本文選題：王慶國(guó) + 學(xué)術(shù)思想　； 參考：《北京中醫(yī)藥大學(xué)》2016年博士論文

【摘要】：王慶國(guó)教授師從著名中醫(yī)專家劉渡舟先生,是我國(guó)首批中醫(yī)專業(yè)博士學(xué)位獲得者之一。王慶國(guó)教授教學(xué)、行醫(yī)40余年,臨床取法仲景,善用經(jīng)方,不拘時(shí)方,用藥精當(dāng),對(duì)多種消化系統(tǒng)疾病、風(fēng)濕免疫類疾病、心腦血管病以及婦科、兒科等疑難雜癥均有豐富的臨床經(jīng)驗(yàn)和獨(dú)到見解,療效突出。1王慶國(guó)教授的學(xué)術(shù)思想淵源王慶國(guó)教授1969年參加工作,做過(guò)赤腳醫(yī)生、衛(wèi)生員,1972年進(jìn)入遼寧中醫(yī)學(xué)院學(xué)習(xí),畢業(yè)后在遼河油田職工醫(yī)院從事中西結(jié)合工作7年,奠定了扎實(shí)的西醫(yī)臨床基本功,1981年以優(yōu)異成績(jī)考入北京中醫(yī)藥大學(xué),師承中醫(yī)藥大家劉渡舟教授,曾得任應(yīng)秋、程士德、趙紹琴等名家授業(yè)；臨床上隨劉渡舟、王綿之、趙紹琴侍診,得其點(diǎn)撥；工作后也非常注重訪學(xué)各處名家,博采眾長(zhǎng),兼收并蓄�！秲�(nèi)經(jīng)》重視陽(yáng)氣、關(guān)于脾胃病的綱領(lǐng)性治則、嘔膽之說(shuō)等等,張仲景創(chuàng)立的六經(jīng)辨證和臟腑辨證體系是王慶國(guó)教授學(xué)術(shù)思想形成的根基。朱丹溪、李東垣、溫病學(xué)家及張錫純中西匯通的觀點(diǎn),都影響了王慶國(guó)教授學(xué)術(shù)思想的形成。在此基礎(chǔ)之上,他全面繼承了劉渡舟教授的學(xué)術(shù)思想,臨床上注重抓病機(jī)、辨病與辨證相結(jié)合,在靈活使用柴胡劑、瀉心劑的基礎(chǔ)上,辨證用藥方面亦有所發(fā)展,在繼承和發(fā)揚(yáng)劉渡舟先生學(xué)術(shù)觀點(diǎn)的基礎(chǔ)上,進(jìn)一步提高了診斷治療的準(zhǔn)確性和綜合性,深刻體現(xiàn)了其學(xué)術(shù)傳承的脈絡(luò)。2012年王慶國(guó)教授負(fù)責(zé)的“燕京劉氏傷寒流派”,名列國(guó)家中醫(yī)藥管理局公布的首批64家全國(guó)中醫(yī)藥學(xué)術(shù)流派傳承工作室建設(shè)單位之首,為推動(dòng)流派學(xué)術(shù)傳承做出了很大貢獻(xiàn)。2王慶國(guó)老中醫(yī)藥專家學(xué)術(shù)思想概述和合通平,重視肝脾。從對(duì)健康的總體認(rèn)識(shí)和治療疾病的總體把控上,王慶國(guó)教授認(rèn)為“五臟元真通暢,人即安和”是保持健康的重要條件,“氣血通暢”與“調(diào)達(dá)平衡”相輔相成,治療時(shí)主張“通暢氣血”與“調(diào)和陰陽(yáng)”并重,指出和陰陽(yáng)之法重在“通”與“平”,旨在恢復(fù)自然樞機(jī)之性。認(rèn)為人身之中有少陽(yáng)表里之樞和脾胃上下之樞,在通暢氣機(jī)、調(diào)和陰陽(yáng)的功能上相互協(xié)調(diào)。臨證重視顧護(hù)建運(yùn)脾胃,謂其為臨證第一法門,強(qiáng)調(diào)組方藥物的攻補(bǔ)、藥味的寒溫、藥性的升降要平衡合度。常用柴胡湯劑和瀉心劑以和少陽(yáng)、運(yùn)脾胃。辨病辨證,古今接軌。在臨床辨治原則上,王慶國(guó)教授強(qiáng)調(diào)要“辨病辨證相結(jié)合”,辨病為先,辨證為主。在辨證用方時(shí),善于舉一反三,只要病機(jī)相同,即打破原有方證的應(yīng)用格局,擴(kuò)大經(jīng)方的使用范圍。老師遵照劉老“古今接軌”的思想,雖善用經(jīng)方,但不薄時(shí)方,善于將經(jīng)方與時(shí)方合方應(yīng)用,以應(yīng)對(duì)臨床上錯(cuò)綜復(fù)雜的病證,取效良多。用藥尊經(jīng),廣采眾長(zhǎng)。在遣方用藥上,王慶國(guó)教授數(shù)十年致力于張仲景《傷寒雜病論》的研究,常以經(jīng)方的加減法舉例,強(qiáng)調(diào)仲景用藥的精華所在,臨證用藥常宗仲景心法。此外還歷時(shí)近20年編寫《本草綱目精校注》,對(duì)李東垣、葉天士、張錫純等后世醫(yī)家的學(xué)術(shù)經(jīng)驗(yàn)也多所用心,還十分注重民間效驗(yàn)方,遍讀醫(yī)書,廣采眾長(zhǎng),臨證用藥平和,不開貴藥、蠻補(bǔ)藥,臨床取效顯著。內(nèi)外兼治,針?biāo)幉⑿�。在治療手段�?王慶國(guó)教授治病時(shí)不拘泥于內(nèi)服方,主張內(nèi)外兼治,除內(nèi)服藥外,還配合外洗、外敷以及按摩等多法共施。老師早年在基層七年的西醫(yī)內(nèi)科大夫從醫(yī)經(jīng)歷,不僅打下了扎實(shí)的西醫(yī)臨床基礎(chǔ),而且磨練出了一手過(guò)硬的針灸本領(lǐng)。對(duì)于難治性疾病單純用藥物治療力所不逮時(shí),常配合以針刺或灸法,收效顯著。知常達(dá)變,分步治療。在臨證思維上,王慶國(guó)教授謹(jǐn)記《傷寒論》“觀其脈證,知犯何逆,隨證治之”,不僅掌握病之常態(tài),而且熟知疾病動(dòng)態(tài)轉(zhuǎn)變,知守善變,不落窠臼。注重根據(jù)病情的輕重分步治療,強(qiáng)調(diào)用藥須中病即止,勿傷正氣,特別注意病人體質(zhì),斟酌用藥。對(duì)于慢性病,緩解期常予丸藥調(diào)理善后。視野寬廣,傳承發(fā)揚(yáng)。在學(xué)科發(fā)展上,王慶國(guó)教授認(rèn)為發(fā)展中醫(yī)要基于傳統(tǒng),但不能囿于傳統(tǒng),現(xiàn)代與傳統(tǒng)并不是絕對(duì)矛盾和對(duì)立的；要善于利用現(xiàn)代科技的方法和手段,但又不被其束縛。強(qiáng)調(diào)作為中醫(yī)藥繼承人,“臨床是基礎(chǔ),科研是先導(dǎo),教學(xué)是職責(zé)”,三者均不可偏廢,唯有將三者緊密結(jié)合,才可提高理論水平,增強(qiáng)臨床療效,明晰機(jī)理內(nèi)涵,才能更好的體悟、傳承和發(fā)展中醫(yī)。3王慶國(guó)老中醫(yī)藥專家治療脾胃病學(xué)術(shù)思想概述四診合參,尤重舌診。在治療脾胃病方面,王慶國(guó)教授尤其重視舌象。認(rèn)為舌象變化對(duì)脾胃病診治具有一定的客觀性,對(duì)脾胃病的辨證用藥有重要價(jià)值。舌之苔為胃氣蒸脾濕上潮而生。