《未刻本叶天士医案》腰痛辨治特点
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摘要
目的:基于中医传承辅助平台梳理《未刻本叶天士医案》腰痛的组方用药规律。方法:通过《未刻本叶天士医案》的19条腰痛医案,分析治疗腰痛及其伴见症状的用药规律。结果:纳入研究的19首处方中共有59味中药,使用频次3次以上的共有8味药物,依次为:熟地黄、茯苓、杜仲、菟丝子、茯神、巴戟天、沙苑子、枸杞子。对药物组方规律分析可以得到药对有"菟丝子、杜仲""巴戟天、杜仲""沙苑子、杜仲"。治疗腰痛伴见症状以茯苓使用频次最高,使用频次为2次的药物中,以补肾温阳药居多。结论:《未刻本叶天士医案》辨治内伤腰痛,以滋补肝肾为治疗总则,且注重脾胃作用,用药不仅考虑药物功效主治作用,亦重视药物的归经及奇经作用,在腰痛中尤其重视使用督脉药。
Objective:To sort out the prescription medication rules of lumbar pain in Unprinted Medical Cases of Ye Tian-shi based on the platform of TCM inheritance assistant platform.Methods:Through 19 cases of lumbar pain in Unprinted Medical Cases of Ye Tian-shi,the prescription medication rules of lumbar pain and its accompanying symptoms were analyzed.Results:Among the 19 prescriptions included in the study,59 Chinese materia medica were involved and 8 were used more than three times,they were as follows successively:Shudihuang(Radix Rehmanniae Praeparata),Fuling(Poria),Duzhong(Cortex Eucommiae),Tusizi(Semen Cuscutae),Fushen(Sclerotium Poriae Pararadicis),Bajitian(Radix Morindae Officinalis),Shayuanzi(Semen Astragali Complanati),Gouqizi(Fructus Lycii).Through the analysis of the prescription medication rules,we could get the drug pairs as "Tusizi-Duzhong", "Bajitian-Duzhong", "Shayuanzi-Duzhong".Fuling was the most frequently used medicine for the treatment of lumbar pain and its accompanying symptoms.Among the drugs used twice,kidney-tonifying and yang-warming drugs were the most frequently used.Conclusion:In treating lumbar pain,Unprinted Medical Cases of Ye Tian-shi uses nourishing liver and kidney as its general principle,and pays attention to the role of spleen and stomach.Its drug use not only considers the main therapeutic effect of drugs,but also pays attention to the meridian tropism and peculiar meridian function of drugs.Drugs for using in govern vessel are especially emphasized.
Objective:To sort out the prescription medication rules of lumbar pain in Unprinted Medical Cases of Ye Tian-shi based on the platform of TCM inheritance assistant platform.Methods:Through 19 cases of lumbar pain in Unprinted Medical Cases of Ye Tian-shi,the prescription medication rules of lumbar pain and its accompanying symptoms were analyzed.Results:Among the 19 prescriptions included in the study,59 Chinese materia medica were involved and 8 were used more than three times,they were as follows successively:Shudihuang(Radix Rehmanniae Praeparata),Fuling(Poria),Duzhong(Cortex Eucommiae),Tusizi(Semen Cuscutae),Fushen(Sclerotium Poriae Pararadicis),Bajitian(Radix Morindae Officinalis),Shayuanzi(Semen Astragali Complanati),Gouqizi(Fructus Lycii).Through the analysis of the prescription medication rules,we could get the drug pairs as "Tusizi-Duzhong", "Bajitian-Duzhong", "Shayuanzi-Duzhong".Fuling was the most frequently used medicine for the treatment of lumbar pain and its accompanying symptoms.Among the drugs used twice,kidney-tonifying and yang-warming drugs were the most frequently used.Conclusion:In treating lumbar pain,Unprinted Medical Cases of Ye Tian-shi uses nourishing liver and kidney as its general principle,and pays attention to the role of spleen and stomach.Its drug use not only considers the main therapeutic effect of drugs,but also pays attention to the meridian tropism and peculiar meridian function of drugs.Drugs for using in govern vessel are especially emphasized.
引文
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[6] 岳寿伟.腰痛的评估与康复治疗进展[J].中国康复医学杂志,2017,32(2):136-139.
[7] 王亮,王莹莹,杨金生.腰痛中医外治疗法临床研究[J].世界中医药,2013,8(4):472-476.
[8] 邱新红,李淳,邱新萍,等.国家级名老中医高才达治疗腰痛临床经验[J].中医临床研究,2015,7(15):6-7.
[9] 赵翠霞,阿衣努尔·木合买提巴克.沈宝藩名老中医辨证论治老年腰痛的经验[J].陕西中医,2017,38(7):949-950.
[10] 白松绵.VAS量化腰痛在不同中医证型中的分布研究[D].北京:北京中医药大学,2018.
[2] 张砚卓,王倩倩,袁越,等.中国45岁以上人群腰痛患病率调查:基于中国健康与养老追踪调查数据[J].骨科临床与研究杂志,2018,3(1):38-42.
[3] 周仲瑛.中医内科学 [M].2版.北京:中国中医药出版社,2007:2.
[4] 相鲁闽.叶香岩与《未刻本叶天士医案》[J].河南中医,2011,31(10):1087.
[5] 古歙叶,桂天士,古吴小狂,等.《未刻本叶天士医案发微》选载[J].上海中医药杂志,1991,25(6):5-7.
[6] 岳寿伟.腰痛的评估与康复治疗进展[J].中国康复医学杂志,2017,32(2):136-139.
[7] 王亮,王莹莹,杨金生.腰痛中医外治疗法临床研究[J].世界中医药,2013,8(4):472-476.
[8] 邱新红,李淳,邱新萍,等.国家级名老中医高才达治疗腰痛临床经验[J].中医临床研究,2015,7(15):6-7.
[9] 赵翠霞,阿衣努尔·木合买提巴克.沈宝藩名老中医辨证论治老年腰痛的经验[J].陕西中医,2017,38(7):949-950.
[10] 白松绵.VAS量化腰痛在不同中医证型中的分布研究[D].北京:北京中医药大学,2018.