中医名家治疗支气管哮喘用药规律研究
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摘要
目的:探讨中医名家治疗支气管哮喘的证治及用药的一般规律,从而为中医治疗哮喘提供理论依据。方法:收集医学期刊上所发表的有关支气管哮喘的名中医医案文献5篇,共涉及时振声、朱星江、裘沛然、周仲瑛、胡希恕5位医家,13则医案,通过频数统计的方法,对其中医病位、病因、病机、证治及组方用药进行数据统计分析,总结归纳出支气管哮喘的中医证治及用药规律。结果:支气管哮喘的临床表现以喘息、咳嗽、咳逆倚息、胸闷、哮鸣、呼吸急促为主,病位在肺,与脾、肾相关,其病因与痰、风寒、内热、体虚、血瘀相关,病机以痰浊阻肺,外邪引动肺气上逆为主;在用药方面,麻黄、苦杏仁、紫苏子、紫菀、葶苈子、半夏、茯苓、射干、甘草等药的出现频率最高,是治疗哮喘的常见中药组方;其治疗遵循急则治标、缓则治本的原则,在发作期多采用泻肺平喘、化痰止咳的中药,缓解期多兼用补益脾肾的中药。结论:哮喘病因病机复杂,在治疗上,其表现出来的证候不同,所用方药也有所不同,应用药物时要做到准确辨证,方证对应,才是见效的关键。
Objective:To explore the treatment of bronchial asthma by famous Chinese doctors and the general rules of medication,so as to provide a theoretical basis for the treatment of asthma by Chinese medicine.Methods:Through the collection of medical journals published bronze asthma famous Chinese medical literature 5 articles,involving a total of 5 doctors,13 medical records.By means of frequency statistics,statistical analysis was made on the TCM patient's position,etiology,pathogenesis,syndrome differentiation and prescription medication,and the TCM syndrome differentiation and medication rules of bronchial asthma were summarized.Results:Bronchial asthma clinical manifestations to wheezing,cough,cough inverse benefit,chest tightness,wheezing,shortness of breath based.The location of the disease is in the lungs,spleen and kidney related.Its cause is sputum,cold,heat,deficiency,blood stasis.Pathogenesis is mainly phlegm blocking the lungs,exogenous evoked lung qi.In the medication,Ephedra,Bitter almonds,Perilla seed,Aster,Grifola frondosa,Pinellia,Poria,Shegan,Licorice and some other drugs appear the most frequently,is a common Chinese medicine treatment of asthma prescription.The treatment is to follow the emergency rule,slow rule of the principle.In the attack period,the general use of Xiefei asthma and Huatanzhike Chinese medicine.In remission,the general plus spleen and kidney medicine.Conclusion:Pathogenesis of Asthma is complex,in the treatment,if the syndromes showed different,the prescriptions used are also different.Accurate dialectical use of drugs,Fang and Zheng corresponding,are the keys to effectiveness.
Objective:To explore the treatment of bronchial asthma by famous Chinese doctors and the general rules of medication,so as to provide a theoretical basis for the treatment of asthma by Chinese medicine.Methods:Through the collection of medical journals published bronze asthma famous Chinese medical literature 5 articles,involving a total of 5 doctors,13 medical records.By means of frequency statistics,statistical analysis was made on the TCM patient's position,etiology,pathogenesis,syndrome differentiation and prescription medication,and the TCM syndrome differentiation and medication rules of bronchial asthma were summarized.Results:Bronchial asthma clinical manifestations to wheezing,cough,cough inverse benefit,chest tightness,wheezing,shortness of breath based.The location of the disease is in the lungs,spleen and kidney related.Its cause is sputum,cold,heat,deficiency,blood stasis.Pathogenesis is mainly phlegm blocking the lungs,exogenous evoked lung qi.In the medication,Ephedra,Bitter almonds,Perilla seed,Aster,Grifola frondosa,Pinellia,Poria,Shegan,Licorice and some other drugs appear the most frequently,is a common Chinese medicine treatment of asthma prescription.The treatment is to follow the emergency rule,slow rule of the principle.In the attack period,the general use of Xiefei asthma and Huatanzhike Chinese medicine.In remission,the general plus spleen and kidney medicine.Conclusion:Pathogenesis of Asthma is complex,in the treatment,if the syndromes showed different,the prescriptions used are also different.Accurate dialectical use of drugs,Fang and Zheng corresponding,are the keys to effectiveness.
引文
[1]中华医学会呼吸病学分会哮喘学组.支气管哮喘防治指南(2016年版)[J].中华结核和呼吸杂志,2016,39(9):675-697.
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[3]雒志明,高赏,任魁,等.支气管哮喘患者外周血嗜酸性粒细胞计数与诱导痰嗜酸性粒细胞百分比和呼出气一氧化氮的相关性[J].山西医科大学学报,2017,48(10):1039-1043.
[4]季秀丽.济南地区支气管哮喘经济负担及其影响因素分析[D].济南:山东大学,2012.
[5]裴海寅,奚肇庆.中医治疗支气管哮喘的研究进展[J].中医学报,2013,28(1):22,23.
[6]徐顺富,南淑玲,周涛.中医治疗哮喘的临床进展[J].辽宁中医药大学学报,2016,18(8):150-153.
[7]曹永年,席连吉.时振声医案3则[J].新中医,1996,8(1):3-5.
[8]朱建秀.朱星江老中医治疗哮喘病的经验[J].中医文献杂志,1995,1(1):31,32.
[9]王庆其,李孝刚,邹纯朴,等.国医大师裘沛然之诊籍[J].浙江中医杂志,2011,46(10):717-719.
[10]王志英,周学平,郭立中,等.周仲瑛教授从风痰论治支气管哮喘的经验介绍[J].南京中医药大学学报.2010,26(1):67-69.
[11]陈海英.学习胡希恕运用经方治疗哮喘的经验[J].内蒙古中医药,2013,7(1):80,81.
[2]张方琪,杨学敏,唐元元,等.嗜酸性粒细胞在哮喘发病机制中的研究进展[J].中华肺部疾病杂志:电子版,2013,6(2):162-165.
[3]雒志明,高赏,任魁,等.支气管哮喘患者外周血嗜酸性粒细胞计数与诱导痰嗜酸性粒细胞百分比和呼出气一氧化氮的相关性[J].山西医科大学学报,2017,48(10):1039-1043.
[4]季秀丽.济南地区支气管哮喘经济负担及其影响因素分析[D].济南:山东大学,2012.
[5]裴海寅,奚肇庆.中医治疗支气管哮喘的研究进展[J].中医学报,2013,28(1):22,23.
[6]徐顺富,南淑玲,周涛.中医治疗哮喘的临床进展[J].辽宁中医药大学学报,2016,18(8):150-153.
[7]曹永年,席连吉.时振声医案3则[J].新中医,1996,8(1):3-5.
[8]朱建秀.朱星江老中医治疗哮喘病的经验[J].中医文献杂志,1995,1(1):31,32.
[9]王庆其,李孝刚,邹纯朴,等.国医大师裘沛然之诊籍[J].浙江中医杂志,2011,46(10):717-719.
[10]王志英,周学平,郭立中,等.周仲瑛教授从风痰论治支气管哮喘的经验介绍[J].南京中医药大学学报.2010,26(1):67-69.
[11]陈海英.学习胡希恕运用经方治疗哮喘的经验[J].内蒙古中医药,2013,7(1):80,81.