路志正教授调理脾胃法治疗胸痹心痛的经验研究
|
摘要
冠心病是在冠状动脉粥样硬化的基础上导致血管腔狭窄,冠状动脉供血不足,心肌急性、短暂性缺血、缺氧所引起的临床综合征,属于中医学“胸痹”范畴。目前本病是危害人们健康的常见疾病,其发病率和死亡率均较高。导师路志正教授通过60余年的临床研究率先提出胸痹与脾胃关系尤为密切,其发生、发展、治疗、转归、预后,都与脾胃的功能状态密切相关。
本课题选取路老治疗的88例胸痹病例,将每一病例录入名老中医临床信息采集系统,并进行数据的转化、处理。分别采用频数分析、因子分析、关联规则分析、Logistic回归、相关性分析、配对t检验等统计方法,系统总结了该病的证候特征及路老从脾胃论治本病的辨治规律,以期探讨从脾胃论治胸痹的客观依据,及具体方法,丰富中医药治疗冠心病的理论体系。
研究结果表明:胸痹临床表现中,脾胃症状多见,其证候以心脾两虚、中气不足、痰浊内阻、湿热内阻等证居多。这些证候均与脾胃关系密切。胸痹虽与五脏相关,而脾胃在其中的作用尤为重要,脾胃功能失调往往是导致胸痹的主要原因之一。运用调理脾胃法治疗胸痹,包括健脾益气法、清热化湿法、理脾化痰法、温中健脾法、益气养血法等,虽然治法各异,然而从脾胃入手则是其共同特点。综合方药分析充分体现了路老治疗胸痹的调理脾胃以斡旋气机、调理脾胃以化痰祛湿宣痹、调理脾胃以助气血之源、调理脾胃以宁心定志、调理脾胃以安五脏的学术思想,通过调理脾胃,使脾胃健旺则气血化生,脾运一行则痰湿自化,瘀血消,脉道畅,胸阳展而痹自除。调理脾胃法治疗胸痹突出了中医整体观念及治病求本,辨证论治的特点,显著提高了临床疗效。
Coronary heart disease (CHD) is a common cardiovascular disease. Its etiology is cavity vascular stenosis, coronary insufficiency, acute or transient ischemia,hypoxia of myocardial caused by coronary atherosclerosis. It belongs to chest stuffiness and pains in Chinese medicine. Now CHD is one of the most common diseases which endanger people's health. Professor Lu zhizheng holds that relation between CHD and spleen is very close.
88 cases of CHD are chosen in this subject,and input them into the old Chinese medicine doctor's clinical information collection system. Data is analyzed by frequency analysis,factor analysis, analysis of association rules, logistic regression,correlation analysis,paired t test,and so on. The syndrome characteristics of CHD are explored,and summarize regularities in syndrome differentiation for this disease in order to find the objective basis and application method of treating CHD by regulating spleen and stomach. It is concluded that
Symptoms related spleen and stomach are the most symptoms in CHD,and important tcm syndromes types of CHD is damp heat resistance, phlegm resistance, deficiency in heart and spleen, middle qi insufficiency,deficiency of both qi and yin, liver qi stagnation, liver-spleen disharmony, bile-spleen disharmony, phlegm and blood stasis. All of them are related with spleen-stomach. So we hold that CHD is mainly caused by incoor-dination between the spleen and stomach,although it is related with five viscera. Professor Lu proposed to treat CHD by regulating spleen and stomach. It include invigorating spleen and replenishing qi, clearing away damp and heat, regulating spleen and eliminating phlegm, wen zhong and strengthening spleen, replenishing qi and blood,and so on. All of them are embark from spleen and stomach,and have corresponding prescription. Spleen-stomach should receive attention in clinic. Medication reflect professor Lu's academic features that functional activities of qi is regulated, phlegm and dampness is eliminated, qi blood is generated, mental activity is calm down,five viscera is conditioned by regulating spleen and stomach.
We get the satisfied effects in treating coronary by regulating spleen and stomach.
