薛生白《湿热病篇》用药规律研究

发布时间：2018-05-15 21:01

本文选题：薛生白 + 湿热病篇　；参考：《河南中医药大学》2016年硕士论文

【摘要】：目的:通过对薛生白《湿热病篇》篇中药物、方剂的相关研究,以探讨薛氏治疗湿热病证的用药配伍规律。方法:选取权威版本(包括底本和校本),然后对薛氏《湿热病篇》所涉及药物及方剂进行参校核对,以确保本论文研究初始资料的客观性和准确性,此为一。其二,依据参校结果,建立相对应Word文档析出该篇方剂(按条文依序命名)、药物。其三,根据筛选标准,对条文涉及到的具体药物及方剂各自创建内容为药物“功效”、“四气”、“五味”、“气味”、“归经”的Excel信息表。其四,以创建的信息表为依据,参照排除标准对该篇方剂数目、药味味次数、药味总数次、药物频次、功效频次、四性频次、五味频次、归经频次等指标给予统计分析。最后,采用IBM公司开发的SPSS20.0统计软件对符合纳入标准的该篇药物、方剂的各个指标给予统计描述和相关聚类分析,以探讨薛氏用药配伍规律。结果:1.薛氏该篇符合纳入标准的方剂有36首、药物味数(不计重复次数)有111味次,药物总频次为240药次。2.其中高频药物是:甘草、滑石、菖蒲、生地、苍术、茯苓、半夏、金银花、人参、藿香、厚朴、犀角、连翘、陈皮、草果等。3.高频药物功效是:利水渗湿、芳香化湿、补气、清热凉血、祛痰止咳平喘、辛凉解表、清热解毒、理气、清热泻火、补血等。对其以“药物功效”指标聚类,聚类点为12时该篇方剂易聚为11类,各类方大抵以祛湿清热为主,兼以理气、补气等。4.该篇药物归经频次位居前6的经别是:胃经、肺经、脾经、肝经、心经、肾经,说明湿热病变中心多在中焦脾胃,可蒙上流下波及上下二焦。对其以“药物归经”指标聚类,聚类点为6时方剂易聚为8类,各类方归经或脾胃、或肺胃、或心肝、或心肾各有偏移。5.药物四性以寒凉为主、温热为辅,寒温并用;方剂以“药物四性”指标聚类,聚类点为6时该篇方剂易聚为7类,方剂内药物寒温构成有所差异。6.用药以甘味、苦味、辛味、淡味为主,咸味、酸涩味次之;对该篇方剂以“药物五味”为指标对其聚类,聚类点为7时该篇方剂易聚为8类,各类方剂五味比重有所不同。结论:通过对薛生白《湿热病篇》全篇方药统计得出薛氏方药运用规律是:湿热病证病因为湿热合邪,病变中心多在脾胃,主要病机为内外相引;用药多归胃、肺、肝经、脾经;治疗原则以祛湿清热为主,兼以顾护正气;选用药味以寒凉为主、温热为辅,寒温并用;注重立法用药,用药精当,药尽其用,也颇重视气味配伍。而通过对其所用药物配伍的管测探讨可知,薛氏对湿热病证研究可谓见解颇深、体悟独到,彰显了薛氏作为一代温病大家的风采。薛氏此篇是对温病学理论的进一步发展和有益补充,对后世医家比如吴鞠通独立湿温病名和完善规范诊治产生了较为深远影响,具有很高的学术价值。此外,现在临床上常见湿热为患疾病,无论外感抑或内伤杂病,涉及全身各个系统,与它症比如阴虚、寒湿等症难于鉴别,且治疗起来亦颇为棘手,故也很具有临床研究必要。因此继续深入研习薛生白《湿热病篇》有着现实和长远的意义,值得我们进一步好好探究。
[Abstract]:Objective: through the study of medicine and prescription in Xue Shengbai's "dampness and heat" article, to explore the compatibility of schaeh's treatment of damp heat syndrome. Methods: select the authoritative version (including the base and school edition), and then check the drugs and prescriptions involved in Xue's "dampness fever", so as to ensure the objectivity of the initial data in this paper. And this is one. Secondly, according to the results of the school, we set up the prescription of the prescription (named according to the provisions) and the medicine. Thirdly, according to the screening standard, the specific drugs and prescriptions involved in the provisions are created for the drug "efficacy", "four Qi", "five flavors", "smell", "return to the classics" of the Excel information table. Fourthly, based on the information table created, the number of prescriptions, the number of drug flavors, the number of drug flavour, the frequency of drug, the frequency of efficacy, the frequency of four sex, the frequency of five flavors, and the frequency of the classics were analyzed according to the exclusion criteria. Finally, the SPSS20.0 statistical software developed by IBM company was used for the drug, which was in conformity with the standard. Each index was given a statistical description and a correlation cluster analysis to explore the rules of the compatibility of Xue's medicine. Results 1. schroech was 36 of the prescriptions in accordance with the standard. The number of drug flavors (without repetition) was 111 times, and the total frequency of the drug was 240 times.2.. The high frequency drugs were licorice, talcum, calamus, land, Atractylodes, Poria, pinellia, and silver. Flowers, ginseng, huoxien, cortex magnolia, rhinoceros horn, forsythia, tangerine, grass fruit and other.3. high frequency drug effects are: water infiltration, aromatic humid, Qi, dispelling phlegm and cooling blood, dispelling phlegm and relieving cough, relieving cough, relieving heat, clearing heat and detoxifying, Qi, clearing heat and reducing fire, enriching blood and so on. It is mainly to remove the heat and remove the heat, and to make Qi, Qi and other.4. in the first 6 of the classics: stomach meridian, lung meridian, spleen meridian, liver meridian, heart meridian, kidney meridian, indicating that the center of damp and hot lesions is mostly in the middle of the spleen and stomach, and can be covered up and down in the upper and lower two coke. The four sex of.5. drugs, either in the spleen or stomach, or in the stomach, or in the heart and the heart, or in the heart and kidney, are mainly cold, cold and cold. The prescription is clustered with "drug four", and when the cluster point is 6, the prescription of the prescription is 7. The composition of the cold temperature in the prescription is different from that of the bitter taste, the bitterness, the bitter taste, the light taste, the salty taste and the sour taste. The prescription of this prescription was clustered with "five flavour of medicine" as the index. When the cluster point was 7, the prescription of the prescription was 8 and the proportion of all kinds of prescriptions was different. Conclusion: through the statistics of Xue Shengbai < damp heat disease > the whole prescription of prescription medicine, the rule of applying Xue's prescription is that damp heat syndrome is due to damp heat and heat, and the center of the lesion is mostly in the spleen and stomach. The main pathogenesis is internal and external induction; the medicine is mainly stomach, lung, liver, and spleen meridian; the treatment principle is mainly to dispel the damp and clear heat, and to protect the positive gas; the drug taste is cold and cold mainly, the warm heat is supplemented, the cold temperature is used. The study of the syndrome of damp and heat disease is very deep, and its unique understanding shows the elegant demeanor of Xue Shi as a generation of febrile diseases. This article is a further development and beneficial supplement to the theory of febrile diseases. It has a profound influence on the later physicians, such as Wu Jutong's name and the perfect standard of diagnosis and treatment, and has a high academic value. In addition, the clinical common humid and heat for the disease, whether external or internal injury, involving the whole body system, and its disease such as yin deficiency, cold and dampness are difficult to identify, and the treatment is quite difficult, so it is also very necessary for clinical research. Therefore, it is worth continuing to study Xue Shengbai's "dampness and fever", which has practical and long-term significance. Let's further explore.

【学位授予单位】：河南中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R254

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