【摘要】：田玉美是湖北省仙桃市人,湖北中醫(yī)藥大學教授、湖北省著名中醫(yī),全國第一批、第二批名老中醫(yī)師帶徒指導老師,國務院特殊津貼享受者。田老出身中醫(yī)世家,自少時即從祖父習醫(yī),從事中醫(yī)臨床與《金匱要略》教學多年。田老在學習、繼承前人理論和經驗的基礎上,知常達變,法古而不泥古,勇于探索,形成了自己的治療體系,在臨床中獲取了顯著療效。本文試從脾胃病的生理病理特點及田玉美教授對脾胃病治療的認識與臨床經驗出發(fā),在導師李云海副教授的指導下,就田老治療脾胃病證的醫(yī)案進行整理分析,并結合平時跟師抄方時從田老處所獲的醫(yī)學見解,以具體病癥為依據,從診療特點、治法特色、用藥特點與規(guī)律、常用藥對等方面系統(tǒng)地總結田老對脾胃病論治的理解與治療特色。重點從以下三方面著手：(1)將田玉美教授近兩年的脾胃病醫(yī)案按病名進行歸類整理,包括跟師、從導師、師兄師姐處獲得田玉美教授的原始病案；(2)對分散于著作、期刊雜志(報紙)及學術會議論文集中的,由田教授本人、學術繼承人及徒弟、所在單位名醫(yī)學術思想傳承工作室所撰寫或著述的醫(yī)學論文文集、專著以及其他研究機構或個人已經總結或論述的田教授關于脾胃病的診療經驗與醫(yī)論醫(yī)話進行系統(tǒng)整理；(3)結合所整理的田玉美教授診治脾胃病經驗及醫(yī)案提煉并闡述其診治脾胃病的核心思想。本文主要的研究材料為近兩年跟隨田玉美教授抄方、導師或師兄師姐處的脾胃病醫(yī)案及由田教授本人、學術繼承人及徒弟、所在單位名醫(yī)學術思想傳承工作室所撰寫或著述的與脾胃疾病相關的醫(yī)學論文、專著,以及其他研究機構或個人已經總結或論述的田教授關于脾胃病的診療經驗與醫(yī)論醫(yī)話,并排除記錄不全者(病情、方藥等)、僅就診一次者(明確藥后即愈者保留)的病案。本文準備通過資料整理、文獻綜述、比較分析、系統(tǒng)闡述等方法來研究田玉美教授的脾胃病治療經驗,其中以系統(tǒng)闡述為主,首先從生理機制、病因病機、辨證論治及臨床調護等方面入手,闡述脾胃病的古代文獻源流及現代醫(yī)家診療特色；其次從理、法、方、藥等方面全面論述田教授診療脾胃病方面的學術思想及臨床經驗,并通過田老診療胃痛、痞滿、嘔吐、噎膈、呃逆、腹痛、泄瀉、便秘等脾胃病癥的經典驗案分析其診治精粹。田玉美教授吸收各家治療脾胃病經驗與理論的精華部分,結合自己多年的臨證經驗,探索出了自己的診療思路。田老的脾胃病診療思想可大致概括為：在整體觀的指導下,診病注重四診合參,辨證以臟腑為核心,辨證辨病相結合,顧護胃氣為原則,區(qū)別脾胃的不同特點,以脾胃為中心兼顧五臟論治脾胃病。
[Abstract]:Tian Yumei is a native of Xiantao, Hubei Province, a professor of Hubei University of traditional Chinese Medicine, famous Chinese medicine in Hubei Province, the first batch in the country, the second group of old Chinese medicine doctors with apprentice guidance teacher, the State Council special allowance recipients. Tian Lao came from a family of traditional Chinese medicine. He studied medicine from his grandfather and taught Chinese medicine and synopsis of the Golden Chamber for many years. On the basis of studying, inheriting the previous theories and experiences, Tian Lao knew and changed frequently, and was brave to explore, and formed his own treatment system, and obtained remarkable curative effect in clinic. Based on the physiological and pathological characteristics of spleen and stomach disease and Professor Tian Yumei's understanding and clinical experience in the treatment of spleen and stomach disease, and under the guidance of Li Yunhai, an associate professor, this paper makes an analysis of the medical records of Tian Lao's treatment of spleen and stomach disease. And combined with the medical opinions obtained from Tian Lao when copying the prescription with the teacher at ordinary times, according to the specific disease, from the characteristics of diagnosis and treatment, from the characteristics of medication, and from the characteristics and laws of drug use, The understanding and treatment characteristics of Tian Lao's treatment of spleen and stomach diseases were summarized systematically. It focuses on the following three aspects: (1) classifying the medical records of Professor Tian Yumei's spleen and stomach diseases in the past two years according to the name of the disease, including following the teacher, obtaining the original medical records of Professor Tian Yumei from his mentor, brother and sister, and (2) distributing the original medical records of Professor Tian Yumei from his works. A collection of medical papers written or written by Professor Tian himself, academic successors and apprentices in journals (newspapers) and academic conferences. The monographs and other research institutions or individuals have summarized or discussed Professor Tian's experience in the diagnosis and treatment of spleen and stomach diseases and the medical theory of medicine for a systematic arrangement; (3) combined with the experience of Professor Tian Yumei in the diagnosis and treatment of spleen and stomach disease and the medical records, the core ideas of his diagnosis and treatment of spleen and stomach disease were expounded. The main research materials in this paper are following professor Tian Yumei's copy of the doctor's case of spleen and stomach diseases in the past two years, including professor Tian himself, academic successor and apprentice The medical papers and monographs related to spleen and stomach diseases written or written by the famous doctors' academic thought inheritance Studio in their units, as well as Professor Tian's experience in diagnosis and treatment of spleen and stomach diseases and the medical theory of medicine that have been summarized or discussed by other research institutions or individuals, Exclusion of incomplete records (illness, prescription, etc.), only one visit (clear after the cure is retained) medical records. This paper intends to study Professor Tian Yumei's experience in the treatment of spleen and stomach diseases by means of data collation, literature review, comparative analysis, systematic elaboration, etc. Starting with the treatment of syndrome differentiation and clinical nursing, this paper expounds the ancient literature source of spleen and stomach disease and the characteristics of diagnosis and treatment of modern doctors. Secondly, it comprehensively discusses Professor Tian's academic thoughts and clinical experience in the diagnosis and treatment of spleen and stomach diseases from the aspects of theory, method, prescription and medicine. Through the diagnosis and treatment of stomach pain, fullness, vomiting, choking, hiccup, abdominal pain, diarrhea, constipation and other spleen and stomach disease classic case analysis of its diagnosis and treatment essence. Professor Tian Yumei absorbed the essence of the experience and theory of treating spleen and stomach diseases, combined with his own clinical experience for many years, explored his own diagnosis and treatment ideas. Tian Lao's thought of diagnosis and treatment of spleen and stomach diseases can be roughly summarized as follows: under the guidance of the holistic view, the diagnosis of diseases pays attention to the four diagnoses and ginseng, the differentiation of symptoms and signs is the core of the zang-fu organs, the combination of syndrome differentiation and disease differentiation, the principle of protecting the stomach and qi, and differentiating the different characteristics of the spleen and stomach. Take spleen and stomach as the center to treat spleen and stomach disease.
【學位授予單位】：湖北中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2016
【分類號】：R249;R256.3

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