本课题选取路老治疗的88例胸痹病例,将每一病例录入名老中医临床信息采集系统,并进行数据的转化、处理。分别采用频数分析、因子分析、关联规则分析、Logistic回归、相关性分析、配对t检验等统计方法,系统总结了该病的证候特征及路老从脾胃论治本病的辨治规律,以期探讨从脾胃论治胸痹的客观依据,及具体方法,丰富中医药治疗冠心病的理论体系。
研究结果表明:胸痹临床表现中,脾胃症状多见,其证候以心脾两虚、中气不足、痰浊内阻、湿热内阻等证居多。这些证候均与脾胃关系密切。胸痹虽与五脏相关,而脾胃在其中的作用尤为重要,脾胃功能失调往往是导致胸痹的主要原因之一。运用调理脾胃法治疗胸痹,包括健脾益气法、清热化湿法、理脾化痰法、温中健脾法、益气养血法等,虽然治法各异,然而从脾胃入手则是其共同特点。综合方药分析充分体现了路老治疗胸痹的调理脾胃以斡旋气机、调理脾胃以化痰祛湿宣痹、调理脾胃以助气血之源、调理脾胃以宁心定志、调理脾胃以安五脏的学术思想,通过调理脾胃,使脾胃健旺则气血化生,脾运一行则痰湿自化,瘀血消,脉道畅,胸阳展而痹自除。调理脾胃法治疗胸痹突出了中医整体观念及治病求本,辨证论治的特点,显著提高了临床疗效。
Coronary heart disease (CHD) is a common cardiovascular disease. Its etiology is cavity vascular stenosis, coronary insufficiency, acute or transient ischemia,hypoxia of myocardial caused by coronary atherosclerosis. It belongs to chest stuffiness and pains in Chinese medicine. Now CHD is one of the most common diseases which endanger people's health. Professor Lu zhizheng holds that relation between CHD and spleen is very close.
88 cases of CHD are chosen in this subject,and input them into the old Chinese medicine doctor's clinical information collection system. Data is analyzed by frequency analysis,factor analysis, analysis of association rules, logistic regression,correlation analysis,paired t test,and so on. The syndrome characteristics of CHD are explored,and summarize regularities in syndrome differentiation for this disease in order to find the objective basis and application method of treating CHD by regulating spleen and stomach. It is concluded that
Symptoms related spleen and stomach are the most symptoms in CHD,and important tcm syndromes types of CHD is damp heat resistance, phlegm resistance, deficiency in heart and spleen, middle qi insufficiency,deficiency of both qi and yin, liver qi stagnation, liver-spleen disharmony, bile-spleen disharmony, phlegm and blood stasis. All of them are related with spleen-stomach. So we hold that CHD is mainly caused by incoor-dination between the spleen and stomach,although it is related with five viscera. Professor Lu proposed to treat CHD by regulating spleen and stomach. It include invigorating spleen and replenishing qi, clearing away damp and heat, regulating spleen and eliminating phlegm, wen zhong and strengthening spleen, replenishing qi and blood,and so on. All of them are embark from spleen and stomach,and have corresponding prescription. Spleen-stomach should receive attention in clinic. Medication reflect professor Lu's academic features that functional activities of qi is regulated, phlegm and dampness is eliminated, qi blood is generated, mental activity is calm down,five viscera is conditioned by regulating spleen and stomach.
We get the satisfied effects in treating coronary by regulating spleen and stomach.
引文
[1]张忠琴,宋桂德.2004-2005年天津市四种慢性病发病、死亡报告分析.中国慢性病预防与控制,2007,15(1):72.
[2]韩学杰,沈绍功.中医治疗冠心病心绞痛研究进展.中国中医基础医学杂志,2003,9(2):78-80.
[3]Lenfant C.NHLBI at 50:reflections on a half-century of research on the heart,lungs,and blood.National Heart,Lung,and Blood Institute,Interview by Charles Marwick[J].JAMA,1998,280(24):2062-2064.
[4]李刚.新的冠心病危险因素.心血管病学进展,2005,26(3):266-270.
[5]焦启超.冠心病发病机制及干预措施的新观点.中国基层医药,2002,9(9):833.
[6]余华,马礼坤,丁晓梅,等.凝血因子在冠心病发病机制中的作用研究.临床心电学杂志,2005,14(4):264-265.
[7]李秀昌.同型半胱氨酸致动脉粥样硬化发病机制的研究进展.心血管病学进展,2001,22(3):170-171.
[8]常桂娟.同型半胱氨酸与心脑血管疾病的研究进展.现代诊断与治疗2006,17(2):125-126.
