《女科指要》中治疗闭经的辨治思路及方药探析
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摘要
目的通过分析《女科指要》一书中闭经的论述及收载的方剂,探讨其治疗闭经的辨证思路及用药规律。方法通过对《女科指要》中闭经篇的脉法、治法、用药、选方的学习,整体把握徐大椿治疗闭经的辨治思路;将闭经方剂整理并建立数据库,输入中医传承辅助平台软件,利用其中的数据挖掘方法,对方剂进行频次统计、用药模式及组方规律分析,归纳总结其治疗闭经的特色;整理徐大椿对方剂剂型的选择应用,探析剂型选择对闭经治疗的优势。结果归纳脉象32种;方药部分筛选方剂32首,涉及中药74味,所用药物频率前10位的为当归、大黄、白芍、桃仁、肉桂、川芎、牛膝、莪术、熟地黄、炙甘草,得出药物出现频次以活血化瘀药最多,同时配伍养血药、补气药、行气药等;得到常用药物组合9个,使用频数最多的药物组合为当归-白芍、当归-肉桂、川芎-当归、当归-大黄;归纳分类闭经方剂的剂型,总结煎服方法及酒剂运用特色。结论徐大椿治疗闭经分型细致且重视脉诊,在组方用药上重视活血化瘀药物的应用,善用大黄,并在辨证的基础上,佐以补气养血、理气行气之品,以通为要,攻补兼施,在闭经方剂的剂型选择上多种剂型兼用,重视丸剂、散剂的应用,且煎服方法多样,或助药势,或顾护正气,使攻不伤正。
Objective Through analyzing the discussion of amenorrhea in Nü Ke Zhi Yao and its recorded prescription,to explore the dialectical way of treating amenorrhea and the law of its medication. Methods Through the study of the pulse method, treatment method, medication and prescription selection of amenorrhea article in Nü Ke Zhi Yao, the thoughts of diagnosis and treatment of Xu Dachun in the treatment of amenorrhea were mastered overall. The amenorrhea prescription was prepared to establish database, which was input into the software of traditional Chinese medicine inheritance auxiliary platform. By using the data mining method, the frequency statistics, medication mode and prescription rule of prescription were analyzed, so as to summarize the characteristics of treating amenorrhea. The selection and application of Xu Dachun for the prescription dosage form was sorted out, so as to explore the advantages of dosage form selection for amenorrhea therapy. Results Thirty-two kinds of pulse were concluded. In the prescription part, a total of 32 prescriptions were selected, involving 74 Chinese medicinal flavors. The top 10 drug frequencies were Radix Angelicae Sinensis, Radix et Rhizoma Rhei, Radix Paeoniae Alba, Semen Persicae, Cortex Cinnamomi, Rhizoma Ligustici Chuanxiong, Radix Achyranthis Bidentatae, Rhizoma Curcumae, Radix Rehmanniae Preparata and prepared Radix Glycyrrhizae. The results showed that the highest frequency of drug occurrence was the drugs of promoting blood circulation for removing blood stasis, with concerted application of nourishing blood drugs, invigorating vital energy drugs, activating qi flowing drugs and other drugs. There were 9 common drug combinations,the most frequent drug combinations were Radix Angelicae Sinensis-Radix Paeoniae Alba, Radix Angelicae Sinensis-Cortex Cinnamomi, Rhizoma Ligustici Chuanxiong-Radix Angelicae Sinensis, Radix Angelicae Sinensis-Radix et Rhizoma Rhei. The dosage forms of amenorrhea prescription were summed up, the decoction methods and characteristics of liquor application were summarized. Conclusion Xu Dachun treats amenorrhea classification carefully and pays attention to pulse diagnosis. He pays great attention to the application of promoting blood circulation for removing blood stasis drugs, he is especially good at the application of Radix et Rhizoma Rhei. And on the basis of syndrome differentiation, he adds the drugs of benefiting qi and nourishing blood, regulating vital energy and activating qi flowing, taking unobstructed as the main purpose, with reinforcement and elimination in combination. In dosage form selection of amenorrhea prescription, he uses multiple dosage forms simultaneously, pays attention to the application of pills and powders, And the decoction methods are various,which is helpful to strengthen drug potential, or protect positive qi, so that the attack against evil does not damage the positive qi.
Objective Through analyzing the discussion of amenorrhea in Nü Ke Zhi Yao and its recorded prescription,to explore the dialectical way of treating amenorrhea and the law of its medication. Methods Through the study of the pulse method, treatment method, medication and prescription selection of amenorrhea article in Nü Ke Zhi Yao, the thoughts of diagnosis and treatment of Xu Dachun in the treatment of amenorrhea were mastered overall. The amenorrhea prescription was prepared to establish database, which was input into the software of traditional Chinese medicine inheritance auxiliary platform. By using the data mining method, the frequency statistics, medication mode and prescription rule of prescription were analyzed, so as to summarize the characteristics of treating amenorrhea. The selection and application of Xu Dachun for the prescription dosage form was sorted out, so as to explore the advantages of dosage form selection for amenorrhea therapy. Results Thirty-two kinds of pulse were concluded. In the prescription part, a total of 32 prescriptions were selected, involving 74 Chinese medicinal flavors. The top 10 drug frequencies were Radix Angelicae Sinensis, Radix et Rhizoma Rhei, Radix Paeoniae Alba, Semen Persicae, Cortex Cinnamomi, Rhizoma Ligustici Chuanxiong, Radix Achyranthis Bidentatae, Rhizoma Curcumae, Radix Rehmanniae Preparata and prepared Radix Glycyrrhizae. The results showed that the highest frequency of drug occurrence was the drugs of promoting blood circulation for removing blood stasis, with concerted application of nourishing blood drugs, invigorating vital energy drugs, activating qi flowing drugs and other drugs. There were 9 common drug combinations,the most frequent drug combinations were Radix Angelicae Sinensis-Radix Paeoniae Alba, Radix Angelicae Sinensis-Cortex Cinnamomi, Rhizoma Ligustici Chuanxiong-Radix Angelicae Sinensis, Radix Angelicae Sinensis-Radix et Rhizoma Rhei. The dosage forms of amenorrhea prescription were summed up, the decoction methods and characteristics of liquor application were summarized. Conclusion Xu Dachun treats amenorrhea classification carefully and pays attention to pulse diagnosis. He pays great attention to the application of promoting blood circulation for removing blood stasis drugs, he is especially good at the application of Radix et Rhizoma Rhei. And on the basis of syndrome differentiation, he adds the drugs of benefiting qi and nourishing blood, regulating vital energy and activating qi flowing, taking unobstructed as the main purpose, with reinforcement and elimination in combination. In dosage form selection of amenorrhea prescription, he uses multiple dosage forms simultaneously, pays attention to the application of pills and powders, And the decoction methods are various,which is helpful to strengthen drug potential, or protect positive qi, so that the attack against evil does not damage the positive qi.
