【摘要】：目的:通過搜集整理古籍與現(xiàn)代對大腸癌病證治療的文獻(xiàn),對古今醫(yī)家應(yīng)用中醫(yī)藥對大腸癌治療的用藥進(jìn)行對比,梳理大腸癌中醫(yī)藥治療的發(fā)展脈絡(luò)、系統(tǒng)總結(jié)其用藥規(guī)律、對比古今各自用藥特點,為當(dāng)今臨床治療提供用藥依據(jù),尋找合理用藥、有效用藥,探索防治大腸癌的有效途徑,更好的為臨床服務(wù)。材料與方法:古代文獻(xiàn)來源:為更加全面的總結(jié)古人對于本病的論治,在現(xiàn)代醫(yī)家對于本病認(rèn)識的共識基礎(chǔ)上,運用正版授權(quán)的《中華醫(yī)典》軟件以以“腸溜”、“腸覃”、“腸o肌�、“积聚”、“伏梁”、“ve瘕”、“腸風(fēng)”、“臟毒”、“痢疾”、“便血”、“鎖肛痔”、“臟癰痔”為關(guān)鍵詞進(jìn)行目錄搜索,將搜索出的文獻(xiàn)進(jìn)行篩選,然后與遼寧中醫(yī)藥大學(xué)圖書館館藏古籍進(jìn)行對比校正,采用電子檢索與手工檢索相結(jié)合的方式,根據(jù)選方標(biāo)準(zhǔn),確定所需錄入的方藥�，F(xiàn)代文獻(xiàn)來源:分別用“大腸癌”或“腸腫瘤”或“結(jié)直腸腫瘤”與“中醫(yī)藥”或“中醫(yī)藥療法”為主題詞,在相關(guān)期刊論文(CNKI)、萬方數(shù)據(jù)、中國生物醫(yī)學(xué)文獻(xiàn)數(shù)據(jù)庫(CBM)數(shù)據(jù)庫中搜索1996年1月—2016年12月公開發(fā)表的中醫(yī)藥治療大腸癌的相關(guān)文獻(xiàn)及論著,篩選后,根據(jù)選方標(biāo)準(zhǔn)確定所需錄入的方藥。將所得方藥錄入Excel表格中,建立數(shù)據(jù)庫,進(jìn)行統(tǒng)計分析。結(jié)果:1.根據(jù)選方標(biāo)準(zhǔn),共選出符合標(biāo)準(zhǔn)古代處方209首,共涉及186味中藥,藥物總頻次為1358味次;共選出符合標(biāo)準(zhǔn)現(xiàn)代處方107首,共涉及193味中藥,藥物總頻次為1055味次。2.當(dāng)歸用藥頻次為79味次,處方出現(xiàn)率為38.80%,在古方用藥頻次中位列第一;白術(shù)用藥頻次為62味次,處方出現(xiàn)率為57.94%,在今方用藥頻次中位列第一。3.古方中:補虛藥、清熱藥、止血藥、理氣藥、解表藥、收澀藥、活血化瘀藥、溫里藥,這8類藥總用藥頻次為1129味次,相對頻次為83.14%;今方中:補虛藥、清熱藥、利濕滲水藥、活血化瘀藥、理氣藥、消食藥、化痰止咳平喘藥、化濕藥,這8類總用藥頻次為943味次,相對頻次為89.38%。4.今方中應(yīng)用利水滲濕藥的相對頻次為11.28%,古方中為1.27%,今方中應(yīng)用最突出的為茯苓,在處方中的出現(xiàn)率為43.93%。5.今方中應(yīng)用消食藥的相對頻次為4.63%,古方中為0.44%,今方中最突出的用藥為麥芽。6.古方中補虛藥的應(yīng)用相對頻次為25.92%,其中補氣藥在補虛藥中所占頻率為41.48%,補血藥為43.47%;今方中補虛藥的應(yīng)用相對頻次為33.83%,其中補氣藥在補虛藥中所占頻率為64.71%,補血藥為13.17%。7.古方中清熱藥的應(yīng)用相對頻次為16.27%,其中清熱燥濕藥在清熱藥中所占頻率為46.61%,清熱解毒藥為10.86%,清熱涼血藥為32.13%;今方中清熱藥的應(yīng)用相對頻次18.58%,其中清熱燥濕藥在清熱藥中所占頻率為14.80%,清熱解毒藥為72.96%,清熱涼血藥為6.63%。結(jié)論:1.古代醫(yī)家主要應(yīng)用的藥物有:補虛藥、清熱藥、止血藥、理氣藥、收澀藥、溫里藥、活血化瘀藥;現(xiàn)代醫(yī)家主要應(yīng)用的藥物有:補虛藥、清熱藥、利水滲濕藥、理氣藥、活血化瘀藥、消食藥。2.古今醫(yī)家對于本病的治法均以補虛清熱為主。但古代醫(yī)家在補虛清熱的基礎(chǔ)上,兼以理氣止血、活血化瘀、溫里等治法,更注重從“血”論治;而現(xiàn)代醫(yī)家則更多的兼之以利水滲濕藥與消食藥,與補虛藥相合來固護脾胃,更注重從“氣”論治。3.補虛藥與清熱藥均為古今醫(yī)家應(yīng)用最多的藥物。4.古代醫(yī)家應(yīng)用補虛藥以補氣藥、補血藥為主;現(xiàn)代醫(yī)家則重點應(yīng)用補氣藥。5.古代醫(yī)家應(yīng)用清熱藥以燥濕清熱藥、清熱涼血藥為主;現(xiàn)代醫(yī)家則主要應(yīng)用清熱解毒藥。
[Abstract]:Objective: By collecting and sorting out ancient books and modern literatures on the treatment of colorectal cancer, this paper compares the use of traditional Chinese medicine in the treatment of colorectal cancer between ancient and modern physicians, combs the development of traditional Chinese medicine in the treatment of colorectal cancer, systematically summarizes the law of its use of drugs, compares the characteristics of their use of drugs in ancient and modern times, so as to provide the basis for clinical treatment and find a combination. Materials and Methods: Ancient literature sources: In order to summarize the treatment of the disease more comprehensively, on the basis of the consensus of modern physicians on the disease, using the authorized "Chinese Medical Code" software to "intestinal slippage" and "bowel fever". "Intestinal o-muscle thin____________________8594 Modern literature sources: the keywords of "colorectal cancer" or "colorectal cancer" and "traditional Chinese medicine" or "traditional Chinese medicine therapy" were used respectively, in the Chinese Journal Full Text Database (CNKI), Wanfang data, and Chinese Biomedical Literature Database (CBM). In the database, we searched the relevant literature and literatures published from January 1996 to December 2016 on the treatment of colorectal cancer. After screening, the prescriptions and medicines needed to be entered were determined according to the selection criteria. Nine of them involved 186 traditional Chinese medicines with a total frequency of 1358; 107 modern prescriptions were selected, involving 193 traditional Chinese medicines with a total frequency of 1 055. 