[9]李刚.新的冠心病危险因素.心血管病学进展,2005,26(3):269.
[10]张芳芹.冠心病最新危险因素研究进展.中国医学文摘·内科学,2003,24(1):108.
[11]刘晓红.慢性幽门螺杆菌感染与冠心病发病及其危险因素的关系.实用诊断与治疗杂志,2005,19(12):882.
[12]郭新贵,王守东,林宪如.冠心病患者抗幽门螺杆菌抗体的检出及与冠心病危险因素的关系.中国动脉硬化杂志,2005,13(1):84.
[13]李俊峡,吕泽平.心肌缺血冉灌注中心肌细胞凋亡的研究进展.心脏杂志(ChinHeartJ),2002,14(4):350-351.
[14]刘静.心肌缺血再灌注损伤诱发细胞凋亡的研究进展.中国心血管病研究杂志,2005,3(12):952.
[15]席嘉宾.细胞因子与冠心病.现代中西医结合杂志,2005,14(21): 2889-2890.
[16]刘元生,陈运贞.冠心病基因机制研究进展.内蒙古医学杂志,2000,32(1)期:61-64.
[17]张晓黎,陈忠,马根山.早发冠心病病因的遗传学研究进展.东南大学学报(医学版),2005,24(2):130-135.
[18]马跃.一氧化氮与冠心病发病的研究进展.辽宁医学杂志,2006,20(3):197.
[19]高分飞,石刚刚.缺血-再灌注损伤研究进展.现代诊断与治疗,2003,14(2):88-89.
[20]牛永军,曹雪梅.从脾胃论治胸痹举隅.实用中医内科杂志,2007,21(1):43.
[21]路志正.调理脾胃法在胸痹治疗中的运用.中国中医急症,1999,8(5):198.
[22]李平,提桂香.路志正教授调理脾胃法在内科临床运用经验.北京中医药大学学报(中医临床版),2003,10(1):23.
[23]李启允.胸痹与脾胃证治.云南中医学院学报,2002,25(2):47.
[24]林晓忠,吴焕林,严夏,等.邓铁涛教授论治冠心病规律探要.中医药学刊,2001,19(5):413.
[25]余胜珠.心病血脂异常中西医结合研究进展.国医论坛,2000,15(5):53.
[26]Scanu AM.Lipoprotein(a).Agenetic risk factor for premature coro-nary heart disease.JAMA,1992,267:3326.
[27]Danesh J,Collins R,Peto R.Lipoprotern(a) and coronary heart disease.Meta-analysis of prospective studies.Circulation,2000,102:1082.
[28]安辉.脾胃与冠心病关系初探.湖南中医学院学报,1995,15(2):12.
[29]沈舒文,曹海涛,宇文亚.胃肠动力与脾胃气机的相关性探讨.陕西中医学院学报,2002,25(4):1-2.
[30]肖烈钢,汤希孟.冠心病与心脾肾相关的临床研究.江西中医药,1998,29(2):15-16.
[31]Sarkar R,Meinberg EG,Stanley JC,et al.Nitric oxide reversibly inhibits the migration of cultued vasculars mooth muscle cells CircRes,1996,78:225.
[32]黄忠耀,朱洪生,赵涵芳.缺血-再灌注心肌诱导型一氧化氮合酶基因表达及其活性的变化和卡托普利的影响.福建医科大学学报,2006,40(3):208.
[33]Mendall MA,Goggin PM,Molineaux N,Levy J,Toosy T,Strachan D,Camm AJ,Northfield TC.Relatic.n of Helicobacter pyloriin fection and coronary heart disease.Br Heart J,1994,71:437-439.
[34]徐云生.邓铁涛教授甘温健脾法治疗疑难病.四川中医,2002,2(3):2.
[35]熊丽辉.胸痹心痛的中医治疗及研究进展.中国中医急症,2005,14(9):885.
[36]张冬英.脾胃学说在心脑血管疾病中的运用概况.云南中医中药杂志,2004,25(5):44-45.
[37]叶旭.余世光胸痹从脾论治经验.安徽中医临床杂志,2002,14(5):396-397.
[38]宋郁珍.李七一从中焦论治冠心病四法.江西中医药,2003,11:8.
[39]李新梅,吴焕林,罗文杰,等.邓氏冠心胶囊治疗气虚痰瘀型胸痹的临床研究.中西医结合心脑血管病杂志,2005,3(4):300.