舌作為消化系統(tǒng)的一部分,猶如人體外露的內(nèi)臟,內(nèi)臟的生理與病理變化通過(guò)望舌能客觀地反映于外,是病情變化最靈敏的外象反應(yīng)。舌象對(duì)脾胃病反映迅敏而準(zhǔn)確,望舌是診治脾胃病的重要依據(jù)。重視氣機(jī),兼調(diào)肝膽。脾胃居于中焦,是人體氣機(jī)升降出入的樞紐。脾主升清,胃主降濁,脾胃陰陽(yáng)相因、升降有序、協(xié)調(diào)統(tǒng)一才能共同完成飲食物的受納、消化和水谷精微的吸收、輸布。而肝脾“左升右降”,調(diào)節(jié)全身氣機(jī),又相互制約,因此肝膽脾胃息息相關(guān)。脾與胃燥濕相濟(jì),木能疏土則脾滯以行,肝與胃土木相關(guān),肝主疏泄而藏血,脾主運(yùn)化而生血,正常情況下,肝的疏泄功能正常,則脾胃升降適度,納化有權(quán),化源有繼,氣血輪生,肝得此而長(zhǎng)養(yǎng),更好地發(fā)揮疏泄條達(dá)作用。補(bǔ)瀉兼施,側(cè)重各異。脾與胃同居中焦,臟腑相關(guān),互為表里。在病理情況下,脾胃常常同病,但各有側(cè)重。實(shí)則陽(yáng)明,虛則太陰。胃病多實(shí)、熱,脾病多虛、寒。而脾胃同病者則多寒熱錯(cuò)雜,虛實(shí)兼夾。老師根據(jù)這一病機(jī)特點(diǎn),在臨證用藥時(shí)常補(bǔ)瀉兼施,寒熱同調(diào),動(dòng)靜結(jié)合,側(cè)重不同。臨床應(yīng)用半夏瀉心湯時(shí),非常注重通過(guò)調(diào)整方中辛苦藥味與甘藥味比例的變化,而使全方的補(bǔ)瀉作用有所側(cè)重。巧妙變通,活用合方。當(dāng)經(jīng)方難以適應(yīng)臨床復(fù)雜的病因病機(jī)病癥時(shí),活用合方可以起到出乎意料的效果。既可以經(jīng)方與經(jīng)方合方、經(jīng)方與時(shí)方合方,又可以兩個(gè)或兩個(gè)以上的時(shí)方相合,具體則需據(jù)證靈活變通,巧妙化裁。如王慶國(guó)教授治療慢性胃炎的常用藥物常選用半夏瀉心湯合百合烏藥散。此二方契合本病脾胃虛弱,寒熱錯(cuò)雜,氣機(jī)不暢的病機(jī)特點(diǎn),以辛開苦降,行氣養(yǎng)陰,平調(diào)陰陽(yáng)為主要治則。4基于關(guān)聯(lián)規(guī)則和復(fù)雜系統(tǒng)熵聚類的王慶國(guó)教授治療脾胃病的用藥規(guī)律研究通過(guò)收集、整理2013年—2015年王慶國(guó)教授在北京中醫(yī)藥大學(xué)國(guó)醫(yī)堂治療慢性萎縮性胃炎、潰瘍性結(jié)腸炎、反流性食道炎的處方,使用中醫(yī)傳承輔助系統(tǒng)軟件,采用關(guān)聯(lián)規(guī)則apriori算法、復(fù)雜系統(tǒng)熵聚類等無(wú)監(jiān)督數(shù)據(jù)挖掘方法,分析處方中的藥物使用頻次以及藥物之間的關(guān)聯(lián)規(guī)則、處方規(guī)律,探討總結(jié)王慶國(guó)教授治療脾胃病的用藥經(jīng)驗(yàn)。研究結(jié)果發(fā)現(xiàn),王慶國(guó)教授臨床治療慢性萎縮性胃炎以半夏瀉心湯為主方,常配伍百合、烏藥,益智仁、煅牡蠣兩個(gè)藥對(duì)；治療潰瘍性結(jié)腸炎的常用藥物多出自柴胡桂枝干姜湯和薏苡附子敗醬散,其中當(dāng)歸,白芍藥物組合出現(xiàn)頻次最高；治療反流性食管炎的常用藥物多出自半夏瀉心湯和小柴胡湯,其中半夏與黃芩/煅牡蠣最為常用。王教授治療三種脾胃病常用藥中都含有半夏瀉心湯中辛開苦降的核心藥對(duì),印證了三病均有寒熱錯(cuò)雜的病機(jī)存在。據(jù)其常用藥對(duì)及合方用藥分析,慢性萎縮性胃炎多伴有胃陰虛、脾陽(yáng)不足等；反流性食管炎多伴有肝郁、膽熱；潰瘍性結(jié)腸炎則以脾陽(yáng)虛濕熱重為主。綜上,通過(guò)挖掘整理王慶國(guó)教授治療三種常見脾胃系疾病的用藥規(guī)律,結(jié)果體現(xiàn)了王慶國(guó)教授治療脾胃病“和合通平、重視肝脾、補(bǔ)瀉兼施、側(cè)重各異”的學(xué)術(shù)思想,以及恢復(fù)脾升胃降氣機(jī)平衡的治療理念。此外,研究中還總結(jié)出了王教授常用的新方,如“百合烏藥瀉心湯”和“益仁牡蠣瀉心湯”,已申請(qǐng)相關(guān)新藥研發(fā)課題,將通過(guò)規(guī)范的基礎(chǔ)研究,客觀評(píng)價(jià)這些新方的臨床療效,并對(duì)其作用機(jī)理進(jìn)行研究,系統(tǒng)探討其成藥性,以期將臨床經(jīng)驗(yàn)再次轉(zhuǎn)化回歸臨床,從而提高脾胃病的臨床治療水平。本研究通過(guò)使用數(shù)據(jù)挖掘技術(shù)研究王慶國(guó)教授治療慢性萎縮性胃炎、潰瘍性結(jié)腸炎、反流性食管炎的用藥規(guī)律,獲得了傳統(tǒng)的醫(yī)案整理及統(tǒng)計(jì)學(xué)處理所不能獲得的新知識(shí)、新信息,對(duì)于王教授治療脾胃病學(xué)術(shù)思想及經(jīng)驗(yàn)的系統(tǒng)梳理及傳承有一定的參考價(jià)值。通過(guò)對(duì)王慶國(guó)老專家治療脾胃系統(tǒng)疾病學(xué)術(shù)思想、用藥規(guī)律的總結(jié)及梳理,分享其豐富的臨床經(jīng)驗(yàn),可為后學(xué)者提供寶貴的財(cái)富,亦可為新藥研發(fā)及臨床轉(zhuǎn)化提供有力的基礎(chǔ)支持。
[Abstract]:Professor Wang Qingguo, Professor Liu Duzhou, a famous doctor of traditional Chinese medicine, is one of the first doctor degree doctorates in Chinese medicine. Professor Wang Qingguo has been teaching and practicing medicine for more than 40 years. Miscellaneous diseases have rich clinical experience and unique insight, the curative effect outstanding.1 professor Wang Qingguo's academic thought origin, Professor Wang Qingguo in 1969 to work, as a barefoot doctor, a hygienist, to study in Liaoning College of