引文
[1]梁慧秋.浅谈徐灵胎妇科学术思想[J].世界中医药,2009,4(5):266.
[2]徐大椿.女科指要[M].太原:山西科学技术出版社,2002.
[3]梁慧秋.浅谈徐灵胎妇科学术思想[J].光明中医,2009,24(9):1655-1656.
[4]马宝璋,齐聪.中医妇科学[M].北京:中国中医药出版社,2012:88.
[5]侯王君,高媛媛,庄贺,等.基于中医传承辅助平台的《脾胃论》方剂组方用药规律分析[J].辽宁中医杂志,2018,45(6):1182-1184.
[6]徐福平,黄遂和,林立宇,等.基于中医传承辅助平台对张景岳《新方八阵》用药规律分析[J].辽宁中医杂志,2018,45(4):683-685.
[7]张志国,杨磊,邓桂明,等.中医药历代度量衡的研究[J].辽宁中医杂志,2018,45(3):499-503.
[8]国家药典委员会.中华人民共和国药典[M].北京:中国医药科学技术出版社,2015.
[9]南京中医药大学.中药大辞典[M].上海:上海科学技术出版社,2016.
[10]肖承悰.中医妇科临床研究[M].北京:人民卫生出版社,2009:246-249.
[11]马宝璋.中医妇科学[M].3版.中国中医药出版社,2012:226.
[12]张景岳.景岳全书妇人规[M].北京:中国医药科技出版社,2017:5.
[13]杨琴,王翠霞.从肝论治闭经浅析[J].山西中医,2018,34(9):1-3.
[14]罗天益.卫生宝鉴[M].北京:中国中医药出版社,2007:232.
[15]陈自明.妇人大全良方[M].北京:人民卫生出版社,1992:32.
[16]王肯堂.女科正治准绳[M].北京:人民卫生出版社,2014:24.
[17]难经、神农本草经[M].北京:中国中医药出版社,2010:95.
[18]陶弘景.本草经集注[M].北京:人民卫生出版社,1994:14.
[19]傅延龄,杨琳.论秦汉时期多用丸散剂型的原因[J].中华中医药杂志,2014,29(3):829-831.
[20]赵倍.圣济总录[M].北京:人民卫生出版化,2013:45.
[2]徐大椿.女科指要[M].太原:山西科学技术出版社,2002.
[3]梁慧秋.浅谈徐灵胎妇科学术思想[J].光明中医,2009,24(9):1655-1656.
[4]马宝璋,齐聪.中医妇科学[M].北京:中国中医药出版社,2012:88.
[5]侯王君,高媛媛,庄贺,等.基于中医传承辅助平台的《脾胃论》方剂组方用药规律分析[J].辽宁中医杂志,2018,45(6):1182-1184.
[6]徐福平,黄遂和,林立宇,等.基于中医传承辅助平台对张景岳《新方八阵》用药规律分析[J].辽宁中医杂志,2018,45(4):683-685.
[7]张志国,杨磊,邓桂明,等.中医药历代度量衡的研究[J].辽宁中医杂志,2018,45(3):499-503.
[8]国家药典委员会.中华人民共和国药典[M].北京:中国医药科学技术出版社,2015.
[9]南京中医药大学.中药大辞典[M].上海:上海科学技术出版社,2016.
[10]肖承悰.中医妇科临床研究[M].北京:人民卫生出版社,2009:246-249.
[11]马宝璋.中医妇科学[M].3版.中国中医药出版社,2012:226.
[12]张景岳.景岳全书妇人规[M].北京:中国医药科技出版社,2017:5.
[13]杨琴,王翠霞.从肝论治闭经浅析[J].山西中医,2018,34(9):1-3.
[14]罗天益.卫生宝鉴[M].北京:中国中医药出版社,2007:232.
[15]陈自明.妇人大全良方[M].北京:人民卫生出版社,1992:32.
[16]王肯堂.女科正治准绳[M].北京:人民卫生出版社,2014:24.
[17]难经、神农本草经[M].北京:中国中医药出版社,2010:95.
[18]陶弘景.本草经集注[M].北京:人民卫生出版社,1994:14.
[19]傅延龄,杨琳.论秦汉时期多用丸散剂型的原因[J].中华中医药杂志,2014,29(3):829-831.
[20]赵倍.圣济总录[M].北京:人民卫生出版化,2013:45.