[40]鲁燕侠,蔺兴遥,崔佳.心胃同病与心胃同治探究.中医药学报,2003,31(1):9.
[41]陈晓刚,铁小红,魏薇.中西医结合治疗外伤性前房积血48例临床观察.甘肃中医,2005,18(6):24.
[42]Report if thejoin(?) international society and federation of cardiology/world heal thorganization task forceon standardization of clinical nomenclature and criteriafor diagnosis of ischemicheart disease[J].Circulation,1979,59:507.
[43]国家中医药管理局.中华人民共和国中医药行业标准[M].北京:中国标准出版社,1994:18.
[44]肖冰.肝硬化常见中医证候的计量诊断.暨南大学2005年硕士论文,2005:13-14.
[45]张晓杰.尊麻疹方药证治规律研究.山东中医药大学2003年博士论文, 2003:19.
[46]赵万水.血瘀证临床用药规律的数据挖掘试验.暨南大学2006年硕士论文,2007:20-21.
[47]龚燕冰,倪青,王永炎.中医证候研究的现代方法学述评(二)--中医证候的量化及数理统计方法.北京中医药大学学报,2007,30(1):6-7.
[48]张文彤主编.SPSS11统计分析教程.北京:北京希望电子出版社,2002:271.
[49]李洁,解品启.冠心病从脾胃论治.山西中医,1997,13(6):52.
[50]赵益业,林晓忠,张敏州.邓铁涛教授以心脾相关学说诊治冠心病经验介绍.新中医,2007,39(4):5.
[51]黄富军,刘华盛.临床表现不典型的急性心肌梗死17例误诊、漏诊分析[J].临床误诊误治,2005,18(1):8-9.
[52]顾裕民.急性心梗420例误诊分析[J].实用内科杂志,1992,12(2):101.
[53]姜以振.腹痛型急性心梗34例临床分析[J].实用内科杂志,1991,11(2):110.
[54]丁成华,曹晓瑞,马丽珍.略论心系疾病从脾胃论治.江西中医学院学报,2007,1(5):17.
[55]潘光明,邹旭,林晓忠.《黄帝内经》心脾相关理论浅析.新中医,2007,39(11):94.
[56]张晓阳,张孟仁.郭赛珊治疗湿热证的临床特色.中国中医药信息杂志,2006,13(2):78.
[57]朱涛.化痰降浊法治疗脾虚证初探.国医论坛,2003,18(2):18.
[58]宋剑南,刘东远,牛晓红,等.高脂血症与中医痰浊关系的实验研究.中国中医基拙医学杂志,1995,1(1):51.
[59]金明柱.虚实学说对衰老的机理探讨.光明中医,2007,22(2):8.
[60]李克光主编.金匮要略讲义.上海:上海科技出版社,1998:94.
[61]李连成,高荣林.从脾胃论治胸痹的理论意义.中国中医基础医学杂志,1996,1(4):38.
[62]吴耀南,谢俊杰,许正锦.路志正调理脾胃治疗胸痹的学术思想浅析.北京中医,2006,25(2):88-89.
[63]李晓琴,周新颖,廖明星,等.生痰之源非独脾也.河南中医,2006,26(6):13-14.
[64]马清钧,王淑玲主编.临床实用中药学.江西:江西科学技术出版社,2001:408.
[65]张民庆,张名伟,唐德才主编.现代临床中药学.上海:上海中医药大学出版社,2002:357.
[66]张曼.脾胃与神志关系探析.江西中医学院学报,2007,19(3):26-27.
[67]吕景山主编.施今墨对药.北京:人民军医出版社,1998:216-217.
[68]沈浪泳.治脾胃以调五脏浅探.安徽中医学院学报,1994,13(2):5-6.
[2]韩学杰,沈绍功.中医治疗冠心病心绞痛研究进展.中国中医基础医学杂志,2003,9(2):78-80.
[3]Lenfant C.NHLBI at 50:reflections on a half-century of research on the heart,lungs,and blood.National Heart,Lung,and Blood Institute,Interview by Charles Marwick[J].JAMA,1998,280(24):2062-2064.
[4]李刚.新的冠心病危险因素.心血管病学进展,2005,26(3):266-270.