2. Angelica sinensis was used 79 times with a prescription occurrence rate of 38.80%, ranking first in ancient prescriptions; Atractylodes macrocephala was used 62 times with a prescription occurrence rate of 57.94%. Ancient prescriptions: tonifying deficiency, clearing away heat, hemostasis, regulating qi, relieving exterior symptoms, astringent, activating blood circulation and removing blood stasis, warming the internal medicine, the total frequency of these eight drugs is 1129, the relative frequency is 83.14%; now: tonifying deficiency, clearing away heat, regulating dampness and permeating water, activating blood circulation and removing blood stasis, regulating qi, eliminating food, relieving phlegm, relieving cough and relieving asthma, regulating phlegm, relieving cough and relieving asthma. The relative frequencies of the eight kinds of herbs were 89.38%. 4. The relative frequencies of the herbs were 11.28% in the present prescription and 1.27% in the ancient prescription. The most prominent one in the present prescription was Poria cocos. The occurrence rate in the prescription was 43.93%. 5. The relative frequencies of the herbs used in the present prescription were 4.63%, 0.44% in the ancient prescription and the most prominent in the present prescription. 6. The relative frequency of the application of tonic drugs in ancient prescriptions was 25.92%. The frequency of the application of tonic drugs in tonic drugs was 41.48% and that of blood tonic drugs was 43.47%. The relative frequency of the application of tonic drugs in modern prescriptions was 33.83%. The frequency of the application of tonic drugs in tonic drugs was 64.71% and that of blood tonic drugs was 13.17%. The frequency of antipyretic and Dampness-drying drugs in antipyretic drugs was 46.61%, antipyretic and detoxicating drugs were 10.86%, and antipyretic and blood-cooling drugs were 32.13%. The relative frequency of antipyretic drugs in the present prescription was 18.58%. The frequency of antipyretic and Dampness-drying drugs in antipyretic drugs was 14.80%, antipyretic and detoxicating drugs 72.96%, and antipyretic and blood-cooling drugs was 6.63%. The medicines to be used are: tonifying deficiency medicine, clearing away heat, hemostatic medicine, regulating qi medicine, astringent medicine, warm medicine, activating blood circulation and removing stasis; the main medicines used by modern physicians are: tonifying deficiency medicine, clearing away heat medicine, diuresis and dampness medicine, regulating qi medicine, activating blood circulation and removing stasis medicine, and digestive medicine. 2. Ancient and modern physicians treat this disease mainly by tonifying deficiency and clearing away heat. On the basis of this, the treatment methods of regulating qi and stopping bleeding, activating blood circulation and removing blood stasis, warming li, etc., pay more attention to the treatment from "blood"; modern physicians pay more attention to the combination of water-promoting and dampness-permeating medicines and digestive medicines, and the combination of tonifying deficiency medicines to strengthen the spleen and stomach, and pay more attention to the treatment from "qi". 3. tonifying deficiency medicines and clearing away heat medicines are the most used medicines in ancient and modern times. Deficiency-tonifying drugs are mainly Qi-tonifying drugs and blood-tonifying drugs, while modern physicians mainly use Qi-tonifying drugs. 5. Ancient physicians used heat-clearing drugs mainly for dampness and heat-clearing, while modern physicians mainly used heat-clearing and detoxifying drugs.
【學(xué)位授予單位】：遼寧中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R273

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