Traditional Chinese Medicine in 1972, after graduating in Liaohe Oilfield staff hospital for 7 years, laid a solid clinical basis for western medicine. In 1981, Ben Gong was admitted to Beijing University of Chinese Medicine with excellent results. Liu Duzhou, a Chinese medicine Professor, had been taught by Ren Yingqiu, Cheng Shide, Zhao Shaoqin and other famous families. In clinical, Liu Duzhou, Wang Mianzhi, Zhao Shaoqin had been assigned to the clinic. The basis for the formation of Professor Wang Qingguo's academic thought is the basis for the formation of Professor Wang Qingguo's academic thought by Zhang Zhongjing's syndrome differentiation and viscera syndrome differentiation, on the basis of Zhu Danxi, Li Dongyuan, febrile scientists and Zhang Xichun, which influenced the formation of academic thought of Wang Qingguo teaching. Professor Liu Duzhou's academic thought has been carried out in clinical practice, focusing on pathogenesis, disease discrimination and syndrome differentiation, on the basis of flexible use of Bupleurum and purging agent, and the development of dialectical medication. On the basis of inheriting and carrying forward Mr. Liu Duzhou's academic viewpoint, the accuracy and comprehensiveness of diagnosis and treatment are further improved, and its profound embodiment has been deeply embodied. In the context of academic inheritance, Professor Wang Qingguo was in charge of "Yanjing Liu's typhus school" in.2012. It was the first of the first 64 national traditional Chinese medicine academic schools to inherit the studio, which made a great contribution to the academic inheritance of the school of traditional Chinese medicine (.2), and made a great contribution to the academic thought of the traditional Chinese medicine experts of the Chinese traditional Chinese medicine (.2). From the overall understanding of the health and the overall control of the disease, Professor Wang Qingguo believes that "the five dirty elements are unobstructed and the man is peaceful" is an important condition for maintaining health. The "Qi and blood unobstructed" and "balance the balance" complement each other, and the treatment advocates "unobstructed Qi and blood" and "Yin and Yang", and the Yin and Yang. In order to restore the nature of the natural pivot, the law emphasizes the nature of the natural pivot. It is considered that the pivot of Shaoyang and the upper and lower pivot of the spleen and stomach are in harmony with each other in the function of unobstructing the Qi and regulating yin and Yang. In the principle of clinical differentiation, Professor Wang Qingguo emphasized that "combining disease differentiation and syndrome differentiation", identifying disease as the first and syndrome differentiation, is good at the diagnosis and syndrome differentiation, as long as the disease machine is the same, that is to break the application pattern of the original prescription and expand the meridian. The scope of use of Fang. The teacher follows