[5]焦启超.冠心病发病机制及干预措施的新观点.中国基层医药,2002,9(9):833.
[6]余华,马礼坤,丁晓梅,等.凝血因子在冠心病发病机制中的作用研究.临床心电学杂志,2005,14(4):264-265.
[7]李秀昌.同型半胱氨酸致动脉粥样硬化发病机制的研究进展.心血管病学进展,2001,22(3):170-171.
[8]常桂娟.同型半胱氨酸与心脑血管疾病的研究进展.现代诊断与治疗2006,17(2):125-126.
[9]李刚.新的冠心病危险因素.心血管病学进展,2005,26(3):269.
[10]张芳芹.冠心病最新危险因素研究进展.中国医学文摘·内科学,2003,24(1):108.
[11]刘晓红.慢性幽门螺杆菌感染与冠心病发病及其危险因素的关系.实用诊断与治疗杂志,2005,19(12):882.
[12]郭新贵,王守东,林宪如.冠心病患者抗幽门螺杆菌抗体的检出及与冠心病危险因素的关系.中国动脉硬化杂志,2005,13(1):84.
[13]李俊峡,吕泽平.心肌缺血冉灌注中心肌细胞凋亡的研究进展.心脏杂志(ChinHeartJ),2002,14(4):350-351.
[14]刘静.心肌缺血再灌注损伤诱发细胞凋亡的研究进展.中国心血管病研究杂志,2005,3(12):952.
[15]席嘉宾.细胞因子与冠心病.现代中西医结合杂志,2005,14(21): 2889-2890.
[16]刘元生,陈运贞.冠心病基因机制研究进展.内蒙古医学杂志,2000,32(1)期:61-64.
[17]张晓黎,陈忠,马根山.早发冠心病病因的遗传学研究进展.东南大学学报(医学版),2005,24(2):130-135.
[18]马跃.一氧化氮与冠心病发病的研究进展.辽宁医学杂志,2006,20(3):197.
[19]高分飞,石刚刚.缺血-再灌注损伤研究进展.现代诊断与治疗,2003,14(2):88-89.
[20]牛永军,曹雪梅.从脾胃论治胸痹举隅.实用中医内科杂志,2007,21(1):43.
[21]路志正.调理脾胃法在胸痹治疗中的运用.中国中医急症,1999,8(5):198.
[22]李平,提桂香.路志正教授调理脾胃法在内科临床运用经验.北京中医药大学学报(中医临床版),2003,10(1):23.
[23]李启允.胸痹与脾胃证治.云南中医学院学报,2002,25(2):47.
[24]林晓忠,吴焕林,严夏,等.邓铁涛教授论治冠心病规律探要.中医药学刊,2001,19(5):413.
[25]余胜珠.心病血脂异常中西医结合研究进展.国医论坛,2000,15(5):53.
[26]Scanu AM.Lipoprotein(a).Agenetic risk factor for premature coro-nary heart disease.JAMA,1992,267:3326.
[27]Danesh J,Collins R,Peto R.Lipoprotern(a) and coronary heart disease.Meta-analysis of prospective studies.Circulation,2000,102:1082.
[28]安辉.脾胃与冠心病关系初探.湖南中医学院学报,1995,15(2):12.
[29]沈舒文,曹海涛,宇文亚.胃肠动力与脾胃气机的相关性探讨.陕西中医学院学报,2002,25(4):1-2.
[30]肖烈钢,汤希孟.冠心病与心脾肾相关的临床研究.江西中医药,1998,29(2):15-16.
[31]Sarkar R,Meinberg EG,Stanley JC,et al.Nitric oxide reversibly inhibits the migration of cultued vasculars mooth muscle cells CircRes,1996,78:225.
[32]黄忠耀,朱洪生,赵涵芳.缺血-再灌注心肌诱导型一氧化氮合酶基因表达及其活性的变化和卡托普利的影响.福建医科大学学报,2006,40(3):208.
[33]Mendall MA,Goggin PM,Molineaux N,Levy J,Toosy T,Strachan D,Camm AJ,Northfield TC.Relatic.n of Helicobacter pyloriin fection and coronary heart disease.Br Heart J,1994,71:437-439.
[34]徐云生.邓铁涛教授甘温健脾法治疗疑难病.四川中医,2002,2(3):2.
[35]熊丽辉.胸痹心痛的中医治疗及研究进展.中国中医急症,2005,14(9):885.
