、乏力、氣短、失眠、頭暈、面色暗黃、舌質(zhì)暗淡、苔膩、脈沉、脈細(xì)、脈細(xì)弦。心脾虛弱證常見(jiàn)癥狀:胸悶、浮腫、乏力、心悸、失眠、氣短、神疲、頭暈、面色暗黃、舌質(zhì)暗淡、舌質(zhì)暗、苔膩、脈沉、脈細(xì)、脈無(wú)力。濕瘀內(nèi)阻證常見(jiàn)癥狀:胸悶、氣短、浮腫、乏力、失眠、心悸、頭暈、神疲、喘息、不耐疲勞、面色暗黃、舌質(zhì)暗、舌質(zhì)暗淡、苔膩、苔厚、脈沉、脈細(xì)。心氣虛弱證常見(jiàn)癥狀:胸悶、乏力、心悸、氣短、失眠、不耐疲勞、浮腫、面色萎黃、面色暗黃、舌質(zhì)暗、舌質(zhì)暗淡、苔膩、苔白、苔薄、脈沉、脈細(xì)、脈無(wú)力、脈細(xì)弦。氣陰兩虛證常見(jiàn)癥狀:浮腫、胸悶、心悸、乏力、失眠、神疲、食欲不振、氣短、腹脹、胸痛、面色暗黃、舌質(zhì)暗淡、舌質(zhì)暗紅、苔膩、苔薄、苔白、細(xì)弦。瘀阻心脈證常見(jiàn)癥狀:胸悶、浮腫、心悸、乏力、失眠、胸痛、氣短、頭暈、面色暗黃、舌質(zhì)暗淡、苔薄、苔白、脈沉、脈細(xì)、脈無(wú)力。8.男性與心肺虛弱證;女性患者與心脾虛弱證;27歲至不滿40歲的與痰瘀內(nèi)阻證和瘀熱內(nèi)阻證;40歲至不滿50歲的與陽(yáng)虛水停證;50歲至不滿60歲的與氣滯血瘀證;60歲至不滿70歲的與心肺虛弱證;70歲至不滿80歲的與瘀阻心脈證;80歲至91歲的與氣陰兩虛證、心脾腎陽(yáng)虛證、水氣凌心證、瘀熱水停證具有相關(guān)性。9.理論研究結(jié)果:(1)明確病因,知其所犯。(2)以氣血津液辨證為主,確定基本病機(jī)。(3)結(jié)合臟腑辨證,整體論治。(4)謹(jǐn)守病機(jī),明辨證型。(5)治法靈活,有的放矢。(6)基本病機(jī),基礎(chǔ)方藥。(7)病證結(jié)合,中西合參。(8)中病即止,注重調(diào)護(hù)。結(jié)論:導(dǎo)師認(rèn)為本病的致病因素繁多。心水病40歲以后發(fā)病率逐漸上升。導(dǎo)師診療心水病主要癥狀是胸悶、浮腫、乏力、心悸、氣短,心水病的病機(jī)復(fù)雜,基本病機(jī)是初期氣虛、后期陽(yáng)虛,血瘀、水停,貫穿始終。又有五臟相關(guān),氣血陰陽(yáng)虧虛。導(dǎo)師診病注重四診合參。望診面色、脈診多提示氣血盛衰。舌診多提示病邪性質(zhì)。且常見(jiàn)面診面色、脈象、舌診與基本病機(jī)吻合。每個(gè)證型常見(jiàn)癥狀與證型基本吻合。治療上,要靈活運(yùn)用益氣、助陽(yáng),理氣、化瘀、行水的治療大法。診病治病不拘一格。中病即止,以求治療的最大公約數(shù);注重調(diào)護(hù),提高生存質(zhì)量和存活率。
[Abstract]:Objective: guided by the theory of traditional Chinese medicine, based on the outpatient cases of tutor Yuan Haibo, combined with the contents of tutor literature, book, lecture and so on, the academic thought and clinical experience of Professor Yuan Haibo of famous old Chinese medicine in diagnosis and treatment of heart water disease for decades are deeply explored, and the dialectical thought of mentor treatment of heart water disease is summed up to make it possible. Inherit and carry forward, effectively guide the clinical, improve the clinical curative effect of syndrome differentiation of hydroheart disease. Method: 1. according to the inclusion criteria, collect the pro - diagnosis of the heart water disease cases of Professor Yuan Haibo, the First Affiliated Hospital of Henan University of traditional Chinese medicine from 07 to December 2015 02 days from April 2010 to December 2015, and standardize them into the form, and ensure the accuracy of the data. Several methods were used to count the tongue diagnosis, pulse diagnosis, inspection, syndrome, symptoms and symptoms of main syndromes. Using SPSS19.0 to carry out bivariate correlation methods, statistics the relationship between age and sex and syndrome type.2. reading literature, books, lectures and other contents, and to instruct professor Yuan Haibo for diagnosis and treatment of heart water disease. Results: 1. a total of 170 patients were collected. 63 men, the average age of 60.24 + 14.672 years, 107 women, average age 63.77 + 11.212 years old, the average age 62.46 + 12.679 years.2. common pulse: sinking, thin, weak, knot, fine chord, chord,.3. common face color: dark yellow, yellow, dark.4. common tongue diagnosis: Dark tongue, dark tongue, dark red tongue. Tongue body medium, thin tongue body, body fat tongue body fat, body fat body The main symptoms of.5., such as moss, moss, moss and thickness: chest tightness, swelling, fatigue, palpitation, and shortness of breath.6.: blood stasis syndrome, heart and liver failure syndrome, weak syndrome of heart and spleen, damp stasis syndrome, weak syndrome of heart qi, two deficiency syndrome of Qi Yin, blood stasis and blood stasis syndrome of.7. blood stasis syndrome: swelling, chest tightness, weakness, palpitation, shortness of