the thought of Lao Liu 's "ancient and modern integration". Although it is good to use the classics, but not thin, the teacher is good at applying the combination of the warp and the time side to cope with the complicated syndrome in the clinic. It takes a lot of effect. In the use of medicine, Professor Wang Qingguo devoted himself to the research of Zhang Zhongjing's theory of typhoid and miscellaneous diseases for decades. After 20 years of writing < Compendium of Materia Medica fine school note >, the academic experience of Li Dongyuan, ye Tianshi, Zhang Xichun and other generations of physicians has also been more attentively concerned. In the treatment of medical treatment, Professor Wang Qingguo, in the treatment of medical treatment, advocated both internal and external treatment, advocated internal and external treatment, except for internal medicine, and combined external washing, external application and massage. We have laid a solid foundation for the clinical practice of Western medicine, and have honed a strong skill in acupuncture and moxibustion. For the difficult treatment of the disease, it is often accompanied by acupuncture or moxibustion, which is often combined with the acupuncture or moxibustion, and the effect is remarkable. "Not only mastering the normal condition of the disease, but also knowing the dynamic change of the disease, knowing and keeping the change, not being the same. Pay attention to the step of treatment according to the severity of the disease, emphasize that the medicine must be moderate and stop, do not hurt the positive gas, pay special attention to the patient's physique and consider the medicine. Professor Wang Qingguo believes that the development of traditional Chinese medicine should be based on tradition, but cannot be limited to tradition. Modern and traditional Chinese medicine should not be absolutely contradictory and antagonistic. We should be good at using the methods and means of modern science and technology, but are not bound by them. It is emphasized that as the heir of Chinese medicine, "clinical is the foundation, scientific research is the precursor, teaching is duty", the three are all irrelevant, Only with the close combination of the three can we improve the theoretical level, enhance the clinical efficacy and clarify the connotation of the mechanism, so as to better understand, inherit and develop the traditional Chinese medicine experts of traditional Chinese medicine (.3 Wang Qingguo) to treat the academic thought of the spleen and stomach disease, especially the tongue diagnosis. In the treatment of spleen and stomach disease, Professor Wang Qingguo attaches great importance to the tongue image. The diagnosis and treatment of spleen and stomach disease has certain objectivity, and it is of great value to the syndrome differentiation of spleen and stomach disease. The tongue coating is produced by the wet tide of the stomach qi and spleen. As part of the digestive system, the tongue