[36]张冬英.脾胃学说在心脑血管疾病中的运用概况.云南中医中药杂志,2004,25(5):44-45.
[37]叶旭.余世光胸痹从脾论治经验.安徽中医临床杂志,2002,14(5):396-397.
[38]宋郁珍.李七一从中焦论治冠心病四法.江西中医药,2003,11:8.
[39]李新梅,吴焕林,罗文杰,等.邓氏冠心胶囊治疗气虚痰瘀型胸痹的临床研究.中西医结合心脑血管病杂志,2005,3(4):300.
[40]鲁燕侠,蔺兴遥,崔佳.心胃同病与心胃同治探究.中医药学报,2003,31(1):9.
[41]陈晓刚,铁小红,魏薇.中西医结合治疗外伤性前房积血48例临床观察.甘肃中医,2005,18(6):24.
[42]Report if thejoin(?) international society and federation of cardiology/world heal thorganization task forceon standardization of clinical nomenclature and criteriafor diagnosis of ischemicheart disease[J].Circulation,1979,59:507.
[43]国家中医药管理局.中华人民共和国中医药行业标准[M].北京:中国标准出版社,1994:18.
[44]肖冰.肝硬化常见中医证候的计量诊断.暨南大学2005年硕士论文,2005:13-14.
[45]张晓杰.尊麻疹方药证治规律研究.山东中医药大学2003年博士论文, 2003:19.
[46]赵万水.血瘀证临床用药规律的数据挖掘试验.暨南大学2006年硕士论文,2007:20-21.
[47]龚燕冰,倪青,王永炎.中医证候研究的现代方法学述评(二)--中医证候的量化及数理统计方法.北京中医药大学学报,2007,30(1):6-7.
[48]张文彤主编.SPSS11统计分析教程.北京:北京希望电子出版社,2002:271.
[49]李洁,解品启.冠心病从脾胃论治.山西中医,1997,13(6):52.
[50]赵益业,林晓忠,张敏州.邓铁涛教授以心脾相关学说诊治冠心病经验介绍.新中医,2007,39(4):5.
[51]黄富军,刘华盛.临床表现不典型的急性心肌梗死17例误诊、漏诊分析[J].临床误诊误治,2005,18(1):8-9.
[52]顾裕民.急性心梗420例误诊分析[J].实用内科杂志,1992,12(2):101.
[53]姜以振.腹痛型急性心梗34例临床分析[J].实用内科杂志,1991,11(2):110.
[54]丁成华,曹晓瑞,马丽珍.略论心系疾病从脾胃论治.江西中医学院学报,2007,1(5):17.
[55]潘光明,邹旭,林晓忠.《黄帝内经》心脾相关理论浅析.新中医,2007,39(11):94.
[56]张晓阳,张孟仁.郭赛珊治疗湿热证的临床特色.中国中医药信息杂志,2006,13(2):78.
[57]朱涛.化痰降浊法治疗脾虚证初探.国医论坛,2003,18(2):18.
[58]宋剑南,刘东远,牛晓红,等.高脂血症与中医痰浊关系的实验研究.中国中医基拙医学杂志,1995,1(1):51.
[59]金明柱.虚实学说对衰老的机理探讨.光明中医,2007,22(2):8.
[60]李克光主编.金匮要略讲义.上海:上海科技出版社,1998:94.
[61]李连成,高荣林.从脾胃论治胸痹的理论意义.中国中医基础医学杂志,1996,1(4):38.
[62]吴耀南,谢俊杰,许正锦.路志正调理脾胃治疗胸痹的学术思想浅析.北京中医,2006,25(2):88-89.
[63]李晓琴,周新颖,廖明星,等.生痰之源非独脾也.河南中医,2006,26(6):13-14.
[64]马清钧,王淑玲主编.临床实用中药学.江西:江西科学技术出版社,2001:408.
[65]张民庆,张名伟,唐德才主编.现代临床中药学.上海:上海中医药大学出版社,2002:357.
[66]张曼.脾胃与神志关系探析.江西中医学院学报,2007,19(3):26-27.
[67]吕景山主编.施今墨对药.北京:人民军医出版社,1998:216-217.
[68]沈浪泳.治脾胃以调五脏浅探.安徽中医学院学报,1994,13(2):5-6.