breath, insomnia and anorexia, God Weakness of the tongue, dark yellow, dyke and pulse. The common symptoms of heart and liver syndrome: edema, chest tightness, palpitation, weakness, shortness of breath, dizziness, dark yellow, dark tongue, greasy fur, pulse sinks, pulse fine, pulse fine chords. The common symptoms of heart and spleen weakness: chest tightness, swelling, weakness, palpitation, insomnia, shortness, faint yellow, dim tongues, dark tongue, The common symptoms: chest tightness, shortness of breath, swollen, asthenia, insomnia, palpitation, dizziness, fatigue, asthenia, dark yellow, dark tongue, dull tongue, greasy fur, thick fur, pulse, pulse, weakness, heart palpitations, palpitations, insomnia, fatigue, swollen and yellowing face Dark yellow color, dark tongue, dark tongue, greasy tongue, moss white, thin moss, pulse sink, pulse thin, pulse weakness, pulse fine chord. The common symptoms of Qi Yin two deficiency syndrome: edema, chest tightness, palpitation, weakness, insomnia, fatigue, shortness, shortness of appetite, shortness of appetite, dysphasia, chest pain, dark yellow, tongue quality, dark red tongue, tongue coating, thin moss, fine chords, thin chords, common symptoms of stasis and heart pulse: chest tightness, floating Swelling, palpitation, fatigue, insomnia, chest pain, shortness of breath, dark yellow, dim tongues, thin fur, moss, pulse depression, weak pulse, pulse weakness.8. and weakness of heart and lung syndrome; female patients and weak heart and spleen syndrome; 27 to 40 years old with phlegm stasis syndrome and blood stasis syndrome; 40 to 50 years old and yang deficiency syndrome; 50 to 60 years old and qi stagnation Blood stasis syndrome; the syndrome of heart and lung weakness from 60 to 70 years old; the syndrome of blood stasis and heart pulse from 70 to 80 years old; 80 to 91 years old with Qi Yin deficiency syndrome, heart spleen and kidney yang deficiency syndrome, water and Qi Lingxin syndrome, blood stasis hot water stop syndrome related.9. theory research results: (1) clear cause and know it. (2) based on Qi and blood body fluid syndrome differentiation, determine basic pathogenesis. (3) knot Combining the viscera syndrome differentiation, holistic treatment. (4) keep the disease machine and discernment syndrome type. (5) the treatment method is flexible and has a definite target. (6) basic disease machine, basic prescription medicine. (7) combination of disease and syndrome, Chinese and Western joint ginseng. (8) disease is stop, and attention is paid to the disease. The guidance is that the pathogeny factors of this disease are various. After 40 years of heart water disease, the incidence of disease is gradually rising. Main symptoms of diagnosis and treatment of heart water disease are the main symptoms of mentor and treatment of mentor Chest tightness, swelling, fatigue, palpitation, shortness of breath, complex pathogenesis of heart water disease, basic pathogenesis is the initial Qi deficiency, the later Yang deficiency, blood stasis, water stop, through all the time. There are five organs related, Qi and blood Yin and yang deficiency. The common symptoms of each syndrome are consistent with the syndrome type. In the treatment, we should use the flexible use of Qi, Yang, Qi, blood stasis, the treatment of water. The diagnosis and treatment of diseases are not restricted.

【學(xué)位授予單位】：河南中醫(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;R259

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