is like the exposed viscera of the human body. The physiological and pathological changes of the viscera can be objectively reflected by the tongue, and the most sensitive external response to the change of the condition. As an important basis for the diagnosis of spleen and stomach disease, the tongue is an important basis for the diagnosis and treatment of the spleen and stomach disease. The liver and spleen "left rise and right drop", "left rise and right drop", regulate the whole body gas machine and restrict each other, so the liver and the spleen and stomach are closely related. The spleen and the stomach are dry and wet, the wood can thinning the soil and the spleen is stagnant, the liver and the stomach are related, the liver is dredging and the blood is hidden, the spleen is transported and the blood is produced, the liver is normal, the spleen and stomach are moderate, and the spleen and stomach are moderate, the power and source of the spleen and stomach are the source. The spleen and the stomach are cohabiting with the stomach, the spleen and the stomach are associated with the Zang Fu, and the spleen and stomach are often the same, but the spleen and stomach are often the same. In accordance with the characteristics of this disease, the teachers often make up and take diarrhea and diarrhea in the treatment of the syndrome, the cold and heat, the combination of moving and static, and the different emphasis. In order to adapt to the complicated pathogeny and pathogenesis of clinical disease, it can be unexpected effect. It can be combined with the prescription, the prescription and the time side, and two or more than two of the time, and the specific evidence is flexible and skillful. For example, the common medicine for the treatment of chronic gastritis is often used by Professor Wang Qingguo. Xiexin Decoction and Liliu Wu Yao powder. The two parties fit the weakness of the spleen and stomach of the disease, the cold and heat are mixed and the machine is not smooth, and the rule of Professor Wang Qingguo, based on the association rules and the entropy clustering of complex system, is the main rule of treating spleen and stomach disease by the association rules and the entropy clustering of complex system. The study through collecting and sorting out Wang Qing from 2013 to 2015. Chinese professor at the state medical Hall of Beijing University of Chinese Medicine is used to treat chronic atrophic gastritis, ulcerative colitis, and reflux esophagitis, using the traditional Chinese Medicine Inheritance auxiliary system software, the association rule Apriori algorithm, the entropy clustering of complex system and other unsupervised data mining methods, analyzing the frequency of drug use in the prescription and the relationship between drugs. According to the results of the study, Professor Wang Qing Guo's clinical treatment for chronic atrophic gastritis with Banxia Xiexin soup is the main recipe for the treatment of chronic atrophic gastritis, and it is often matched with two drugs, Lilium, oysters, and calcined oysters. The commonly used drugs for ulcerative colitis are mostly from Radix Bupleuri and Cinnamomum cinnamomi. The most commonly used drugs for the treatment of reflux esophagitis are mostly from Banxia Xiexin soup and small Bupleurum soup, and the most commonly used Pinellia and scutellaria and calcined oyster are the common drugs for the treatment of reflux esophagitis. Professor Wang has the core medicine for the treatment of three kinds of spleen and stomach diseases. It was confirmed that the pathogenesis of three diseases all had cold, hot and mixed diseases. According to the analysis of the commonly used drugs, the chronic atrophic gastritis was mostly accompanied by the deficiency of stomach yin and Spleen Yang, and the reflux esophagitis was accompanied by liver depression, bile heat, and ulcerative colitis with Spleen Yang deficiency and damp heat. Combined with Professor Wang Qingguo, three common kinds of treatment were found. The rule of drug use in spleen and stomach diseases shows that Professor Wang Qingguo's treatment of spleen and stomach disease and hehe Tong Ping, paying attention to liver and spleen, supplementing diarrhea and combined application, and focusing on the balance of spleen raising and stomach lowering machine, as well as the treatment concept of restoring the balance between spleen raising and stomach lowering machine, are also summarized, in addition, the new methods commonly used by Professor Wang, such as "lily purgant Decoction" and "Yi Ren", are also summarized. Oysters Xiexin soup, which has applied for research and development of new drugs, will objectively evaluate the clinical efficacy of these new parties through a standardized basic study, and study its mechanism of action and systematically explore its drug resistance in order to transform the clinical experience to the clinic again, so as to improve the clinical treatment level of the spleen and stomach disease. Research on the rules of Professor Wang Qingguo's treatment of chronic atrophic gastritis, ulcerative colitis and reflux esophagitis, and obtained new knowledge and new information that can not be obtained by traditional medical case arrangement and statistical treatment. It has some reference value for the systematic combing and inheriting of Professor Wang's academic thought and experience in the treatment of spleen and stomach disease. Through the summary and combing of the academic thought of the treatment of the disease of the spleen and stomach system by Wang Qingguo's old experts and the sharing of its rich clinical experience, it can provide valuable wealth for the post scholars, and also provide powerful basic support for the research and development of new drugs and the clinical transformation.
【學(xué)位授予單位】：北京中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：博士
【學(xué)位授予年份】：2016
【分類號(hào)】：R249;R256.3

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